The effect of fatigue, sleep deprivation and onerous working hours on the physical and mental wellbeing of pre-registration house officers



The potential deleterious effects of doctors’ long and arduous shifts have received relatively scant attention.

This study addressed the effect of a 32 h on-call shift on 16 pre-registration medical house officers in St. James’s Hospital, Dublin.

We assessed 5 psychological parameters (Tension-Anxiety, Depression-Dejection, Vigour-Activity, Fatigue-Inertia and Confusion-Bewilderment) as well as 5 simple tests of alertness and concentration both pre-and post-call. The doctors were randomly assigned to be tested either pre-or post-call.

On average the doctors got 4.5 hours sleep during a 32 h shift. This long shift had an adverse effect on all the psychological parameters (p>0.05) except Depression-Dejection. The total mood disturbance score, which has been shown to correlate well with general psychological well-being, deteriorated significantly after the 32 h shift, p>0.005. Two of the simple tests of alertness and concentration (Trail-making test and Stroop Color-Word test) also showed a significant fall-off in performance with sleep deprivation, p>0.05, although the remaining tests (Delayed Story Recall, Critical Flicker Fusion and Three Minute Grammatical Reasoning Test) were not significantly impaired by the 32 h shift.

This study shows that prolonged periods of duty without sleep adversely affect junior doctors, both in their psychological well-being and in their ability to carry out simple tasks.


Sleep Deprivation Junior Doctor House Officer Critical Flicker Fusion Mood Score 
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Copyright information

© Springer-Verlag 1998

Authors and Affiliations

  • C. Leonard
    • 1
    • 2
  • N. Fanning
    • 1
  • J. Attwood
    • 1
  • M. Buckley
    • 1
  1. 1.Department of MedicineSt. James’s HospitalDublin 8
  2. 2.Division of Pulmonary and Critical Care MedicineStanford University Medical CenterStanford

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