Term Paper: Altered Sleep Wake Schedules Regarding Firefighters or First Responders

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¶ … human body have revealed new information about the importance of specific functions such as sleeping. Although sleep has always been noted to be an important component of human functioning, research into this process demonstrates that sleep provides individuals with notable benefits, including the ability to repair significant internal damage. With this in mind, it is not surprising to find that researchers have begun to focus on the problems that can arise when individuals experience sleep deprivation. This phenomenon can be readily studied in subjects that endure prolonged hours of work. Through research in this area, scholars are now able to compare outcomes for subjects that receive "normal" levels of sleep which subjects that are essentially sleep deprived.

Given the importance of sleep to the development and maintenance of the human body, there is a direct impetus to better understand the outcomes that result when an individual becomes sleep deprived. Using this as a basis for investigation, this research considers how prolonged hours of work and sleep deprivation impact outcomes for the individual. Specifically, this research considers altered sleep-wake schedules for firefighters and first responders. Through a careful review of what has been noted on these subjects, it will be possible to provide a more integral understanding of the problems that can arise when individuals do not acquire enough sleep.

Literature Review

Prolonged Hours of Work and Sleep Deprivation

In order to begin this investigation, it is first helpful to consider what has been note about the scope and impact of prolonged hours and their impact on the individual with regard to sleep deprivation. A critical review of what has been reported on this subject demonstrates that there are a myriad of ways in which this issue can be addressed. Research has focused on both the physiological impacts as well as the overall impact of sleep deprivation on work performance. Examining first the physiological impact of sleep deprivation on the body, Kushida (2005) reports that sleep deprivation can create a cascade of events which make it difficult for the body to function properly. Kushida reports that sleep deprivation impacts almost every aspect of physiological functioning altering cardiovascular, respiratory, gastrointestinal, renal, integumentary, neurological, immunological and endocrine function. Researchers have found that sleep induces certain physiological changes that are needed to improve the function of the human body. Thus, when sleep deprivation occurs, changes in the overall function of most bodily systems occur.

Akerstedt and Nilsson (2003) have also considered the physiological impact of sleep deprivation on the human body. Specifically, these authors considered separate areas of human function and development to elucidate the overall impact that sleep deprivation can have on the human body. The results of this investigation are as follows:

Mortality: Akerstedt and Nilsson report that individuals with dramatically lower sleep amounts -- i.e. 3-4 hours less per night than the 8-hour average -- mortality rates were noted in the data.

Morbidity: Poor sleep has been widely associated with the development of myocardial infarction. In women that have had a heart attack, the risk for a second heart attack is increased for individuals that do not sleep well (Akerstedt & Nilsson, 2003).

Metabolism: Akerstedt and Nilsson report that sleep can impact Metabolism. Because various sleep states are associated with the release and uptake of specific hormones, sleep deprivation can prevent these events from occurring. This can lead to a decrease in metabolism, which in turn can lead to an increase in obesity.

Immune System: Akerstedt and Nilsson also report that sleep deprivation impacts the immune system. During sleep white cells in tissue increase, improving the body's immune system response. In individuals that are sleep deprived, this build-up of white blood cells does not occur.

Clearly, the data presented by Akerstedt and Nilsson (2003) demonstrates the overall importance of sleep to improving the function of the human body.

Considering next the impact of sleep deprivation on the overall work performance of the individual. Kenyon (2007) examined the results of a nursing survey in which professionals that were on call were asked about their experiences. Kenyon reports that while most nurses start their shifts well rested, those that are required to remain on the job for 12 hours or more often begin to experience symptoms of sleep deprivation. Explicating the symptoms that accompany this experience, Kenyon makes the following observations. Sleep deprivation results in: "increased anxiety, decreased short-term memory, slowed reaction time, decreased work efficiency, reduced motivational drive, decreased vigilance, increased variability in work performance, an] increased errors of omission which increase to commission when time pressure is added to the task" (p. 631). The end result in this case, argues Kenyon, is a greater chance of error and greater risk taking behavior. Similar results have been reported elsewhere in the literature (Residency programs..., 2007).

Akerstedt, Fredlund, Gillberg, and Jansson (2002) have also considered the impact of sleep deprivation on workplace performance. Specifically, these authors considered fatal occupational accidence and their relationship to both sleeping difficulties and occupational factors. According to these authors, while the link between sleep deprivation and occupational accidents has not been widely investigated in the literature, anecdotal evidence suggests that there is a direct link between the two. In particular, these authors report that: "Disturbed sleep because of night work or long hours has been implicated in several major accidents, such as the nuclear plant accidents at Three-Mile Island and Chernobyl, as well as in transport disasters such as the grounding of the oil tanker Exxon Valdez" (p. 69). Despite this research however, few studies have attempted to make a quantitative link between occupational accidents and sleep deprivation.

In an effort to address this gap in the literature, Akerstedt, et al., (2002) surveyed a national sample of 47,860 individuals over the course of a 20-year period. During this time period a total of 166 fatal occupational accidents occurred. Accident data was correlated with a host of variables to determine the impact of sleep deprivation in these incidents. The variables included: gender, relative risk, difficulties in sleeping, shift work or non-day work, age, socioeconomic status, hectic work, overtime and strenuous work. The results of the investigation demonstrate that self reported disturbed sleep was a statistically significant predictor of accidental death at work. Other variables of significance in this research included gender -- men rather than women were more likely to die in workplace accidents -- and non-day work -- a majority of accidents occurred during shift work which took place in the evening or at night. These results clearly demonstrate the impact that sleep deprivation can have on outcomes for the individual and the workplace.

Firefighters and First Responders

Because the central focus of this investigation is firefighter and first responders, it is helpful to consider what has been noted about the impacts of prolonged hours on these professionals. In order to begin this portion of the investigation, it is first necessary to consider a review of the circumstances which encompass the working conditions experienced by firefighters and first responders. Takeyama (2005) in his review of working conditions in firefighting makes the following observations:

Firefighters must be on duty 24 h a day to handle unexpected emergencies. The duty of firefighters is characterized by their heavy social responsibility and the various risks they encounter in fire extinguishing and lifesaving activities. These activities also expose them to some critical risk factors and impose a high psycho-physiological workload. Firefighting and lifesaving activities are very strenuous. Previous studies have indicated that firefighting is more stressful due to sudden alarm calls after a long period of relative inactivity as well as to the burden of social responsibility and the risks associated with firefighting (p. 1).

Takeyama goes on to report that, in most instances, firefighters do not receive enough sleep; however, the overall impact of this working environment has not been widely investigated by researchers.

While the data presented above on the impact of sleep deprivation and work outcomes clearly demonstrates the negative impact that prolonged work hours can have on the development of sleep deprivation and outcomes for both the individual and the organization, a review of what has been noted about how these issues impact firefighters and first responders is also warranted. Although research on this topic is scant, there are some reports which provide insight into the issue and its overall impact. For instance, Sollecito (2007) reports that a recent study conducted on "employees regularly working evening and night shifts in 24/7 operations" demonstrated that, "These workers...tend to consume more cigarettes, caffeine and other stimulants than their daytime counterparts, with more than double the rate of smoking. These workers account for about 18% of the total workforce" (Extended hours...). Sollecito goes on to note that because firefighters work these types of schedules, these results are particularly important to this group.

Sollecito (2007) goes on to report that research on professionals that work evening and night shifts in 24/7 operations are more prone to "sleep-related problems including chronic sleep deprivation, insomnia and sleep apnea (11% vs. two to four… [END OF PREVIEW]

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