The exploration of physical fatigue, sleep and depression in paramedics: a pilot study


circadian rhythm
occupational stress
shift work
sleep deprivation
sleep disorder

How to Cite

Sofianopoulos S, Williams B, Archer F, Thompson B. The exploration of physical fatigue, sleep and depression in paramedics: a pilot study. Australasian Journal of Paramedicine [Internet]. 2011Feb.7 [cited 2023Jan.26];9(1). Available from:



Ambulance paramedics are members of a discipline that forms a unique part of the emergency services. As pre-hospital providers they are constantly and increasing faced with heavy workloads that are physically, mentally and emotionally tiring. Fatigue and sleep disturbance are factors which can compromise the effectiveness of these workers, and as a result not only hamper patient safety but can have detrimental consequences on the paramedics‟ health and overall well-being. The objective of this study was to investigate the impact shift work on physical fatigue, sleep and psychological factors among paramedics in Australia.


A convenience sample of paramedics was asked to complete a number of self-reporting standardised questionnaires: The Epworth Sleepiness Scale (ESS) (8-items), Berlin Questionnaire (BQ) (10-items), Pittsburgh Sleep Quality Index (PSQI) (19-items) and the Beck Depression Inventory (BDI) (21-items). Ethics approval was granted.


The study recruited 60 participants, the majority of which were male 77% (n=46), > 45 years of age 31% (n=19), and having worked shift work between 5-10 years 35% (n=21). Nine out of ten (92%, n=55) of paramedics reported having experienced fatigue in the last 6 months, with 88% (n=53) believing it had affected their performance at work. The ESS reported 30% (n=18) of people had excessive daytime sleepiness, and 10% (n=6) being dangerously sleepy. Statistical significance was observed in the ESS items „chance of dozing while sitting and talking to someone‟ (p<0.05), and „whilst stopped in traffic for a few minutes‟ (p<0.05) between males and females. Almost half (48%, n=29) of paramedics answered yes to having nodded off or fallen asleep whilst driving. The PSQI found 68% (n=41) of participants suffered poor quality sleep, while 21 % (n=13) of respondents were at high risk for sleep apnoea (BQ). Depression was found to be mild among 27% (n=16) and moderate among 10% (n=6) of respondents


Shift work affects health and well-being both physiologically and psychologically, which translates from work into home. Further research using a larger sample size is warranted to prevent the issues of patient safety, work-related fatigue and the cumulative effects of shift work in paramedic employees.