The “safety” dimensions of sleepiness require interactions and assessments by the physician that go beyond the clinical encounter and have garnered interest by legislative bodies and regulatory agencies. This review is a brief accounting of certain specific policies, procedures, and judicial instructions developed to address issues of drowsy driving. The major body of work involves commercial and noncommercial assessments, but increasingly, sleepiness has become a recognizable issue for the design of service hours and for management of human resources. The insertion of this literature into appropriate regulations and remediative measures is appearing in state noncommercial licensure as well as trucking and aviation licensure and health maintenance. The challenge is now for legislative bodies to design policy to address and mitigate excessive sleepiness in an appropriate and cost-effective manner.