Combatting Sleep Deprivation for First Responders
“The woods are lovely, dark and deep.
But I have promises to keep.
And miles to go before I sleep...
and miles to go before I sleep.”
Robert Frost “Stopping by Woods on a Snowy Evening”
Across the board Emergency Services are seeing drops in team members due to funding deficits in this “new economy” we’re experiencing.
The demands are going up with fewer “hands to the pump.” This is occurring at a time when natural disasters and wildfires are happening at epic proportions, and crime continues to happen as always. Tours-of-duty are not getting any easier / safer for those on the ground. Required overtime, non-stop shifts running from one call to the next, increases in stress, poor diet, irregular mealtimes...these and more can all contribute to a deficit in sleep and this can then cause LE / First Responders to lose their edge when out on duty.
Research shows that task performance drops during the early morning hours. Likewise, performance declines on shifts that go beyond 8 hours, especially for workers who must do physically and/or mentally demanding or repetitive tasks (Everly, 2002).
All of these concerns require a “thinking outside the box” approach to shift designs as well as to a re-tooling for possible options that can help Police, Fire, Paramedic and ER Staff to maintain optimum performance and safety in the face of a time that has brought with it some of the highest levels of job demand ever before seen.
For Starters My Top 3 “Pet Peeves”:
There is no “perfect” 24-hour Emergency / Law Enforcement shift pattern but there are some things that can make some more problematic/ risky than others. Here are a few that top my list of “pet peeves”:
1. Mixing “earlies” with “lates”.... dramatically interrupts the body’s ability to set its adaptive cercadian rhythm. This dramatically derails the brain’s ability to move through all of the 5 necessary phases of sleep to allow the body and brain to replenish. It takes the body 1 day to adjust for every hour of sleep delay. In other words, if you stay up 2 hours later on weekend nights then you won’t have normalized sleeping patterns return until Wednesday night.
2. Shift changes that go “counter-clockwise”.... We humans do far better when we’re starting a new shift at a later time vs an earlier one. Moving forward with the clock vs backward is a far easier shift transition for the body and the brain to make (think of Daylight Saving Time...is it easier to fall back or spring forward by 1 hour?).
3. Shift Patterns that disallow built-in “overlap”.... (i.e. one team overlapping another during shift changes / oncoming team briefings/times of higher demand) as well as the regular integration of training.
“The Early Bird Gets the Worm, but the 2nd Mouse Gets the Cheese”
(Most likely because he caught a “power nap” @ 3:00 AM):
Consider integrating optional sleep breaks on night duty shifts as discussed in Force Science News (4/09’s transmission):
Research has shown that allowing for a 30-40 minute break in a quiet location during a night shift (typically “graves” which run from the approx. 21:00-7:00) can significantly increase performance for shift nappers vs non nappers...
“They reported “more vigor, less fatigue, and less sleepiness” than those who had worked without napping. Moreover, the nappers were able to more quickly complete a simple job-performance task (the simulated insertion of a catheter IV) and exhibited “less dangerous driving,” although both groups showed signs of driving impairment after working overnight.
The only negative outcome evident in the nappers was a temporary worsening of memory “immediately after the nap.” This was attributed to sleep inertia, “the feeling of grogginess…that can persist for up to 30 minutes after awakening.”
Generally, “nap intervention provided beneficial effects,” the researchers noted, and planned naps in the workplace might well “promote a high level of alertness, attention to detail, and decision-making proficiency.”
[A full report of this study appears in the Nov. 2006 issue of the Annals of Emergency Medicine, under the title "Improving Alertness and Performance in Emergency Dept. Physicians and Nurses: the Use of Planned Naps," (Listed below)
Worthy of Consideration
Here is a list of possible options to consider forwarding, that could help officers who are “working midnights.: These come out of the FBI July 2001 article by Glory Cochrane, M.S. on the Effects of Sleep Deprivation, “Focus on Performance”):
• Devising an overtime timesheet that officers must submit in conjunction with their regular timesheet to allow immediate supervisors to assess and handle excessive overtime before it becomes a problem;
• Soliciting better cooperation from the district courts in devising better-suited court schedules for night shift officers;
• Offering classes that guide officers on how to cope with shift work, recognize and understand the symptoms and effects of sleep deprivation, and avoid the problems associated with it;
• Ensuring classes and other opportunities (e.g., training, firearms ranges, and physical exams) are available to officers working the night shifts;
• Allowing the department repair shops (e.g., automobile, radio) to remain open later to allow night shift officers access either before or after their shift;
• Keeping all work areas freshly painted, clean, and bright, which can promote heightened alertness, better moods, and increased productivity;
• Ensuring vending machines throughout the department offer an assortment of healthy products (e.g., juice and low fat or natural snacks);
• Increasing contact with night shift workers; and...
