04 Sep Do you ask your patients if they have been sleepy while driving?
Bioulac et al. recently had a systematic review of the risk of motor vehicle accidents related to sleepiness at the wheel accepted by the journal of Sleep. What they found was: Of the 17 studies included, all except one found that drivers reporting sleepiness at the wheel were at greater risk of motor vehicle accidents compared to other drivers. The pooled risk estimate found more than a two-fold increased risk of motor vehicle accidents due to sleepiness at the wheel.
The authors looked at 2932 articles, and filtered these down to 233 which subsequently went under review. Of these, 17 were included in the meta-analysis.
The inclusion criteria were:
1) Outcome of interest: Motor vehicle accidents: 2 or 4 wheeled vehicles in road traffic, professional and non-professional drivers, with and without objective consequences
2) Exposure: Sleepiness at the wheel evaluated with a specific question. I.e. self-reported sleepiness at the wheel leading to difficulty in remaining awake inferring with driving skills.
3) Sleep disorders or sleep hygiene measured through individual declaration or through clinical sleep evaluation
4) Presence of a comparison group.
The exclusion criteria were:
1) Case reports and case series with no comparison group
2) Experimental studies (real driving, simulator driving)
3) Pedestrian injuries,
4) Bicycle injuries
5) Studies involving children
6) Studies in which the distinction between near-misses accidents and accidents is not clear.
They extracted the definition of sleepiness at the wheel and sleepiness at the wheel assessment period before the accident. These time periods included just before the accident, during the year preceding it, or more than a year preceding it.
These studies seemingly covered most population groups; men and women (all bar one), ages 18 – 50+ with sample sizes from 229 to 35004 participants. Case control, cross-sectional and cohort studies were included.
Original article can be found here: https://academic.oup.com/sleep/article/4049536/Risk-of-motor-vehicle-accidents-related-to
Stéphanie Bioulac, MD PhD, Jean-Arthur Micoulaud Franchi, MD PhD, Mickael Arnaud, MsC, Patricia Sagaspe, PhD, Nicholas Moore, PhD, Francesco Salvo, PhD, Pierre Philip, MD PhD; Risk of motor vehicle accidents related to sleepiness at the wheel: a systematic review and meta-analysis, Sleep, , zsx134, https://doi.org/10.1093/sleep/zsx134