Intended for healthcare professionals


Fatigue: time to recognise and deal with an old problem

BMJ 2001; 322 doi: (Published 07 April 2001) Cite this as: BMJ 2001;322:808

It's time to stop treating lack of sleep as a badge of honour

  1. Anne-Marie Feyer (, director
  1. New Zealand Environmental and Occupational Health Research Centre, PO Box 913, Dunedin, New Zealand

    Papers p 829

    Being awake at times that are biologically programmed for sleep, prolonged wakefulness, and having had restricted sleep over a period of time result in fatigue and sleepiness. These conditions undoubtedly adversely affect human performance. This week's issue includes another reminder of the dangers of sleepiness while driving,1 yet we continue to fail to treat fatigue with the seriousness it deserves.

    The impact of sleep loss on performance is well documented by laboratory research.2 Even modest amounts of sleep loss over short periods (about two hours a night over one week) accumulate and manifest themselves as an irresistible tendency to fall asleep during inappropriate or dangerous situations, like driving.3 The vulnerability of performance to circadian rhythm in alertness and sleepiness, even in well rested individuals, is similarly well documented.2 Data on accidents from a variety of sources worldwide confirm the impact of time of day on the occurrence of accidents.4 Working at night, and working hours that restrict sleep opportunity, have long been implicated in compromised safety at work.5

    The size of the problem is significant. A survey of car drivers in the United Kingdom found …

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