• Videotaping mandatory meetings to allow night and swing shift employees to view them on their regular shifts.
PLEASE NOTE: Sgt. Betsy Brantner Smith (Ret) a reporter / author of PoliceOne.com notoriety, has an extremely useful article on more Office Fatigue Coping Options...Please Check out the 2nd Article in the list below...
Some Links / Articles to Get You Thinking:
http://www.forcescience.org/fsinews/2007/04/snooze-you-lose-actually-the-opposite-may-be-true/
http://www.policeone.com/health-fitness/articles/1960200-Fatal-fatigue/ (8/24/09 PoliceOne News Ltr)
http://www.aele.org/law/2010all06/2010-06MLJ501.pdf Force & Fatigue: Threshold The Point of No Return
http://www.fbi.gov/publications/leb/2001/july2001/july01leb.htm Page 23
http://www.fbi.gov/publications/leb/2007/jan2007/jan2007leb.htm
http://www.fbi.gov/publications/leb/2007/august07/august07leb.htm Page 1
R. Smith-Coggins, S. Howard, D. Mac, C. Wang, S. Kwan, M. Rosekind, Y. Sowb, R. Balise, J. Levis, D. Gaba; “Improving Alertness and Performance in Emergency Department Physicians and Nurses: The Use of Planned Naps,” Annals of Emergency Medicine, Volume 48, Issue 5, Pages 596-604.e3
N. Lamond and D. Dawson, “Quantifying the Performance Impairment Associated with Fatigue,” Journal of Sleep Research 8 (1999): 255-262
Y. Harrison and J.A. Horne, “The Impact of Sleep Deprivation on Decision Making: A Review,” Journal of Experimental Psychology Applied 6 (April 2000):236-249.
J.M. Violanti & C.M. Curchfiel, et al, “Atypical Work Hours and Metabolic Syndrome Among Police Officers (See reference & abstract below) http://www.heldref.org/pubs/aeoh/about.html
Archives of Environmental and Occupational Health
Issue: Volume 64, Number 3 / 2009
Pages: 194 - 201
URL: Linking Options DOI: 10.1080/19338240903241259
Atypical Work Hours and Metabolic Syndrome Among Police Officers
John M. Violanti AF0001, Cecil M. Burchfiel AF0002, Tara A. Hartley AF0002, Anna Mnatsakanova AF0002, Desta Fekedulegn AF0002, Michael E. Andrew AF0002, Luenda E. Charles AF0002, Bryan J. Vila AF0003
AF0001 Department of Social and Preventative Medicine, School of Public Health and Health Professions, State University of New York, Buffalo
AF0002 Biostatistics and Epidemiology Branch, Health Effects Laboratory Division, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Morgantown, West Virginia
AF0003 Criminal Justice Program and Sleep and Performance Research Center, Washington State University, Spokane, Washington
Abstract
This study examined whether atypical work hours are associated with metabolic syndrome among a random sample of 98 police officers. Shift work and overtime data from daily payroll records and reported sleep duration were obtained. Metabolic syndrome was defined as elevated waist circumference and triglycerides, low HDL cholesterol, hypertension, and glucose intolerance. Multivariate analysis of variance and analysis of covariance models were used for analyses. Officers working midnight shifts were on average younger and had a slightly higher mean number of metabolic syndrome components. Stratification on sleep duration and overtime revealed significant associations between midnight shifts and the mean number of metabolic syndrome components among officers with less sleep (p = .013) and more overtime (p = .007). Results suggest shorter sleep duration and more overtime combined with midnight shift work may be important contributors to the metabolic syndrome.
Keywords
cardiovascular disease, overtime, police officers, shift work, sleep
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Photo by: Karen Lansing
Taken @ Bramshill in the Autumn
The woods are lovely, dark, and deep.
But I have promises to keep,
And miles to go before I sleep,
And miles to go before I sleep.
~Robert Frost~
Overdrawn on the Sleep Account