Archive for the ‘First Responders’ category

The Critical Importance of Sleep for Firefighters

September 11, 2019

September 11 is a day we will never forget. I am forever thankful for the firefighters and others who step forward to watch over us all as first responders.

In honor of the day, here is a summary of what we know about firefighters’ sleep, and the costs they pay to provide 24/7 service.

It is critically important that firefighters are able to perform well when they are on duty, however, a large number are impaired by inadequate sleep. Many common concerns of firefighters such as cancer and cardiovascular disease risk, barriers to physical fitness, food culture, psychological stress from trauma and injuries (1), are related to or can be improved by sleep health.

Health and Safety:

The effects of inadequate sleep on human mental and physical health have been well documented. For firefighters the leading causes of death are heart attack and auto accidents (2).

  • 51.2% of firefighters report disturbed sleep, which contributes to psychological distress (3).
  • 37.2% of firefighters surveyed screen positive for sleep disorders: 28.4% obstructive sleep apnea, 9.1% shift work disorder, 6% insomnia, and 3.4% restless legs syndrome (3). Of these, the majority (80%) have not been diagnosed or treated.
  • Those who have sleep disorders are twice as likely to have an auto accident, and 2.4 times as likely to experience falling asleep while driving. They also are at increased risk of cardiovascular disease, diabetes, anxiety and depression (4).
  • Another study found that 17% have sleep problems, and as sleep hours decreased, so did physical quality of life (5).
  • Sleep deprivation among firefighters appears to increase high-risk behaviors such as alcohol consumption and decrease mental health and physical well-being (6).
  • Compared to firefighters with 8 hours of sleep, sleep deprived firefighters show changes in both their inflammatory cells and evening cortisol levels which has been shown to have adverse health effects (7).
  • Night and extended shifts increase the prevalence of cardiovascular and mental health disorders (8).

Shift Work and Performance:

Night shift and the extended shifts typical among firefighters are inherently difficult, though improved individual sleep plans and administrative policies can improve daytime sleep and alertness at night.

  • Response time by firefighters is slowest at 5am, twice as long as at 4pm (9).
  • The risk of a work related injury peaks at 2am (10).

Costs:

Firefighter injuries in the U.S. are estimated to cost $3.7 to 11.7 billion per year (11). Sleep deprivation is known to contribute to obesity via changes in appetite hormones, calorie intake and the insulin system. Obese firefighters miss five times as many work days as those of normal weight, at an annual cost of $1683 per employee (12), and those with BMI >30 have a three times increase in worker compensation claims due to injury (13).

Public safety personnel need to be able to perform well at all times of the day and night, however firefighters are not getting adequate sleep to perform well, make good judgments, or maintain their physical and mental health. Implementing wellness and fitness programs has been shown to improve cardiorespiratory endurance, experienced health and job satisfaction, while decreasing weight, high blood pressure and anxiety(14). Providing expert-led sleep and fatigue management education to firefighters will assist in achieving a higher level of sleep health(15) and safety on the job. A simple sleep education and screening program for firefighters resulted in a 46% decrease in disability days, and 24% decrease in injury reports (16).