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Sprajcer M, Dawson D, Kosmadopoulos A, Sach EJ, Crowther ME, Sargent C, Roach GD. How Tired is Too Tired to Drive? A Systematic Review Assessing the Use of Prior Sleep Duration to Detect Driving Impairment. Nat Sci Sleep 2023; 15:175-206. [PMID: 37038440 PMCID: PMC10082604 DOI: 10.2147/nss.s392441] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Accepted: 02/03/2023] [Indexed: 04/12/2023] Open
Abstract
Driver fatigue is a contributory factor in approximately 20% of vehicle crashes. While other causal factors (eg, drink-driving) have decreased in recent decades due to increased public education strategies and punitive measures, similar decreases have not been seen in fatigue-related crashes. Fatigued driving could be managed in a similar way to drink-driving, with an established point (ie, amount of prior sleep) after which drivers are "deemed impaired". This systematic review aimed to provide an evidence-base for the concept of deemed impairment and to identify how much prior sleep may be required to drive safely. Four online databases were searched (PubMed, Web of Science, Scopus, Embase). Eligibility requirements included a) measurement of prior sleep duration and b) driving performance indicators (eg, lane deviation) and/or outcomes (eg, crash likelihood). After screening 1940 unique records, a total of 61 studies were included. Included studies were categorised as having experimental/quasi-experimental (n = 21), naturalistic (n = 3), longitudinal (n = 1), case-control (n = 11), or cross-sectional (n = 25) designs. Findings suggest that after either 6 or 7 hours of prior sleep, a modest level of impairment is generally seen compared with after ≥ 8 hours of prior sleep (ie, well rested), depending on the test used. Crash likelihood appears to be ~30% greater after 6 or 7 hours of prior sleep, as compared to individuals who are well rested. After one night of either 4 or 5 hours of sleep, there are large decrements to driving performance and approximately double the likelihood of a crash when compared with well-rested individuals. When considering the scientific evidence, it appears that there is a notable decrease in driving performance (and associated increase in crash likelihood) when less than 5h prior sleep is obtained. This is a critical first step in establishing community standards regarding the amount of sleep required to drive safely.
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Affiliation(s)
- Madeline Sprajcer
- Appleton Institute for Behavioural Sciences, Central Queensland University, Wayville, SA, Australia
- Correspondence: Madeline Sprajcer, Central Queensland University, Appleton Institute, 44 Greenhill Road, Wayville, SA, 5034, Australia, Email
| | - Drew Dawson
- Appleton Institute for Behavioural Sciences, Central Queensland University, Wayville, SA, Australia
| | - Anastasi Kosmadopoulos
- Appleton Institute for Behavioural Sciences, Central Queensland University, Wayville, SA, Australia
| | - Edward J Sach
- Appleton Institute for Behavioural Sciences, Central Queensland University, Wayville, SA, Australia
| | - Meagan E Crowther
- Appleton Institute for Behavioural Sciences, Central Queensland University, Wayville, SA, Australia
| | - Charli Sargent
- Appleton Institute for Behavioural Sciences, Central Queensland University, Wayville, SA, Australia
| | - Gregory D Roach
- Appleton Institute for Behavioural Sciences, Central Queensland University, Wayville, SA, Australia
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