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The Effects of Sleep Deprivation of 
Firefighters, Police Officers and EMS Workers


One of the first things requested after an accident of any kind are training schedules and hours worked for the people in question.  As far as criminal charges, in New Jersey, there is a law known as Maggies law that provides that a knowingly fatigued driving (one that has been up for 30 consecutive hours) who causes a fatal accident can be convicted of vehicular homicide. 

Firefighters, police officers, and other emergency workers have a higher-than-average rate of sleep disorder.  According to the 21st Annual Meeting of the Associated Professional Sleep Societies a self-report survey has been done of 4,471 police officers that included screening for obstructive sleep apnea (OSA), insomnia, restless legs syndrome (RLS), shift work sleep disorder and narcolepsy with cataplexy.  The survey revealed a high incidence of sleep disorders among police officers.

Sleep disorders are common often remain undiagnosed and untreated. Unrecognized sleep disorders adversely affect personal health and may lead to chronic sleep loss, which, can increases the risk of accidents and injuries. These problems are exacerbated in firefighters, police officers and EMS workers, who may experience chronic sleep loss due to their schedules. "Sleep disorder screening and treatment programs may potentially improve police officer health, safety and productivity." said Rajaratnam, the study author Shantha M.W. Rajaratnam, PhD, of Harvard Medical School,


FACTS:

The average adult needs 6-10 hours of sleep per night. Sleep cycles typically last 90 minutes each, and an individual adult has 4-5 per night. 75% of sleep is non-REM (physical repair) sleep and 25% is REM (mental repair) sleep.

The average sleep time for most American adults is 6.8 hours.

Acute sleep deprivation: less than 4 to 6 hours of sleep in a 24 hour period.

Sleep debt: when individuals repeatedly do not get a good nights sleep. Decreasing sleep time by one hour a night for seven
           consecutive nights is equal to staying up for 24 hours straight for once a week.

Immediate effects of sleep deprivation:
          1.  Small amounts of sleep loss can be very dangerous. In one study, sleepy people acted just like drunk people when behind the
               wheel of a car.
          2.  A reduced ability to stay alert
          3.  Performance not stable
          4.  Make errors
          5.  Thinking is impaired
          6.  Inability to sense how tired you are

Chronic effects of sleep deprivation:
          1. Associated with irritability, depression, and a reduced sense of well-being.
          2. Physical effects on firefighters/EMTs particularly [which also happen to be health problems associated with sleep deprivation and    
              fatigue]; Musculoskeletal injuries, Heart disease and Cancer

1/3 of sleep-related crash drivers said they were not aware they were fatigued prior to the crash.  

A per-night sleep average of less than six hours/night is comparable to smoking a pack of cigarettes per day.

Heart disease (also the number one killer of firefighters).  Weight gain and obesity as lack of sleep produces hormonal changes leading to weight gain.


Sleep Deprivation Related Studies from Transit-Related Professions
 (trucking, shipping, air transport):

Approximately 30% of crashed and other accidents are fatigue related.

Typically in a sleep related crash, there is no indication of braking or other attempts to avoid the crash, the driver is often alone, they occur on higher-speed roadways, and serious injuries are more common.

Employed drivers in sleep-related crashes were twice as likely to work two jobs.

Untreated obstructive sleep apnea (OSA) increases the risk of single car crashes between seven and twelve fold.

Many regulations now require testing for OSA before commercial truck drivers are hired.  They also reviewed data from highly studied groups such as medical residents, interns and nurses, regarding the impact of shift work and long hours without sleep and found:

           a.  Long hours compromise both patient safety and the medical staffs overall health.
           b.  Interns and residents were two times more likely to be involved in a car accident on the way home from a long work day.
           c.  There were five times more errors on long hour schedules (24+) versus shorter schedules (12 hours).


Recommendations
Individuals

Exercise daily
Have 5-9 servings of fruits and vegetables per day
Limit intake of saturated and trans-saturated facts
No tobacco use
Maintain a healthy body weight


Sources:
1.http://www.iafc.org/displaycommon.cfm?an=1&subarticlenbr=559
2.http://www.sciencedaily.com/releases/2007/06/070612075008.htm

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