Quantifying the performance impairment associated with fatigue

J Sleep Res. 1999 Dec;8(4):255-62. doi: 10.1046/j.1365-2869.1999.00167.x.


The present study systematically compared the effects of fatigue and alcohol intoxication on a range of neurobehavioural tasks. By doing so, it was possible to quantify the performance impairment associated with fatigue and express it as a blood alcohol impairment equivalent. Twenty-two healthy subjects aged 19-26 years participated in three counterbalanced conditions. In the sustained wakefulness condition, subjects were kept awake for 28 h. In the alcohol and placebo conditions, subjects consumed either an alcoholic or non-alcoholic beverage at 30 min intervals, until their blood alcohol concentration reached 0.10%. In each session, performance was measured at hourly intervals using four tasks from a standardised computer-based test battery. Analysis indicated that the placebo beverage did not significantly effect mean relative performance. In contrast, as blood alcohol concentration increased performance on all the tasks, except for one, significantly decreased. Similarly, as hours of wakefulness increased performance levels for four of the six parameters significantly decreased. More importantly, equating the performance impairment in the two conditions indicated that, depending on the task measured, approximately 20-25 h of wakefulness produced performance decrements equivalent to those observed at a blood alcohol concentration (BAC) of 0.10%. Overall, these results suggest that moderate levels of fatigue produce performance equivalent to or greater than those observed at levels of alcohol intoxication deemed unacceptable when driving, working and/or operating dangerous equipment.

Publication types

  • Clinical Trial
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Alcoholic Intoxication / complications*
  • Alcoholic Intoxication / diagnosis
  • Brain / drug effects
  • Circadian Rhythm / physiology
  • Cross-Over Studies
  • Ethanol / blood
  • Ethanol / pharmacology
  • Fatigue / complications*
  • Humans
  • Psychomotor Disorders / diagnosis*
  • Psychomotor Disorders / etiology*
  • Psychomotor Performance / drug effects*
  • Psychomotor Performance / physiology*
  • Reference Values
  • Surveys and Questionnaires
  • Wakefulness / drug effects
  • Wakefulness / physiology


  • Ethanol