Sleep Health | Sleep Review
A team of investigators at the University of Kansas (KU) collects data and designs measures to improve sleep quality for firefighters and paramedics in the Lawrence Douglas County Fire Medicine Department (LDCFM).
For these first responders, better sleep could improve their quality of life and performance when they encounter life and death situations. The stressful job of responding to emergencies requires both physical endurance and quick decisions.
“Among the many tasks they do, our rescue workers and paramedics must perform drug calculations regardless of the time of day, night or situation. Therefore, sleep deprivation is a problem,” said Kevin Joles, division manager at LDCFM, in a press release. “If someone is deprived of sleep and distracted when they throw a ladder against a house and hit a power line, it can kill them or another firefighter.”
The department recognized the importance of sleep for work performance and conducted its own internal surveys conducted by fire department medic Kathryn Beseth. She then turned to Nancy Hamilton, Associate Professor of Social and Behavioral Sciences and Psychology at KU. Hamilton saw the opportunity to answer the call with a fellowship from the community and agreed to conduct data analysis, advance sleep research, and develop sleep-enhancing measures for LDCFM workers.
“Kathryn has made it her business to investigate the sleep problems of her employees and distributed a highly regarded questionnaire to many coworkers at the front to ask them about their sleep problems,” said Hamilton in a press release. “She contacted me last summer and asked if I would be interested in interpreting the data and thinking about how to proceed from there. I was very interested and that started a conversation. “
Hamilton put a team together at the KU and analyzed the responses on sleep duration, quality, efficiency, latency and disruption of the first responders as well as data on waking time, sleep medication and dysfunction during the day.
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Because firefighters and paramedics have berths at work, they experience a different sleeping environment than most people, with less control over lights, noise, and bedding – and often interrupted sleep to rush to an emergency situation.
With KU alumni Julia Russell, Westley Youngren, Philip Huang and 10 students, Hamilton decided to combine the questionnaire data with anecdotal perspectives on sleep problems within the department.
“We ran a focus group between myself and the students in my lab, as well as Chief Joles and several frontline firefighters on sleep problems they saw while working among their staff,” says Hamilton. “We agreed on a two-phase project and started an anonymous questionnaire in November, which was sent to the front-line staff, where they reported about sleep problems related to sleep apnea, insomnia, nightmares and environmental disturbances in the fire stations. We collected and analyzed this data to provide some interventions for people with sleep apnea and to let them know if they are at risk and where they can be treated. We have identified inpatient sleep problems and have also identified individuals who are at risk for nightmare problems and insomnia problems. “
The data showed that around half of those surveyed had symptoms of sleep apnea and 30% had trouble staying awake at least once a week. Many reported environmental disturbances in the workplace, such as sleeping areas that were too warm, as well as light and noise disturbances.
“Fortunately, we no longer have any shared bedrooms,” says Joles. “But that doesn’t change the fact that firefighters can have sleep disorders for a number of reasons. If a ladder truck goes out in the middle of the night – but the paramedics and rescue workers stay at the fire station – firefighters can hear the firefighters preparing to take off, the sirens, garage doors closing, etc. Everyone hears the alarm – it’s terrifying of distress signals Getting woken up, but that happens all night. LDCFM answers an average of 13,000 calls each year in Lawrence and Douglas Counties. “
Additionally, first responders experience the same sleep disorders that can plague anyone: up to 81% are at risk for insomnia, while 23% are at risk for nightmare disorders.
“In January, I gave feedback to Chief Joles and Chief (Shaun) Coffey, as well as other administrators in the department,” says Hamilton. “We talked about where and how they could intervene with some of the firefighters or address some of the environmental sleep disorders.”
Joles says the department would use the results to make some changes to existing fire stations and could use them to inform the design of future facilities.
“Once Nancy has shared the data with all of our members, we plan to create a plan to make positive changes in our fire stations and allow our members to have a better recovery,” said a press release from Joles. “Our members live here for a third of their lives. They eat, exercise and sleep in the train stations. LDCFM will continue to try to improve the quality of sleep in the fire stations. Some changes can include room darkening hues or something as simple as adding ambient noise to sleeping areas. It takes time to get things right. If money wasn’t an object we could fix this quickly, but unfortunately the city’s budgeting process takes time. “
The Hamilton team has applied for a grant from the Douglas County Community Foundation to help advance the project. She plans a small sleep diary study using wrist-worn accelerometers to gather more accurate data on sleep in the department. Finally, Hamilton plans to publish a grant on the research.
She and Joles hoped that interventions to help first responders get a good night’s sleep in Lawrence and Douglas Counties could be exported to other departments across the country.
“We want to be rested and healthy so we can serve the community,” says Joles.
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