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First Responders Dying for a Good Night's Sleep

How long must we in emergency services ignore the mounting evidence that the lack of good sleep is killing us? We in the fire service tend to learn from our mistakes. Unfortunately, our mistakes can kill people.

It was mid-morning and we were on another medical call when the ambulance pulled up. In the front seat sat a good friend teching the call. I was amazed to see him because I thought I saw him just the day before working on the box. I asked him and he told me that he was on the last bit of a 72 hour shift. My friend looked very tired, and while I know he was incredibly competent as a medic, the first thing that ran through my mind was I didn't want him working on this patient, let alone driving an ambulance.

This is not a new problem with the Fire/EMS service. We have pushed, or allowed our crews to work dangerously long hours, with the hopes that they will be able to do their job competently and then get the rest they need to be fresh when they are due back next shift. But with poor pay (or no pay for our large volunteer force) many of our firefighters work another job just to make ends meet, sacrificing sleep for the service that they love. But are we in the fire service really gambling with their lives and the lives of the public?

Unfortunately it is no longer new news that staying up long hours has a dramatic effect upon our abilities. In a 2000 NIH study it has been shown that just staying awake 17-19 hours has the same effect as having a .05 blood alcohol content while staying up 24 hours has the same effect has having a .1 blood alcohol content. Who knew what the impairment of my friend was after coming to the end of a 72 hour shift? Combine that with the fact that 37% of us in the fire service have a diagnosable sleep problem and don't get good enough sleep even though we can be in bed for 8 hours a night.

In Robert Stickgold's article in the September 1998 edition of the EMDRIA newsletter, "Sleep, Memory, PTSD and EMDR" he makes the link between REM sleep and its effects on PTSD. Is it any wonder that with the stress of the job that studies have shown that upwards of 37% of firefighters have some level of PTSD. Not to mention that the number one killer of firefighters (heart disease) can be directly linked to poor sleep.

In his 2009 article "Sleep Deprivation: What does it mean for public safety officers?" Bryan Vila gives us 9 ideas that can be carried over to the fire service.

  1. Review policies that affect overtime, moonlighting and number of hours a person can work to make sure there is adequate rest time.

  2. Give our people a voice in decisions related to their work hours and shift scheduling.

  3. Formally assess the level of fatigue our people experience and properly train supervisors to be alert to overly tired people.

  4. Create a culture in which staff receive adequate information about the importance of good sleep habits and the hazards associated with fatigue and long shifts.Also teach strategies for managing good sleep.

  5. Stay physically fit, getting enough exercise and eating well.Also, I might add, getting a physical on a regular basis.

  6. Manage our use of caffeine and know when it should and shouldn't be used.

  7. Exercise proper sleep hygiene, trying to get seven or more hours of good sleep a night.This could include not watching TV before bed, limiting alcohol consumption and making our bedrooms a place to get good sleep.

  8. Allowing crews on long shifts to be able to get naps during shift as well as encouraging naps as part of a healthy lifestyle.

  9. If you continue to have sleep problems, consider talking to a sleep doctor. 37% of firefighters have some sort of diagnosable sleep problem.

As a chaplain I look at the sleep issue not only from the physiological/psychological side but also from the spiritual. In the book of Psalms God gives us a gentle rebuke and a reminder that sleep as a gift from Him.

Psalm 127:2 (MSG) It's useless to rise early and go to bed late, and work your worried fingers to the bone. Don't you know he enjoys giving rest to those he loves?

In our world who's mantra is "you can sleep when you're dead" we forget that sleep is a gift from our creator. It would seem that God declares that not only we need sleep, but somehow it is a good gift. It would seem that God knows something good here and wants to share it with us.

While I fully understand the nature of our business, that it calls us to make sacrifices at times and that sleep is sometime a luxury, we must be that much more intent to get our proper sleep. It is said that firefighters are "industrial" or "occupational" athletes and we should work out multiple times a week and watch our diet, but maybe we should add one more thing to our daily workout….a good night's sleep.

Chaplain Chris Wade

Vice President

South Carolina Public Safety Chaplains Association

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