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Background Obstructive Sleep Apnoea Hypopnea Syndrome (OSAHS) is an underdiagnosed condition that contributes to excessive daytime sleepiness. Sleepiness contributes to 20% of road traffic accidents. Prompt treatment of OSAHS has been shown to reduce risk of road traffic accidents as well as work-place accidents. Earlier diagnosis can also help reduce healthcare costs and improve quality of life for our patients.Objective To compare the clinical and historical characteristics of drivers who self-reported sleepiness when driving versus those who did not and to identify characteristics of excessive sleepiness leading to earlier diagnosis and intervention.Methods We retrospectively analysed data from our database looking at all drivers who had completed initial review and CPAP compliance between 2022–2025. 827 drivers were identified. Of these 11% (n=95) admitted to self-reported episodes of excessive sleepiness when driving. We compared demographic, clinical and sleep-related characteristics between the two groups using data from the initial review, sleep study results and blood tests.Results Sleepy drivers had a significantly higher Epworth Sleepiness Scale (ESS), with a mean ESS of 15.2 vs 9.3 (p<0.001) and were more likely to report sleepiness in traffic (p<0.001). Seven symptoms were significantly more prevalent in the sleepy group. These were: Morning headaches (p<0.001), Depression (p=0.002), Difficulty remaining asleep (p<0.00001), Daytime sleepiness (p<0.0001), Difficulty concentrating (p=0.0002), Daytime lethargy (p=0.00015), and Heartburn (p=0.00025).A logistic regression model incorporating these seven variables showed that individuals reporting four or more of these were twice as likely (OR = 1.987, p = 0.005) to be classified as sleepy drivers. Drivers positive on six characteristics were over seven times more likely (OR = 7.65, p = 0.052) to be classified as sleepy drivers. Whilst not statistically significant, we aim to re-test on a larger sample size.Conclusion This study highlights a symptom-based profile that may help to identify drivers at risk of excessive sleepiness. Combined score of four or more characteristics shows promise as a screening tool. The findings support development of proactive algorithms or screening protocols to be used in OSAHS clinics to identify our high-risk symptomatic patients to initiate treatment promptly and to improve road safety.