Common sleep disorders increase risk of motor vehicle crashes and adverse health outcomes in firefighters

Abstract

Study Objectives: Heart attacks and motor vehicle crashes are the leading causes of death in US fi refi ghters. Given that sleep disorders are an independent risk factor for both of these, we examined the prevalence of common sleep disorders in a national sample of fi refi ghters and their association with adverse health and safety outcomes. Methods: Firefi ghters (n = 6,933) from 66 US fi re departments were assessed for common sleep disorders using validated screening tools, as available. Firefi ghters were also surveyed about health and safety, and documentation was collected for reported motor vehicle crashes. Results: A t otal o f 3 7.2% o f fi refi ghters s creened p ositive for any sleep disorder including obstructive sleep apnea (OSA), 28.4%; insomnia, 6.0%; shift work disorder, 9.1%; and restless legs syndrome, 3.4%. Compared with those who did not screen positive, fi refi ghters who screened positive for a sleep disorder were more likely to report a motor vehicle crash (adjusted odds ratio 2.00, 95% CI 1.29-3.12, p = 0.0021) and were more likely to self-report falling asleep while driving (2.41, 2.06-2.82, p < 0.0001). Firefi ghters who screened positive for a sleep disorder were more likely to report having cardiovascular disease (2.37, 1.54-3.66, p < 0.0001), diabetes ( 1.91, 1 .31-2.81, p = 0 .0009), d epression ( 3.10, 2.49-3.85, p < 0.0001), and anxiety (3.81, 2.87-5.05, p < 0.0001), and to report poorer health status (p < 0.0001) than those who did not screen positive. Adverse health and safety associations persisted when OSA and non-OSA sleep disorders were examined separately. Conclusions: Sleep disorders are prevalent in fi refi ghters and are associated with increased risk of adverse health and safety outcomes. Future research is needed to assess the effi cacy of occupational sleep disorders prevention, screening, and treatment programs in fi re departments to reduce these safety and health risks.