Citation

Bioulac S, Micoulaud Franchi JA, Arnaud M, Sagaspe P, Moore N, Salvo F, Philip P. Sleep 2017; 40(10): e134.

Affiliation

CHU Pellegrin, Clinique du Sommeil, F-33076, Bordeaux, France.

Copyright

(Copyright © 2017, American Academy of Sleep Medicine, Publisher Associated Professional Sleep Societies)

DOI

10.1093/sleep/zsx134

PMID

28958002

Abstract

STUDY OBJECTIVES: Sleepiness at the wheel is widely believed to be a cause of motor vehicle accidents. Nevertheless, a systematic review of studies investigating this relationship has not yet been published. The objective of this study was to quantify the relationship between sleepiness at the wheel and motor vehicle accidents.

METHODS: A systematic review was performed using Medline, Scopus and ISI Web of Science. The outcome measure of interest was motor vehicle accident defined as involving four or two wheeled vehicles in road traffic, professional and non-professional drivers, with or without objective consequences. The exposure was sleepiness at the wheel defined as self-reported sleepiness at the wheel. Studies were included if they provided adjusted risk estimates of motor vehicles accidents related to sleepiness at the wheel. Risk estimates and 95% confidence intervals (95%CI) were extracted and pooled as odds ratios (OR) using a random-effect model. Heterogeneity was quantified using Q statistics and the I2 index. The potential causes of heterogeneity were investigated using meta-regressions.

RESULTS: Ten cross-sectional studies (51,520 subjects), six case-control studies (4,904 subjects), and one cohort study (13,674 subjects) were included. Sleepiness at the wheel was associated with an increased risk of motor vehicle accidents (pooled OR 2.51 [95%CI 1.87; 3.39]). A significant heterogeneity was found between the individual risk estimates (Q =93.21; I2 = 83%).

CONCLUSIONS: Sleepiness at the wheel increases the risk of motor vehicle accidents and should be considered when investigating fitness to drive. Further studies are required to explore the nature of this relationship.

Language: en

Keywords

Sleepiness; motor vehicle accidents; sleepiness at the wheel; systematic review