The Effect of Sleep Deprivation and Disruption on DNA Damage and Health of Doctors

Cheung V, Yuen VM, Wong GTC et al.

Anaesthesia. 2019: 74 (4); 434-440


  • DNA damage and repair are dynamic processes
  • Animal studies have shown that sleep loss can induce genetic damage in different organs
  • Sleep deprivation is known to induce oxidative stress
  • Most studies are conducted on older adults, and these results may not be extrapolated to a younger workforce
  • Studies of sleep deprivation and its effect on DNA damage in younger people are lacking


  • Cross‐sectional observational study on 51 healthy, full‐time doctors
  • Assigned into 2 groups:
    • On call group worked at least 3 night shifts/month
    • Control group were full-time clinicians who did offsite on calls or no on calls
      • Majority no on calls for 3-5 years
      • Offsite on calls – travelled back 1-2 times per month after midnight


  • 2 doctors were excluded from analysis as they later admitted to taking dietary suppression pills
  • There was significantly reduced expression of DNA repair genes in doctors who regularly worked night shifts, both at baseline and following a single night of sleep deprivation


  • The DNA repair genes, ERCC1, OGG1 and XRCC1, examined in this study are involved in nucleotide excision repair, base excision repair and recombinational repair
  • Decreased or absent expression of these genes is associated with accumulation of DNA damage, increased rates of mutation and tumour genesis
  • Significantly lower baseline OGG1 and ERCC1 expression, and decreases in expression of all three genes investigated after acute sleep deprivation, suggest impairment of DNA repair activity in sleep‐deprived people
  • Disrupted circadian rhythm and suppression of nocturnal melatonin causes altered endogenous sex hormone balance, de-synchrony of clock genes and the expression of genes implicated in cancer development
  • Heightened neuroendocrine stress responses, higher glucocorticoid and catecholamine levels, disrupted appetite control, pro‐inflammatory responses, immunosuppression and changes in lifestyle, including diet and physical activity, are implicated


  • Results could have been confounded by other factors, including greater work stress in specialties with on‐site calls, different occupational risk exposure (e.g. to radiation) between specialties.
  • Sleep adequacy and acute sleep deprivation was self‐defined
  • Sleep demand and habits can vary greatly between individuals, and in addition to the number of hours slept, sleep quality is also an important factor determining sleep adequacy
  • Participants were mostly young Chinese doctors, and therefore the results of this study may only be applied to this population
  • The genomic consequence of sleep deprivation and disruption may vary as a function of ethnicity, locality and age groups
  • Only doctors in the study-not the only profession who work night shifts
  • Self reporting of adequacy of sleep
  • Longitudinal study would be more useful- following DNA repair genes in the period before on calls and following the commencement of overnight on calls

Summary by Dr S Sethi. Journal Club Meeting 31 January 2019.

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