This is my first post after following this forum for a while. I had some severe fatigue issues after long hours of laptop use, and eventually, I came up with a solution. Even though it may not affect many people in this forum, I hope it can be useful for some. I have been trying to remediate this issue for about 2 years, and there is a noticeable difference in the last year. I will give a compressed version below.
It all started with noticeable fatigue by evening of every workday. This began several years ago and progressively became worse to the point where I had to take a stern decision to look for a solution. I went through all the information I could gather from various internet sources and also came across this forum.
I first started with PWM. The 2019 MacBook Pro (Intel) I still use has PWM but at >100KHz range. I wasn't seeing any flickering, but I still installed Lunar Pro and reduced the brightness in software while keeping actual display brightness at 100%. This turned off PWM, and over a period of a month, I could feel a noticeable improvement in the fatigue situation. I also switched to AMD's discrete card in the MacBook Pro from Intel's built-in one. But I think the 100% brightness hack did the trick mainly. However, fatigue issues were still far from completely gone. Then I started experimenting with WiFi and started using an ethernet connection. This is where I saw a dramatic difference in improvement. After a couple of months, I can say things improved a lot. I had WiFi and Bluetooth turned off all the time during this period.
At this point, I was fine with leaving it like that, but I still wanted to see if things could be further improved. So I started using an old HP 22er monitor with the Mac in clamshell mode. This definitely gave me some relaxation as the screen is big and overall less strain rather than working on the laptop screen. But the improvement from turning off WiFi still remained the most significant one so far. I then decided to buy a good monitor and permanently switch to that from the positive experience of using an external monitor. After much research, I bought a 27" Dell UltraSharp UP2720Q monitor which has DC dimming, excellent colors, and gamma that can even rival an OLED display when viewing head-on. The monitor was excellent already, and I eventually made some adjustments to the Display settings like scaling to pixel-to-pixel, turning off response time (normal to off), and starting using the Adobe RGB color space instead of sRGB. I set Adobe RGB in both monitor and Mac, and colors are perfect; Mac converts colors to Adobe RGB with no over or under saturation issues. This also increased the realism of image and video because Adobe RGB uses pure 2.2 gamma as opposed to the altered sRGB gamma of mathematical 2.2. This is a 10-bit monitor and can easily handle the subtle gray variations, so I can use pure 2.2 gamma without issues. Turning off response time made a difference, I guess. The difference is nearly impossible to perceive. Also, it's a 10-bit monitor and the AMD discrete card is sending 30-bit data, so no more temporal or spatial dithering to worry about. This monitor supports Thunderbolt 3 and no DSC or compression-related issues to deal with either. The final result was really good, very calm whites with no business I have never seen before. Perceptual sharpness is very good as it's a Professional grade monitor.
Overall excellent experience with no more fatigue. There is still fatigue after sitting in front of the computer for a long time, but my evenings are back to the same quality as a weekend evening when I don't have to sit in front of the computer for work.
I also keep the laptop physically away from me. I don't know if that makes any difference. The WiFi experience made me worry about a lot of other possibilities, so I keep it several feet away from me.