Sleep 101 for First Responders (Firefighters, EMTs, Medics)
It can be a challenge. But here are some reasons and ways to improve sleep as a first responder.
As first responders, we understand that our commitment to public safety comes with hefty responsibilities and diverse challenges. We tirelessly work in the front lines, acting as the immediate helping hand when emergencies arise. While our role is undeniably rewarding, the strain placed on our physical health and mental well-being is unparalleled. A critical aspect of this strain, overlooked more often than not, is sleep -- or, quite frankly, the lack thereof.
Quality sleep is fundamental for everyone, but it is particularly essential for us, the first responders. Why, you might ask? Our work involves critical and often life-saving decisions within extremely restricted timeframes. To function at our best, we need a well-rested mind and body.
Let's take a page out of science to underscore the importance of sleep. According to the National Sleep Foundation, adults should aim for 7 to 9 hours of sleep per night. This rest period enables essential body functions like healing and repair of muscles, memory consolidation, and restoration of energy reserves. A lack of sleep can result in slower reaction times, reduced concentration, and weakened immune systems, which can hinder our performance and response. It can also severely affect our mental health, contributing to ongoing stress, anxiety, and even post-traumatic stress disorder (PTSD).
As a first responder, getting the recommended 7-9 hours is not always possible. The nature of our shift work often disrupts our circadian rhythm, the internal "body clock". Following this disrupted pattern, many of us have experienced 'burnout' - the excessive and prolonged stress that comes when we constantly wield the 'always ready' mindset, balancing long shifts, irregular hours, and frequent overtime.
Not to worry. The strongest influence on your mental and physical health may be your sleep quality rather than the quantity. Studies on soldiers and nurses demonstrate that those who slept less than 6 hours, but experienced quality sleep (meaning more deep and REM sleep), did not suffer the same negative effects seen with short sleep. So what does it mean to improve sleep quality, and how do you do it?
What can be done about this, you might wonder? Here are some great strategies we, as first responders, can incorporate to better our sleep health and overall well-being:
- Create a Consistent Sleep Schedule: First responders often have unpredictable work schedules, which can disrupt their sleep. As hard as it can be with shift work, try to maintain a routine. Prioritize sleep where possible. Try to stick to a consistent sleep schedule as much as possible, even on days off. Regular sleep hours can help program the body's internal clock to set a routine, promoting better sleep overall. I have been trying to get powered down around 10 pm every night.
- Design a Sleep-Friendly Environment (sleep cave): Your sleep environment significantly impacts sleep quality. The room should be dark, quiet, and cool for optimal sleep conditions. Consider using earplugs, a sleep mask, a white noise machine (or other noises), or a fan to create an environment that fosters uninterrupted sleep.
- Monitor Your Diet and Exercise: Avoid consuming large meals, caffeine, and alcohol close to bedtime as these can disrupt sleep quality. Regular physical activity can help reduce stress and anxiety, contributing to better sleep. Aim for at least 30 minutes of moderate exercise most days. Try to give yourself a caffeine curfew and not intake any caffeine after 3 or 4 pm.
- Limit Napping: While napping might seem like a good way to catch up on missed sleep, long or frequent naps during the day can disrupt your nighttime sleep schedule. If you choose to nap, try a 20-30-minute coffee nap (click here for more info) and make it in the early afternoon.
- Manage Stress: High-stress levels can lead to insomnia or other sleep disturbances. First responders should invest time in stress management techniques, like meditation, deep breathing exercises, yoga, or hobbies that can help relax the mind and body. Try the 5+1=6 breathing technique (click here).
- Seek Professional Help: If sleep problems persist, it can be beneficial to consult with a sleep specialist. They can diagnose potential sleep disorders, like sleep apnea or insomnia, and provide treatment options. Sleeping is a skill and sometimes coaching can help. There are some programs dedicated to sleep education and training, one organization that I like is 62Romeo.com and a great website for education is the Harvard Medicine Division of Sleep Health website.
Our work calls for resilience, strength, and adaptability, and good quality sleep forms the cornerstone of attaining and maintaining these attributes. Let’s shift the narrative and bring sleep to the forefront of our conversations. We need to address this vital element to ensure our basic wellness and zeal for the duties are preserved.
Remember, it's not only about the efficiency of our service but how well we take care of ourselves while serving. A well-rested first responder is a more effective one. Your sleep matters. Let’s prioritize it not only for our sake but also for those who depend on us every single day.
Sleep well, serve better. Make efforts towards better sleep health.
Stay safe and resilient,
Aaron Zamzow (Zam)
An extra note on Sleep.
Sleeping is a period for unwinding and rejuvenation, not a time for anxiety. Therefore, aim to maintain some flexibility with your sleep routine and avoid becoming too rigid about adhering to these guidelines. I like to view it as an 80-20 strategy. 80% of the time, I adhere to my sleep regimen, while 20% of the time, I may deviate from it slightly. For instance, if you have visitors in town, you might have a later dinner, stay up past your usual bedtime, or consume alcohol in the evening. It's okay! A night or two of less-than-ideal sleep is perfectly acceptable. The problem occurs when that becomes your norm…
Resources
Alves S, Vaz J, & Fernandes A. (2023). Exploring Clinical Trials to Manage Firefighters’ Sleep Quality: A PRISMA Compliant Systematic Review. International Journal of Environmental Research and Public Health, 20(5). https://doi-org.libraryresources.columbiasouthern.edu/10.3390/ijerph20053862
Breus, M. (2022, December 13). Sleep Quality vs. Sleep Quantity. The Sleep Doctor. Retrieved June 7, 2023, from https://thesleepdoctor.com/how-sleep-works/sleep-quality/
How Much Sleep Do I Need? (2022, September 14). Centers for Disease Control and Prevention. https://www.cdc.gov/sleep/about_sleep/how_much_sleep.html
Poston WS, Haddock CK, Jahnke SA, Jitnarin N, Day RS. An examination of the benefits of health promotion programs for the national fire service. BMC Public Health. 2013; 13: 805.
Romero Cabrera JL, Sotos-Prieto M, García Ríos A, Moffatt S, Christophi CA, Pérez-Martínez P, & Kales SN. (2021). Sleep and Association With Cardiovascular Risk Among Midwestern US Firefighters. Frontiers in Endocrinology, 12, 772848. https://doi-org.libraryresources.columbiasouthern.edu/10.3389/fendo.2021.772848
Sullivan, J. P., Barger, L. K., W. Rajaratnam, S. M., Czeisler, C. A., Lockley, S. W., & Group, S. (2017). Randomized, Prospective Study of the Impact of a Sleep Health Program on Firefighter Injury and Disability. Sleep, 40(1). https://doi.org/10.1093/sleep/zsw001