Sleep Deprivation in the Fire Service

A Research Project

Sleep
America is a sleep deprived nation 50 million Americans have sleep issues 74% of adults suffer from sleep issues 1 night a week

How do firefighters compare to the public in terms of sleep deprivation?

Not Very Well

Firefighters experience greater sleep deprivation than the general public Firefighters, in general, are experiencing more fatigue as well due to:
Interrupted sleep cycles Non-restorative sleep patterns Shift work

Research method
Literature Review
Current trends Control groups

Survey of active professional firefighters

Diverse schedules Different geographic locations Diverse respondents

N = 96

Survey
Firefighter Intrinsic Sleep Disorder Questionnaire
BMI Epworth Sleepiness Scale Sleep Disorder Questionnaire STOP-BANG Fatigue Severity Scale (FSS)

BMI
Body Mass Index
BMI affects sleep BMI 35 (Morbidly Obese {MO}) is where sleep issues begin. 0 Reponses in the MO range. Overweight?
BMI views fat and muscle the same. Muscle is more dense. 67% in bottom half

BMI
60

50

40

30

BMI

20

10

0 Underweight Normal Overweight Obese Morbidily Obese

Epworth Sleepiness Scale (ESS)

ESS Scatter
25 20 15

Area of Concern

10
5 0 0 20 40 60 80 100

Used to determine the daytime sleepiness Eight questions with an answer of 0-3 Sum the answer to get the total score Score 10 is concerning

Epworth
Control N = 72 Mean Score of 4.6 95% Confidence Interval (CI) 3.9 5.3 SD = 2.8 Range = 0 -10 Firefighters N = 95 Mean score of 8.2 95% CI 7.4 9.1 SD = 4.2 Range = 1 20 > 40% above 10

STOP-BANG
S = Snoring T = Tired O= Observed stop breathing P = Blood Pressure B = BMI A = Age N = Neck Circumference > 40cm G = Gender

STOP-BANG
Eight Questions STOP Yes = 1 point / No = 0 BANG
BMI 35 = 1 Age 50 = 1 Neck 40 cm = 1 Gender Male = 1 / Female = 0

Results greater 3 = concern

STOP-BANG
Firefighters Mean = 2.5 95% CI = 2.3 2.8 SD = 1 Range = 0-5
STOP-BANG
40 35 30

25
20

Mean of 2.5 is < 3. However 46% of respondents 3.

15 10 5 0 0 1 2 3 4 5 6 7 8

Fatigue Severity Scale

Survey tool used to evaluate fatigue Self-administered 9 questions with answers of 1-7
Scores from 9 63

Two scoring methods

Sum of all answers Mean of answers total will be between 1 - 7

Fatigue Severity Scale

Control Firefighters
FSS Survey Results
8 7 6

5
4 3 2 1 0 1

Fatigue Severity Scale

Control N = 454 Mean = 3.0 SD = 1.08 Alternate Method
N = 98 Mean 20

Firefighter N = 95 Mean = 3.4 SD = 1.2 Alternate Method

N = 95 Mean 30.2

Both cases result in statistically significant findings

Findings
American adults are sleep deprived Firefighters, even more so:
Epworth = 40% of respondents scored in the concern area. STOP-BANG = 46% scored 3 (High Risk) FSS 30% score of 36 (Area of concern)

Large percentage of respondents fall in a high level of concern.

Conclusion
Ways to combat the problem
Longer restorative sleep cycles Minimized Interruptions Naps

Dr. Creegan of the Mayo Clinic

Overwhelming data demonstrate that when you don't get predictable and restorative sleep, you're more likely to suffer from irritability, anxiety, depression and a number of other health problems, including heart conditions