Sleep problems and work injuries: a systematic review and meta-analysis

Sleep Med Rev. 2014 Feb;18(1):61-73. doi: 10.1016/j.smrv.2013.01.004. Epub 2013 May 21.


Objectives: Sleep problems are a potential risk factor for work injuries but the extent of the risk is unclear. We conducted a systematic review and meta-analysis to quantify the effect of sleep problems on work injuries.

Methods: A systematic literature search using several databases was performed. Sleep problems of any duration or frequency as well as work injuries of any severity were of interest. The effect estimates of the individual studies were pooled and relative risks (RR) and 95% confidence intervals (CI) were calculated through random effects models. Additionally, the population attributable risk was estimated.

Results: In total, 27 observational studies (n = 268,332 participants) that provided 54 relative risk estimates were included. The findings of the meta-analysis suggested that workers with sleep problems had a 1.62 times higher risk of being injured than workers without sleep problems (RR: 1.62, 95% CI: 1.43-1.84). Approximately 13% of work injuries could be attributed to sleep problems.

Conclusion: This systematic review confirmed the association between sleep problems and work injuries and, for the first time, quantified its magnitude. As sleep problems are of growing concern in the population, these findings are of interest for both sleep researchers and occupational physicians.

Keywords: Accident prevention; Fatigue; Industrial accidents; Industry; Occupational accidents; Occupational safety; Sleep; Sleep disorders; Sleepiness; Workplace.

Publication types

  • Meta-Analysis
  • Research Support, Non-U.S. Gov't
  • Review
  • Systematic Review

MeSH terms

  • Accidents, Occupational / statistics & numerical data
  • Humans
  • Occupational Injuries / etiology*
  • Risk
  • Sleep Wake Disorders / complications*