THE BIOLOGY OF SLEEP
Every person needs a different amount of sleep to awaken feeling refreshed. Individual sleep requirements are genetic and may be hereditary. Scientists consider six to 10 hours of sleep a normal range, with most people requiring 7.5 to 8.5 hours of sleep in a 24-hour period. At least four to five hours of uninterrupted core sleep is necessary to maintain minimum performance levels. Sleep requirements may change slightly with age and can be affected by general health. Illness, stress, and depression cause the body to require more sleep to heal and recuperate.
WHAT IS SLEEP DEPRIVATION?
Sleep deprivation occurs when a person does not get sufficient amounts of quality sleep. Work demands, family life, and lifestyle choices may cause a person to sleep fewer hours than his body needs to maintain wakefulness and energy levels. In the Fire Service most of us to Shift work and have to interrupt the body’s natural wake/sleep cycle. Over time deprivation of sleep can have both an acute and cumulative effect on our bodies and minds.
THE EFFECTS OF SLEEP DEPRIVATION
Sleep loss is cumulative and creates a sleep debt. Larger sleep debts require greater amounts of restorative sleep to return the body and mind to normal, rested levels. Sleep deprivation affects mental processes and intellectual abilities. It reduces performance on challenging tasks and negatively affects psychomotor skills. Mood, productivity, and communication skills suffer. Extended periods without sleep may cause hallucinations and paranoia. Lack of sleep may slow glucose metabolism by 30 to 40 percent and increase levels of the stress hormone cortisol. Sleep deprivation has also been linked to inadequate levels of the hormone leptin. Leptin signals the body to stop eating when it’s full. Decreased levels of leptin lead to increased carbohydrate cravings and eating.
“Physical and mental performances are not the only casualties of sleep deprivation. Even a minimal loss of sleep impacts general health. Chronic lack of sleep can contribute to serious health problems and even shortened lifespan. In a 1983 study at the University of Chicago, rats kept from sleeping became sick and died after two and a half weeks. Sleep-deprived rats that became ill but were then allowed to sleep, recuperated fully.”
Other effects of chronic sleep deprivation include:
• Adult-onset diabetes
•Menstrual and infertility problems
•Increased use of drugs and alcohol
•Impaired sexual function
•Less satisfaction in personal and domestic pursuits
•Increased appetite and weight gain
•Personality changes, particularly loss of humor and increased ill temper.
COUNTERMEASURES AND COPING STRATEGIES
“Firefighters need to get an adequate amount of uninterrupted sleep every off-duty night”
Quality sleep is the primary weapon in the battle against sleep deprivation. Firefighters must take advantage of opportunities for sleep, both on and off duty. Sleeping areas at home and at the fire station should be quiet and dark, and the room temperature should be cool. A comfortable, good-quality mattress is a must. Invest in comfortable bedding and pillows as well. Good sleep habits are essential. Firefighters need to get an adequate amount of uninterrupted sleep every off-duty night. Going to sleep and waking up at the same times every day, even on weekends, is important for maintaining the body’s natural rhythms.
Other tips for quality sleep include the following:
- Avoid eating, reading, and watching TV in bed.
- Restrict caffeine intake, and avoid caffeinated drinks at least six hours before bedtime.
- Eat healthful foods. Do not eat large meals within four to five hours of sleeping.
- Do not use alcohol to induce sleep. The effects of alcohol-induced drowsiness last only a few hours and cause poor-quality sleep.
- Avoid long-term use of over-the-counter sleeping pills. Habitual use can reduce effectiveness and lead to addiction.
- Reduce life stress as much as possible.
- Use relaxation techniques to relieve stress and invite sleep.
- Exercise, but not more than four hours before bedtime. For 24-hour shift workers, outdoor exercise during daylight hours can help the body maintain natural biological rhythms and increase sleep quality off-duty.
- Napping is an effective coping strategy that can be used in anticipation of a long night or during extended operations. Naps as short as 20 minutes can be effective. Two-hour naps during around-the-clock operations are highly restorative.
