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Insufficient sleep and fitness to drive in shift workers: a systematic literature review protocol
  1. Melissa Knott1,
  2. Sherrilene Classen2,
  3. Sarah Krasniuk1,
  4. Marisa Tippett3,
  5. Liliana Alvarez1
  1. 1 Faculty of Health Sciences, Western University, London, Ontario, Canada
  2. 2 Department of Occupational Therapy, College of Public Health and Health Professions, University of Florida, Gainesville, Florida, USA
  3. 3 Education Library, Althouse College, Western University, London, Ontario, Canada
  1. Correspondence to Melissa Knott, Faculty of Health Sciences, Western University, London, ON N6A 1H1, Canada; mknott{at}


Background The majority of shift workers experience insufficient sleep as a result of their employment. Insufficient sleep is associated with impaired neurocognitive functioning, affecting key skills required for driving, resulting in shift workers experiencing a disproportionate burden of RTC injuries and fatalities. Yet, to our knowledge, no systematic literature review (SLR) exists to critically appraise and synthesise evidence on the determinants of fitness to drive (assessed on-road) and driving performance (assessed in a driving simulator) in shift workers with insufficient sleep.

Objectives A SLR protocol is established to conduct analysis and synthesis of the level of evidence and confidence in the determinants of fitness to drive and driving performance, among shift workers with insufficient sleep.

Methods This study follows Cooper and Hedges’ established SLR methodology: formulate the problem, locate and select studies, collect data, appraise critically, analyse and present data, interpret results and disseminate information. Critical appraisal and analysis follows the 2017 American Academy of Neurology guidelines determining the level of evidence and the level of confidence for each determinant identified in the literature. Protocol and results reporting adhere to the Preferred Reporting Items for Systematic reviews and Meta-Analyses Protocols guidelines.

Conclusions This SLR contributes to research evidence examining the impact of insufficient sleep and driver sleepiness on fitness to drive and driving performance. Analysis of the level of evidence and level of confidence in the existing literature will advance evidence-informed prevention strategies and critical decision-making, to mitigate adverse effects of insufficient sleep for improving road safety.

  • systematic review
  • motor vehicle
  • fatigue

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  • Contributors MK is the guarantor. All authors contributed to the development of the search strategy. MK and SC developed the selection criteria, critical appraisal. SC provided methodological and content area expertise. All authors read, provided feedback and approved the final manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.