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Sleep Disorders Management, Health and Safety in Police



Details

  • Personal Author:
  • Description:
    Background: Sleep disorders are common, costly, and treatable, but often remain undiagnosed and untreated. Police officers work some of the most demanding schedules known, which increases their risk of sleep disorders. The public expects officers to perform flawlessly, but unrecognized sleep disorders lead to severe sleep deprivation, which significantly degrades cognition, alertness, reaction time and performance. In addition, both acute and chronic sleep deprivation adversely affect personal health, increasing the risk of gastrointestinal and heart disease, impairing glucose metabolism, and substantially increasing the risk of injury due to motor vehicle crashes. We implemented and tested in a police department the effectiveness of a sleep disorders detection and treatment program, which we have called Operation Healthy Sleep. The goals of this program were to reduce the adverse consequences of fatigue on officers' health, safety, and performance. Approach: The study design was a station-level randomized experiment. To achieve this design, pairs of stations were identified based on size, employee characteristics and the acuity of police work in which they engage. In phase 1, one of each pair was randomly assigned to the intervention group, the other to the control group, and in phase 2 the intervention was extended to all stations. Subjects were sworn police officers. 878 officers participated in the sleep education session, representing 59 percent of the active and available officers. 605 subjects completed the baseline questionnaire (mean age 38.3 +/- 9.4 years, 94 percent male). The sleep disorders screening tool was the major part of the Baseline survey, and included screening for obstructive sleep apnea, insomnia, restless leg syndrome, shift work disorder, and narcolepsy with cataplexy. We selected validated questionnaires to compile a comprehensive sleep disorders screening tool for the purposes of this study. As there was no validated questionnaire available for shift work disorder, we developed one based on the International Classification of Sleep Disorders-2. In addition to sleep disorder screening, the baseline survey also contained questions about work and sleep schedules, demographics, medical and social history, accidents and stress. Completed surveys were scanned into electronic format and uploaded into the central study database. All free text fields were double-key entered and verified for accuracy. An automatic scoring algorithm based on published scoring criteria was developed for determining whether subjects were at high, low or unknown risk for each of the sleep disorders. Key findings: 1. The Operation Healthy Sleep program was successfully implemented with a high level of participation. 59 percent of active officers who were available to participate attended the sleep health education session, and of these 69 percent (n=605) completed and returned the Baseline survey. 2. Demographic data obtained from the police databases showed that those who elected to attend the education session and complete the survey were on average approximately 2.5-3 years younger and 3 years less in police work than all officers in the Department. 3. 20 percent of our sample reported nodding off or falling asleep while driving a vehicle at least 1-2 times a month. 4. Sleep disorders appear to be highly prevalent in our sample. We found that approximately 25 percent of officers were at high risk for one or more sleep disorder. The most prevalent sleep disorder in the sample was OSA. The majority of subjects (approximately 80 percent for most disorders) who were found to be at high risk for a sleep disorder reported not having been diagnosed previously with that disorder. Given the association between untreated sleep disorders and adverse health and safety outcomes, sleep disorders screening and management programs should be instigated in law enforcement agencies across the country. 5. Sleepiness level was significantly higher in subjects who were found to be at high risk for a sleep disorder compared to those found to be at low risk for all disorders. Of particular note, we found that 12.6 percent of subjects who were at high risk for any sleep disorder showed extremely high levels of sleepiness, compared to only 1.1 percent of subjects who were at low risk for all sleep disorders. 6. Assessment of the efficacy of the detection and treatment program on health, safety and productivity measures is ongoing. Translation of research findings: The overall goal of this research was to develop and test a sleep health detection and treatment program that ultimately can be disseminated to practitioners, policymakers and researchers nationwide to reduce police office fatigue and stress; enhance the ability of officers and their families to cope with shift schedules; improve the health, safety and performance of law enforcement officers; and thereby improve public safety. We are currently evaluating the potential for the Operation Healthy Sleep program to be implemented in law enforcement agencies nationwide and other first response occupational groups as a part of occupational health and safety programs. In addition, we are evaluating different models of program implementation, including a web-based educational and screening program. Of note, the demographic characteristics of subjects who elected to participate in this study suggests that, in the implementation of the Operation Healthy Sleep program, greater efforts need to be made to engage older inindividuals. This is particularly important given that the risk of many sleep disorders increases with age. [Description provided by NIOSH]
  • Subjects:
  • Keywords:
  • Series:
    Grant Final Reports
  • Publisher:
    National Institute for Occupational Safety and Health
  • Document Type:
    Text
  • Funding:
    Grant
  • Genre:
    Final Grant Report
  • Place as Subject:
  • CIO:
    National Institute for Occupational Safety and Health (NIOSH)
  • Division:
    OEP - Office of Extramural Programs
  • Topic:
    Workplace Safety & Health
  • Location:
    North America
  • Pages in Document:
    1-40
  • NIOSHTIC Number:
    nn:20046374
  • NTIS Accession Number:
    PB2015-105192
  • Citation:
    Atlanta, GA: U.S. Department of Health and Human Services, Public Health Service, Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health, R01-OH-008496, 2009 Aug; :1-40
  • Contact Point Address:
    Charles A. Czeisler, Ph.D., M.D., F.R.C.P., Harvard Medical School, Division of Sleep Medicine, Department of Medicine, Brigham & Women's Hospital, 221 Longwood Avenue, Boston MA 02115-5817
  • Email:
    cacadmin@rics.bwh.harvard.edu
  • Federal Fiscal Year:
    2009
  • Performing Organization:
    Brigham and Women's Hospital, Boston
  • Peer Reviewed:
    False
  • Start Date:
    20040930
  • Source Full Name:
    National Institute for Occupational Safety and Health
  • End Date:
    20080929
  • Collection(s):
  • Main Document Checksum:
    urn:sha-512:5516a21be3ba9881f6b397b2cf9ffb67ceaf6151ab9993d219f68032177df44ee90fb64548aaf2723bd65ec598a2c3f8f39a3942f214c37f100d367fceb16158
  • Download URL:
  • File Type:
    Filetype[PDF - 445.20 KB ]
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