Intensive Care Medicine

, Volume 42, Issue 3, pp 393–400 | Cite as

Night shift decreases cognitive performance of ICU physicians

  • François Maltese
  • Mélanie Adda
  • Amandine Bablon
  • Sami Hraeich
  • Christophe Guervilly
  • Samuel Lehingue
  • Sandrine Wiramus
  • Marc Leone
  • Claude Martin
  • Renaud Vialet
  • Xavier Thirion
  • Antoine Roch
  • Jean-Marie Forel
  • Laurent PapazianEmail author



The relationship between tiredness and the risk of medical errors is now commonly accepted. The main objective of this study was to assess the impact of an intensive care unit (ICU) night shift on the cognitive performance of a group of intensivists. The influence of professional experience and the amount of sleep on cognitive performance was also investigated.


A total of 51 intensivists from three ICUs (24 seniors and 27 residents) were included. The study participants were evaluated after a night of rest and after a night shift according to a randomized order. Four cognitive skills were tested according to the Wechsler Adult Intelligence Scale and the Wisconsin Card Sorting Test.


All cognitive abilities worsened after a night shift: working memory capacity (11.3 ± 0.3 vs. 9.4 ± 0.3; p < 0.001), speed of processing information (13.5 ± 0.4 vs. 10.9 ± 0.3; p < 0.001), perceptual reasoning (10.6 ± 0.3 vs. 9.3 ± 0.3; p < 0.002), and cognitive flexibility (41.2 ± 1.2 vs. 44.2 ± 1.3; p = 0.063). There was no significant difference in terms of level of cognitive impairment between the residents and ICU physicians. Only cognitive flexibility appeared to be restored after 2 h of sleep. The other three cognitive skills were altered, regardless of the amount of sleep during the night shift.


The cognitive abilities of intensivists were significantly altered following a night shift in the ICU, regardless of either the amount of professional experience or the duration of sleep during the shift. The consequences for patients’ safety and physicians’ health should be further evaluated.


Cognitive ICU Physicians Residents Night shift Sleep Deprivation 



No financial support.

Compliance with ethical standards

Conflicts of interest

On behalf of all authors, the corresponding author states that there is no conflict of interest.

Supplementary material

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Supplementary material 1 (DOCX 30 kb)
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Supplementary material 2 (DOCX 71 kb)


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Copyright information

© Springer-Verlag Berlin Heidelberg and ESICM 2015

Authors and Affiliations

  • François Maltese
    • 1
  • Mélanie Adda
    • 1
  • Amandine Bablon
    • 1
  • Sami Hraeich
    • 1
    • 2
  • Christophe Guervilly
    • 1
  • Samuel Lehingue
    • 1
    • 2
  • Sandrine Wiramus
    • 3
  • Marc Leone
    • 2
    • 4
  • Claude Martin
    • 2
    • 4
  • Renaud Vialet
    • 4
  • Xavier Thirion
    • 5
  • Antoine Roch
    • 2
    • 6
  • Jean-Marie Forel
    • 1
  • Laurent Papazian
    • 1
    • 2
    Email author
  1. 1.Assistance Publique, Hôpitaux de Marseille, Hôpital Nord, Réanimation des Détresses Respiratoires et des Infections SévèresMarseilleFrance
  2. 2.Faculté de médecineAix-Marseille Université, URMITE UMR CNRS 7278MarseilleFrance
  3. 3.Assistance Publique, Hôpitaux de Marseille, Hôpital de la Conception, Service d’Anesthésie-RéanimationMarseilleFrance
  4. 4.Assistance Publique, Hôpitaux de Marseille, Hôpital Nord, Service d’Anesthésie-RéanimationMarseilleFrance
  5. 5.Assistance Publique, Hôpitaux de Marseille, Hôpital Sainte-Marguerite, Service de Santé Publique et de l’Information MédicaleMarseilleFrance
  6. 6.Assistance Publique, Hôpitaux de Marseille, Hôpital Nord, Service d’accueil des UrgencesMarseilleFrance

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