Bioulac Stéphanie, Micoulaud-Franchi Jean-Arthur, Arnaud Mickael, Sagaspe Patricia, Moore Nicholas, Salvo Francesco, Philip Pierre
University of Bordeaux, SANPSY, Bordeaux, France.
CNRS, SANPSY, Bordeaux, France.
Sleep. 2017 Oct 1;40(10). doi: 10.1093/sleep/zsx134.
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.
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 nonprofessional 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 vehicle accidents related to sleepiness at the wheel. Risk estimates and 95% confidence intervals (95% CIs) were extracted and pooled as odds ratios (ORs) 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.
Ten cross-sectional studies (51,520 participants), six case-control studies (4904 participants), and one cohort study (13,674 participants) 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%).
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.
PROSPERO 2015 CRD42015024805.
人们普遍认为驾车时困倦是机动车事故的一个原因。然而，尚未发表对研究这种关系的系统性综述。本研究的目的是量化驾车时困倦与机动车事故之间的关系。
使用Medline、Scopus和ISI科学网进行系统性综述。感兴趣的结局指标是机动车事故，定义为涉及道路交通中的四轮或两轮车辆、专业和非专业驾驶员，无论有无客观后果。暴露因素是驾车时困倦，定义为自我报告的驾车时困倦。如果研究提供了与驾车时困倦相关的机动车事故的调整风险估计值，则纳入研究。提取风险估计值和95%置信区间（95%CI），并使用随机效应模型汇总为比值比（OR）。使用Q统计量和I²指数对异质性进行量化。使用meta回归研究异质性的潜在原因。
纳入了10项横断面研究（51520名参与者）、6项病例对照研究（4904名参与者）和1项队列研究（13674名参与者）。驾车时困倦与机动车事故风险增加相关（汇总OR 2.51 [95%CI 1.87；3.39]）。在个体风险估计值之间发现了显著的异质性（Q = 93.21；I² = 83%）。
驾车时困倦会增加机动车事故风险，在调查驾驶适宜性时应予以考虑。需要进一步研究来探索这种关系的本质。
PROSPERO 2015 CRD42015024805。
