Being on-call for work disrupts sleep, even when an overnight call never arrives. Findings published by CQUniversity Australia indicate that the sheer awareness of a potential call is sufficient to ruin your rest, regardless of whether you are actually summoned.
In Plain English: The Clinical Takeaway
- Anticipation: Uncertainty about whether you will be called or worry about missing a call can be associated with worse sleep.
- Physiological Toll: Regular sleep disruption impacts the immune, hormonal, and cardiovascular systems over time, increasing long-term health risks.
- Proactive Boundaries: Prioritizing sleep is the most important action on-call workers can take.
The Neurobiology of Standby Anxiety
For professionals across emergency services, health care, utilities, and retail, carrying a pager, phone, or remaining logged into a software application transforms off-hours into a state of standby. According to investigations by Madeline Sprajcer and Grace Vincent from CQUniversity Australia, maintaining standby status prevents total relaxation, necessitating constant availability and preparedness for employer demands.
When an individual sleeps while on-call, the anticipation of disruption can associate with worse sleep. This anticipation effect mirrors the “Sunday scaries,” the feeling of anxiety or dread before the work week starts, which can also have a negative effect on sleep.
Physiological Consequences of Fragmented Sleep
Sleep is an active biological maintenance period. During sleep, the brain encodes memories, regulates emotions, and restores attention. It is when the body repairs tissues and supports the immune, hormonal, and cardiovascular systems. When on-call duties interrupt this process—or when the anticipation of a call prevents deep sleep—the nightly maintenance crew cannot finish the job.
Poor sleep is linked to a greater risk of accidents, mental health difficulties, weight gain, diabetes, and heart disease. Furthermore, cognitive deficits manifest as impaired concentration, slower reaction times, and compromised decision-making and mood.
| Body System | Normal Sleep Function | Impact of On-Call Disruption |
|---|---|---|
| Cardiovascular | Supports the cardiovascular system. | Increased risk of heart disease over time. |
| Immune | Supports the immune system and repairs tissue. | Interrupted nightly maintenance. |
| Neurological | Encodes memories, regulates emotions, and restores attention. | Impaired concentration, delayed reaction time, and mood/decision-making deficits. |
Regulatory Landscapes and Regional Workplace Protections
The conversation surrounding continuous connectivity has prompted legislative action. For instance, the right to disconnect from work has been protected by law in Australia since 2024, meaning most employees can refuse to answer calls from work outside their regular work hours.
Despite these legal shifts, on-call work remains common in healthcare and emergency response, where tasks might be high-pressure, such as a doctor assessing a critically ill patient, where quick decisions can have serious consequences.
Contraindications & When to Consult a Doctor
Conclusion
The expectation of constant availability places a biological tax on workers, degrading sleep quality even when no calls are made.