- Daytime sleep after a night shift is essential to staying well rested, but trying to sleep when the rest of the world is awake can be challenging at best. The shift worker must emphasize to friends and family the importance of restorative sleep. Go as far as having daytime sleep scheduled on the family calendar along with ballgames, school meetings, and other activities.
- Melatonin may help promote better sleep, particularly during the day. However, this supplement is not FDA-approved, and current research is contradictory on short-term and long-term effects.
- People who are regularly unable to sleep should consult their physicians to rule out underlying health problems. Doctors may also be able to prescribe medication to help with sleep. Sleep disorders can be aggravated by shift work. Shift workers with diagnosed sleep disorders need to work closely with their physicians to effectively manage their disorder.
A great insomnia program is available through Mindability. Please click on the link to learn more.
This article is provided as a service by FireStrong.org
We recently published an article that identified some of the protective factors that help reduce the risk of Post-Traumatic Stress Disorder (PTSD) in career firefighters (here) but what about the risk of PTSD with those of you that are volunteer firefighters?
The National Fire Protection Association reported that there were “approximately 1,140,750 firefighters in the U.S. in 2013. Of the total number of firefighters 354,600 (31%) were career firefighters and 786,150 (69%) were volunteer firefighters.” (NFPA, 2014).
That is a huge number of you that volunteer day in and day out to interrupt your normal life at work or home at a moment’s notice and jump at the call to help your community. How do you go from responding to a call one minute and then immediately go back to whatever it was you were doing before you raced to the fire station? Unless you found this magic on/off switch on your body somewhere, (if you did, you should patent that right away), you can’t just shut it all off and go back to your life as it was right before a difficult call.
Many small town America fire departments can sometimes barely afford the equipment you need just to function let alone fund the support you would need following a horrific call.
This one hits home for me because I can remember like it was yesterday hearing my father’s pager go off in the next room, alerting not only him but the entire family that there was a crisis in our small town that needing rescuing. I can still hear the front door slam shut and hear his footsteps pound the sidewalk as he started to run the block down the hill to the volunteer fire station. Each time that pager went off, the men that volunteered for our small town quickly tossed off their hat of being a construction worker, farmer, banker, and ran to put on a helmet and gear. You always knew that our volunteer fire department was out there saving the day when you saw all the haphazardly parked cars and trucks belonging to our firefighters scattered along the street downtown. They got to the station as fast as possibly, never knowing what crisis was awaiting them, never knowing if they were rushing to help a neighbor, a friend or even a family member.
So, you put your life on the line as a volunteer, and your community would feel your absence if you weren’t there, right? Why is there such limited information out there on how this drastically impacts your mental well-being?
It appears that there has been a total of two, that’s right two studies on the effects of trauma on volunteer firefighters. It took a grad student in Ontario, Canada to publish one of them in 2010. Brad Campbell, a Seguin Township resident, a graduate of the School of Social Work at Laurentian University, conducted a two-year study of nine volunteer firefighters to help figure out how big of a problem this really is. His thesis can’t even be found online to see what this 95-page book says because it is probably tucked away on some dusty library shelf in Ontario. The big take away from his two-year study was this: volunteer firefighting psychological trauma remains overlooked.
I don’t think that comes as a surprise to most of you. If you are interested in reading the super short article about that, you can find it here.
Sometimes it doesn’t just stop at PTSD either.
The effects of PTSD can lead to even bigger and more permanent problems, such as taking your own life.
The Firefighter Behavioral Health Alliance (FBHA) is currently tracking the number of suicides each year for all firefighters, both volunteer, and career. Last year alone there were 112 suicides. Since the FBHA started tracking this information in 2012, there has been a total of 754 suicides.
We are talking about 754 avoidable firefighter deaths. Many of these suicides could have been prevented if there was help readily available, easily accessible, and perhaps even required. You can find more of this research at FBHA.
The reality here?
A volunteer firefighter has an increased chance of struggling with PTSD. It could be assumed that the volunteer has an even greater chance than that of a career firefighter because the protective factors are not in place as they are with career firefighters.
