Sleep, fatigue, and altered cognition in healthcare professionals: Evidence from Portugal using the fatigue and altered cognition scale

Abstract

While the detrimental impact of poor sleep on mental health and cognitive performance is well established, few studies have explored these relationships using sensitive, population-specific tools. This study offers a novel contribution by examining the associations between sleep quality, fatigue, altered cognition, and symptoms of anxiety and depression among Portuguese healthcare professionals, incorporating the Fatigue and Altered Cognition Scale (FACs), a newly validated instrument for the Portuguese context. A total of 80 healthcare professionals completed standardized measures assessing sleep (Pittsburgh Sleep Quality Index - PSQI and Sleep Health Scale - SHS), emotional well-being (Hospital Anxiety and Depression Scale - HADS), and psychocognitive exhaustion (FACs). The relationships between these variables were statistically analyzed through correlations and comparisons between groups. The results revealed that poorer sleep quality was significantly associated with higher levels of fatigue, perceived cognitive alterations, and symptoms of anxiety and depression. Marital status, physical exercise, and caffeine consumption showed no statistically significant associations, but age was positively correlated with sleep quality. No significant differences were found between professional categories. However, professionals working in shifts reported significantly poorer sleep quality compared to those with regular schedules. The FACs provided a measure of cognitive and fatigue-related difficulties, allowing for a clearer characterization of how poor sleep affects both mental performance and fatigue symptoms. These findings highlight the value of integrating contextually adapted tools in occupational health research and reinforce the need for institutional strategies targeting sleep hygiene and cognitive well-being in healthcare settings.