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dence of accidents and disease risks to each insur-ance company.In this article, we discuss the problem of truck drivers being treated unfavorably in life insurance coverage due to their CPAP treatment. However, this issue is not limited to truck drivers, but is also important for all workers and retirees who work in various occupations.AcknowledgmentsWe thank the insurance companies for their participation in the study.A part of this study was funded by the Interna-tional Association of Traffic and Safety Sciences.Author contributionsThis manuscript was drafted by DS and TT. The questionnaire was compiled by DS and TT. Data interpretation was performed by DS, KT, and TT. All the authors have read and approved the final manuscript. Conflicts of interest statementDS serves as the president of the Institute for Sleep Health, a non-profit organization, without compensation.References 1) Somers VK, White DP, Amin R, et al: Sleep apnea and cardiovascular disease: an American Heart Association/American College of Cardiology Foundation scientific statement from the American Heart Association Council for High Blood Pressure Research Professional Education Committee, Council on Clinical Cardiology, Stroke Council, and Council on Cardiovascular Nursing. In collaboration with the National Heart, Lung, and Blood Institute National Center on Sleep Disorders Research (National Institutes of Health). Circulation, 2008; 118: 1080-1111.612 2) Muraki I, Tanigawa T, Yamagishi K, et al: Nocturnal intermittent hypoxia and the development of type 2 diabetes: the Circulatory Risk in Communities Study (CIRCS). Diabetologia, 2010; 53: 481-488. 3) Muraki I, Wada H, Tanigawa T: Sleep apnea and type 2 diabetes. J Diabetes Investig, 2018; 9: 991-997. 4) Garbarino S, Guglielmi O, Sanna A, Mancardi GL, Magnavita N: Risk of occupational accidents in workers with obstructive sleep apnea: Systematic review and meta-analysis. Sleep, 2016; 39: 1211-1218. 5) Tregear S, Reston J, Schoelles K, Phillips B: Obstructive sleep apnea and risk of motor vehicle crash: system-atic review and meta-analysis. J Clin Sleep Med, 2009; 5: 573-581. 6) Burks SV, Anderson JE, Bombyk M, et al: Non-compli-ance with employer-mandated sleep apnea treatment and increased risk of serious truck crashes. Sleep, 2016; 39: 967-975. 7) Road Transport Bureau, Ministry of Land, Infrastruc-ture and Transport: Manual for sleep apnea syndrome measures in motor carrier operators - Use of the necessity of SAS measures. https://www.mlit.go.jp/common/001101506.pdf (Accessed on June 11, 2022). 8) Patil SP, Ayappa IA, Caples SM, Kimoff RJ, Patel SR, Harrod CG: Treatment of adult obstructive sleep apnea with positive airway pressure: An American Academy of Sleep Medicine systematic review, meta-analysis, and GRADE assessment. J Clin Sleep Med, 2019; 15: 301-334. 9) Hoffman B, Wingenbach DD, Kagey AN, Schaneman JL, Kasper D: The long-term health plan and disability cost benefit of obstructive sleep apnea treatment in a commercial motorvehicle driver population. J Occup Environ Med, 2010; 52: 473-477. 10) Burks SV, Anderson JE, Panda B, et al: Employer- mandated obstructive sleep apnea treatment and healthcare cost savings among truckers. Sleep, 2020; 43: zsz262.11) Kales SN, Straubel M: Obstructive sleep apnea in North American Commercial drivers. Ind Health, 2014; 52: 13-24.12) Wada H, Ikeda-Noda A, Kales S, Tanigawa T: Screening for sleep disordered breathing (SDB) in truck drivers in the US. Juntendo Med J, 2015; 61: 350-351.13) Kales SN, Czeisler CA: Obstructive sleep apnea and work accidents: time for action. Sleep, 2016; 39: 1171-1173.14) Shirahama R, Kimura M, Wada H, Tanigawa T: Current medical treatment of obstructive sleep apnea (OSA) in sleep center. Juntendo Med J, 2017; 63: 427-434.Funding