Now imagine responding to call where a teenager has been ejected from a vehicle, you are first one scene, and the teen is a mangled corpse. You place her human remains into a body bag, finish the call, and return home to wash the blood off your clothes just in time to enjoy dinner with your family and the 6:00 news.
This scenario, which is common among volunteer firefighters, highlights the need for intervention. Encourage your volunteer fire department to take the initiative for all their members. PTSD support should be a priority for every department.
PTSD isn’t about what’s wrong with you, it’s about what happened to you.
There are resources out there for volunteers. The National Volunteer Fire Council (NVFC) has teamed up with the American Addictions Center (AAC) to offer you and your family a free and confidential helpline. You can call 1-888-731-FIRE 24 hours a day, seven days a week and 365 days a year. The person that answers the phone knows what you are going through, has been there, and has the resources to help you. You can also access more help, training, and resources for not only you but your entire department by visiting http://www.nvfc.org/.
There are a lot of you out there. Each and every one of you deserves to be taken care of just as you take care of your friends, your neighbors, members of your community, and complete strangers.
At the end of the day, this isn’t a new problem. PTSD is an issue that has existed since the dawn of firefighting and other traumatic events. The psychological impacts just haven’t been fully considered until recently. It seems; however, there is a stronger focus on career firefighters while less of an open and verbal concern for volunteers.
You answer the call to help others at a moment’s notice, and many of you may believe that since you are there to help others, you can’t reach out for help yourself. You don’t have to be a statistic; you can get the help you need. Talk to someone, talk to anyone, your life is just as valuable as the person you are rescuing when the alarm goes off.
PTSD is real, and it needs everyone’s attention.
Have you heard of the Mind-Body Connection?
It is a term used to describe the interconnectedness between our emotions and our physical health.
When you are emotionally stressed or anxious, especially for a prolonged period of time, it often has a negative impact on your health. Numerous research studies have shown that stress can cause and/or worsen physical conditions such as:
- High blood pressure
- Chest pain
- Back pain “physical injury, illness, or pain can impact your mood”
- Sleep problems (e.g. insomnia)
- Sexual difficulties
- Gastro-intestinal problems
- A weakened immune system
Likewise, you may have experienced first hand how a physical injury, illness, or pain can impact your mood. If our bodies are “sick”, we worry about a number of things including:
- How long it will take to get better?
- Will I have to go on light duty?
- Will I have to stop working out or limit my physical activity?
- Will I be a burden to those around me?
The Good News
The good news is that there are several things we can do to improve our mental and physical health when it comes to these matters. Relaxation techniques always help.
First, if you’re feeling stressed or anxious you can contact FireStrong.org Crisis Support Line 1-844-525-FIRE (3473).
If you want to hear more about how can work for you, follow this link to a podcast that explains the Mind-Body connection, and some strategies to calm your body and mind to prevent or eliminate physical symptoms. Autonomic Podcast
Next, the link below is to the American Psychological Association website that cites some fascinating research about the Mind-Body Connection. For instance, did you know:
- Stress is linked to the six leading causes of death – heart disease, cancer, lung ailments, accidents, cirrhosis of the liver, and suicide. (“The Stress Solution: An Active Plan to Manage the Stress in Your Life,” Lyle H. Miller, Ph.D. and Alma Dell Smith, Ph.D.)
- People with high levels of anxiety can have between two to seven times the risk of heart disease. (“Emotional Longevity: What Really Determines How Long You Live,” Norman B. Anderson and Elizabeth P. Anderson, 2003)
- Two-thirds of all office visits to family physicians are due to stress-related symptoms (American Academy of Family Physicians)
Learn more about this research at http://www.apa.org/helpcenter/mind-body.aspx
- Stay Strong – Be smart about your body and your mind!
- Chances are high that this will directly affect you or a loved one during your lifetime !
Post Traumatic Stress Disorder (PTSD) is an anxiety disorder that can occur after someone experiences a traumatic event that caused intense fear, helplessness, or horror. PTSD can result from personally experienced traumas (e.g., rape, war, natural disasters, abuse, serious accidents, and captivity) or from the witnessing or learning of a violent or tragic event.
