Chief Leader – November 25, 2014
by SARAH DORSEY
Many U.S. firefighters aren’t sleeping as well as their counterparts outside the firehouse—and their higher rates of car accidents and other health problems may be related, according to a new study.
Researchers at Brigham and Women’s Hospital in Boston surveyed almost 7,000 firefighters nationwide, most of them professionals, about sleep disorders including obstructive sleep apnea, insomnia, shift-work disorder and restless-leg syndrome.
Just over 37 percent reported at least one of the disorders, and more than 80 percent of those had been undiagnosed. Occupational Hazard
Uniformed Fire Officers Association President James Lemonda said in response to the study, “The medical and scientific evidence doesn’t surprise me due to the nature of Firefighters’ and fire officers’ work. We’re certainly put under a lot of stress, and it comes as no shock that there’s a direct correlation to sleep apnea and sleep disorders.”
Firefighters on both regularly scheduled 6 p.m. to 9 a.m. tours and periodic 24-hour shifts are sometimes going out on runs in the middle of the night. Worse, they’re often awakened out of a sound sleep to shift immediately into adrenaline mode, rushing into a potentially life-threatening situation.
The researchers asked about the firefighters’ overall health, how often they had motor-vehicle accidents or near misses, or started to fall asleep while driving. They found that cardiovascular disease, diabetes, depression and anxiety were more common among subjects with sleep disorders. They were also more likely to fall asleep while driving or to get into an accident.
Tough to Compare
Laura K. Barger, a physiologist at Brigham and Women’s Division of Sleep and Circadian Disorders, said that though the percentage of firefighters with sleep disorders is high, it’s not clear exactly how common the ailments are in the general population. Landmark studies conducted two decades ago showed much lower rates, but better detection methods today would likely boost those numbers.
In addition, certain types of sleep disorders like apnea are correlated with excess weight. About 80 percent of the firefighters in the study had body-mass indexes of 25 or higher, which means they were either overweight or had very high muscle mass.
Because Americans have gotten fatter in the last 20 years, we can expect rates of apnea to be higher today, Ms. Barger said.
Nationwide, cardiovascular disease and motor-vehicle crashes are the two leading causes of death for firefighters. According to the U.S. Fire Administration, heart attacks or strokes caused by the stress or overexertion of firefighting are “the major cause of death” among firefighters, often during a run or within 24 hours of completing one.
Important to Screen
The Brigham and Women’s study, supported by a Federal Emergency Management Agency grant, may indicate that occupational screening for sleep disorders could save lives, according to Dr. Charles Czeisler, who heads the Sleep and Circadian Disorders Division.
Dr. Barger and her researchers completed a study in 2011 showing similar results among 5,000 U.S. police officers, many of whom also work night shifts under unpredictable and stressful conditions.
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