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The Trouble with Sleep: A hidden hazard to firefighters’ health

Firefighting trains us to sleep light and wake at a moment’s notice with our physiology on alert. Those habits don’t exactly play nice with our sleep hygiene. Of the four stages of sleep, the most important stage for restoring physical vitality is the fourth, when our brain is emitting delta waves. But it takes time for our body to unwind through the three lighter stages and reach that deep level of sleep. Furthermore, our emotional health depends on a stage even deeper than delta — the REM stage, when we dream.

Unfortunately, the hair trigger instinct to jump up, get dressed, and be gear-ready in under a minute weaves its way deep into a firefighter’s restorative slumber. When that alarm sounds, we awake with the understanding that lives may be at stake. And this instinct stays with us, whether we are in the fire house or away on vacation. I know this syndrome well. It has been a while since I was active on the front lines, and still, to this day, I don’t sleep — part of me is always listening for the buzzer. I call it “sleeping with one ear open.”

Firefighters at risk

Reading the latest news about sleep hygiene makes me cringe a little. Studies continue to find sleep hygiene a factor in everything from mental health to diabetes and heart attack. The firefighting career already has a place in the statistics as a career with “greater incidence of heart attacks and strokes.” While stress is often blamed for this, we are also learning that sleep deprivation is a likely contributing factor.

In their comprehensive article on sleep deprivation, defines sleep deprivation as any time a person’s natural circadian rhythm is disturbed by lack of sleep. There is some variation on hours-of-sleep required, dictated by genetics and other uncontrollable factors, “with most people requiring 7.5 to 8.5 hours of sleep in a 24-hour period. At least four to five hours of uninterrupted core sleep is necessary to maintain minimum performance levels.”

This is bad news for firefighters, especially those in busy fire stations or who sleep, for purposes of alarm preparedness, to awaken at the slightest sound.

Sleep hygiene matters

A 2008 CBS News program called “The Science of Sleep” tracked a sleep study in which a student was continuously deprived of delta-wave sleep, the deepest sleep before REM sleep. The study documented his mental acuity day by day. Within just four days, according to the study, the healthy 19 year-old male showed the brain acuity of a 70-year-old, craved food his body didn’t really need (initiating weight gain), and showed markers for pre-diabetes. Firefighters are known to tend toward obesity — 70% of us, according to research. Once again, it is quite possible that sleep hygiene is playing into this statistic.

Furthermore, sleep deprivation, which is anything below the 7-hour average considered necessary to humans, can debilitate our thinking and response times.

“There’s a cumulative impairment that develops in your ability to think fast, to react quickly, to remember things. And it starts right away,” sleep researcher David Dinges told Lesley Stahl in the CBS News interview. “A single night at four hours or five hours or even six, can in most people, begin to show effects in your attention and your memory and the speed with which you think.”

When we think of some of the big disasters — Exxon Valdez, Three Mile Island, Staten Island Ferry — we often think of “human error,” Dinges says. As the scientist in charge of sleep study at University of Pennsylvania’s School of Medicine, Dinges points to a more specific culprit: sleep.

The connections between firefighters’ poor sleep hygiene and their career health risks, are confirmed by a recent article in Time by Helen Regan, “Firefighter Deaths Could be Linked to Poor Sleep.” The article is based on a report in Sleep Review. It is frightening to think that we who dedicate our lives to mitigating disasters may, in fact, be walking disasters ourselves.

But what can we do to protect ourselves against sleep deprivation, which is almost part of the job?

Take action against poor sleep hygiene

Granted, given our chosen line of work, we must make compromises with the goal of perfect, deep sleep – but we can do so smartly. Here’s a brief check list.

  • Don’t shrug off the opportunity for a good sleep; let other things on the to-do list wait.
  • Reorient our thinking from sleep as “unimportant” to sleep as part of “job preparedness.”
  • Take naps, especially before driving late at night; “any sleep is better than no sleep.”
  • When sleeping, turn off all stimulation — from night lights to televisions to ticking clocks.
  • Sleep on a good quality mattress.
  • Watch for sleep apnea, especially if overweight — if suspected, get tested.
  • Take advantage of monitoring systems that can evaluate your sleep quality.
  • Avoid alcohol before bed — it disrupts sleep and can increase snoring.

To learn more about what you can do about sleep deprivation and sleep hygiene…

1. The International Association of Fire Chiefs offers a quick questionnaire and video training program to help us be more aware of our sleep deficits and opportunities.

2. has provided a comprehensive picture of sleep deprivation with additional list of preventative strategies.

3. Helen Regan’s Time article gives you a reader friendly version of the latest firefighter-sleep research. Regan also cites the original report at Sleep Review.

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