How Does Sleep Loss Affect Clinician Performance?
Sleep loss measurably affects attention, and a 2019 study of first-year resident physicians found that the short sleep they managed during extended overnight shifts did not restore their performance. If you work long or overnight hours, this is a physiological effect, not a lack of discipline.
What the study found
The study, published in Sleep in 2019 by researchers including Charles Czeisler and colleagues from the Harvard Work Hours, Health and Safety Group, followed 34 first-year residents at Brigham and Women’s Hospital during extended-duration shifts of 24 to 28 hours. (CDC Stacks)
- Residents averaged about 1.6 hours of cumulative overnight sleep on those shifts and slept less than 4 hours on 92% of nights.
- Attentional failures on a vigilance test improved significantly only after more than 4 hours of sleep.
- Even then, residents were 2.72 times more likely to have more than one attentional failure than during matched non-extended shifts.
- The authors concluded that strategic napping is insufficient to offset the impairment of extending duty beyond 16 hours.
The data were collected between 2002 and 2004 and the sample was small and from one hospital, so treat it as one study among many, not a rule for every setting.
What this means for well-being
Sleep sits inside the Physical Health dimension of the Wellness Wheel, which covers sleep, movement and energy. It also affects the Mental & Emotional and Time & Energy dimensions. (The Wellness Wheel) That is why a clinician who feels run down may find the roots in more than one place.
Practical, non-medical points
- Notice how your sleep trends over weeks, not only after a single bad night.
- If you have a say in scheduling, long extended shifts are the factor the study singles out.
- If poor sleep persists, raise it with your own physician.
Sleep is not only about shifts
Sleep is one part of the Physical Health dimension, and it affects the others. Poor sleep tends to make stress harder to manage, shortens patience at home and takes away energy for the things that keep you well. Many clinicians treat their own sleep as the first thing to give up. The research above suggests that the cost is real.
Things clinicians can look at
These are general considerations, not medical advice:
- Your pattern over weeks, not only after an overnight shift. A run of short nights matters.
- Recovery after nights, and whether your schedule leaves room for it.
- What you can influence and what you cannot. Some scheduling is up to you or your group; some is set by the system. The 2019 study focuses on extended shifts, which are usually a scheduling decision.
- Whether your sleep problem is persistent. Trouble sleeping that continues is worth raising with your own physician.
This article is education, not medical or mental-health advice.
This article is education, not medical or mental-health advice. Talk with your own clinician about your situation.