- While it is common to experience a brief state of anxiety or depression after such occurrences, people with PTSD continually re-experience the traumatic event; avoid individuals, thoughts, or situations associated with the event; and have symptoms of excessive emotions.
- People with this disorder have these symptoms for longer than one month and cannot function as well as they did before the traumatic event.
- PTSD symptoms usually appear within three months of the traumatic experience; however, they sometimes occur months or even years later.
Although the symptoms for individuals with PTSD can vary considerably, they generally fall into three categories:
– Individuals with PTSD often experience recurrent and intrusive recollections of and/or nightmares about the stressful event. Some may experience flashbacks, hallucinations, or other vivid feelings of the event happening again. Others experience great psychological or physiological distress when certain things (objects, situations, etc.) remind them of the event.
– Many with PTSD will persistently avoid things that remind them of the traumatic event. This can result in avoiding everything from thoughts, feelings, or conversations associated with the incident to activities, places, or people that cause them to recall the event. In others there may be a general lack of responsiveness signaled by an inability to recall aspects of the trauma, a decreased interest in formerly important activities, a feeling of detachment from others, a limited range of emotion, and/or feelings of hopelessness about the future.
– Symptoms in this area may include difficulty falling or staying asleep, irritability or outbursts of anger, difficulty concentrating, becoming very alert or watchful, and/or jumpiness or being easily startled.
Risk Factors for Firefighters
A few studies have also looked at what factors might put firefighters at greater risk for the development of PTSD. A number of risk factors for PTSD among firefighters have been identified. These include:
- Being previously in treatment for another disorder.
- Starting work as a firefighter at a younger age.
- Being unmarried
- Holding a supervisory rank in the fire service.
- Proximity to death during a traumatic event.
- Experiencing feelings of fear and horror during a traumatic event.
- Experiencing another stressful event (for example, loss of a loved one) after a traumatic event.
- Holding negative beliefs about oneself (for example, feeling as though you are inadequate or weak).
- Feeling as though you have little control over your life.
Protective Factors for Firefighters
- Even though firefighters might be at high risk for stress as a result of their jobs, it is important to point out that most firefighters will not develop PTSD. In fact, several factors have been identified that may reduce the likelihood of developing PTSD among firefighters after the experience of multiple traumatic events.
- One of the most important protective factors found was having social support available either at home or through work.
- In addition, it has also been found that having effective coping strategies available may lessen the impact of experiencing multiple traumatic events.
- This is not surprising in that, among people in general, the availability of social support and effective coping strategies have consistently been found to reduce the risk for developing PTSD following a traumatic event.
For Information on Treatment Please visit FireStrong.org
To learn what Fire Strong is all about check out their introduction here
Firestrong is an independently operated online resource for members of the Fire Service and their families. The mission of Firestrong is to offer mental, emotional, and physical support to each member of the fire department and their families by providing educational tools, resources, crisis intervention assistance (crisis line) and peer support services.
- 24/7/365 Independent Fire Crisis Network Line: 602.845.FIRE (3473)
- Mental health information and assessments
- Peer support and testimonials with confidentiality
- Live online chat with professionals
- Counseling & what to expect FAQs
- Free counseling services contact our Experts tab on the Landing page
- Online self help tool through a partnership with Mindability
- Education regarding current medical insurance mental health benefits
- Resources for financial fitness
- Legal backup options
- Crisis Intervention steps
- Member and family services
- Free mental wellness assessments
Firestrong overall goals:
Firestrong.org is designed to be a point of reference for fire service members and their families. Most of this site is available to anybody and is not restricted in anyway. However, departments can use this site as a starting point for their members and have their departments personalized resources placed on this site for additional support. Interested departments should contact us for more information.
Firestrong can also offer a tailor log-in for your department:
- Secured log-in for your members to gain access to a variety of your tools including testimonials
- Placement of your departments logo within the site
- Marketing tools
- Ongoing informational updates and upkeep of websites resources and social network
- Access to Mindability, an online self-help, self-paced program designed to build resilience in your members
Future goals include:
- Ongoing Research for Retiree education
- Ongoing resiliency training