Obstructive Sleep Apnea Syndrome (OSAS) has emerged as a global public health problem. OSAS is largely recognized as a factor for increased risk of vehicular related accidents for those diagnosed and undiagnosed. This article serves as a country report that reviews current and potential policies regarding OSAS induced drowsy driving in both Japan and the United States of America. In addition to reviewing policies, various case finding techniques are also explored as methods to reduce accidents due to OSAS induced drowsy driving. Evaluation of the effectiveness of methods used in the United States of America and Japan for safe driving among commercial drivers is a key step to decreasing vehicular related accidents through stronger policy development and subsequent enforcement. Case finding has emerged as one of the most effective and realistic methods to detect OSAS in the driving population based on research done in the U.S. and Japan. Subsequently, case finding can lead to treatment to further prevent future accidents from occurring due to OSAS drowsy driving.