Associations between sleep, stress, and cardiovascular health in emergency medical services personnel

Abstract

Objective Our objective was to quantify the associations between sleep duration and perceived and chronic stress with ideal cardiovascular health (CVH) among emergency medical services (EMS) personnel from county‐based EMS agencies. Methods We conducted a cross‐sectional survey of cardiovascular disease (CVD)‐free EMS personnel from 4 US EMS agencies. The questionnaire consisted of the Pittsburgh Sleep Quality Index (PSQI), Perceived Stress Scale (PSS), Chronic Burden Scale, and the CVH components (smoking, body mass index, physical activity, diet, blood glucose, blood pressure, cholesterol, each scored 0–2 points). The components were summed and ideal CVH considered 11–14 points. Mixed effects logistic regression models with a random intercept for agency were used to estimate the odds of ideal CVH for good sleep quality (PSQI < 5 points), recommended sleep duration (7 to < 9h), low perceived stress (PSS < 26 points), and low chronic stress (0 recent stressful events). Results We received 379 responses (response rate = 32%). There was low prevalence of good sleep quality (23%) and recommended sleep duration (25%), but 95% reported low perceived stress, and 33% had low chronic stress. Ideal CVH was reported by 30%. No significant associations between ideal CVH and sleep quality, perceived stress, or chronic stress were found. There was a nearly 2‐fold increase in the odds of ideal CVH with recommended sleep duration (odds ratio: 1.83, 95% confidence interval: 1.08–3.10). Conclusion In this sample of EMS personnel, only recommended sleep duration was associated with ideal CVH. Future longitudinal studies are needed to understand the relationship between sleep, stress, and CVD in this understudied occupational group.

Mental Health of Canadian Firefighters: The Impact of Sleep

“…For shift workers, disordered sleep is explained by the irregularity of work hours and the disruption that these hours have on one’s circadian rhythm [ 10 , 44 ]. Furthermore, similar results have been found among samples of American police officers, both on varied shift work (64.1%) and on day shifts (63.7%) [ 45 ], and slightly higher results were found in American paramedics (77%) [ 46 ]. The current results evidence poor sleep quality amongst different types of firefighters, regardless of the type of shifts being worked.…”

EMS workers on the frontline of the opioid epidemic: effects of sleep and social support on depression

“…, 2019). Studies of EMS workers have documented that sleep quality and fatigue are of significant concern for this work force, leading to severe mental and physical fatigue and poor health outcomes (Cash et al. , 2021; Hruska and Barduhn, 2021; Patterson et al.…”

“…In a study of air-medical EMS workers employed in a 12-h shift model, it was found that fatigue, sleepiness and difficulty concentrating increases in near linear pattern over the course of a shift (Patterson et al, 2019). Studies of EMS workers have documented that sleep quality and fatigue are of significant concern for this work force, leading to severe mental and physical fatigue and poor health outcomes (Cash et al, 2021;Hruska and Barduhn, 2021;Patterson et al, 2010).…”

The impact of positive reinforcement on teamwork climate, resiliency, and burnout during the COVID-19 pandemic: The TEAM-ICU (Transforming Employee Attitudes via Messaging strengthens Interconnection, Communication, and Unity) pilot study

“…Studies of healthcare workers during the 2003 SARS pandemic provided insight into the psychological ramifications of a world-wide health crisis that were not only immediate but long-lasting with sequelae of post-traumatic stress disorder (PTSD) and depressive symptoms (Mak et al, 2009; Maunder et al, 2003). The psychological landscape amidst healthcare providers within the current COVID-19 global pandemic reveals clinically elevated psychological symptoms in alarming numbers: stress (86%; Mrklas et al, 2020); depression (20%–50%; Gautam et al, 2020; Mrklas et al, 2020; Pappa et al, 2020); anxiety (45%–47%; Gautam et al, 2020; Mrklas et al, 2020); post-traumatic stress (32%–44%; Li et al, 2021; Zandifar et al, 2020); sleep disturbance (25%–34%; Pappa et al, 2020); and substance use (25%; Cash et al, 2021). Combine reflexive human behaviors during a crisis with underlying burnout syndrome in the healthcare worker and the previously described mental health morbidity may be magnified.…”