Burnout in Firefighters Linked to Sleep Issues, Mental Health Concerns

By Carolyn Crist | June 28, 2019

Firefighters who feel burned out often experience sleep issues, which also increases their risk of emotional fatigue, exhaustion and health problems, researchers say.

Nearly half of U.S. firefighters are likely experiencing burnout and associated health problems, the study authors report in the Journal of Sleep Research.

“Burnout can have a negative impact on the individual worker, the people they provide a service to and their organization, with consequences including increased absenteeism, job turnover, health problems and reduced performance,” said Alexander Wolkow of the Monash University Institute for Brain and Mental Health in Notting Hill, Australia, who led the study.

“Given the critical role firefighters play in assisting the community in times of emergency, it is important we identify the factors which contribute towards burnout in order to help promote the health of this workforce,” he told Reuters Health by email.

Wolkow and colleagues surveyed more than 6,300 North American firefighters at 66 fire departments with a questionnaire designed to assess burnout. It asked about feelings of emotional exhaustion, “depersonalization” of the people firefighters help, and about the individual’s own sense of personal accomplishment.

Firefighters were also screened for sleep disorders and reported any current mental health conditions such as depression, anxiety or post-traumatic stress disorder. With regard to sleep, participants were asked about the quantity of sleep they typically need to feel well rested, and about how much sleep they usually got in the 24-hour period that included working an overnight or 24-hour shift, after working overnight or for 24 hours, while working day shifts, and after more than two days off work.

The research team found that 49% of firefighters reported short sleep, meaning six hours or less, when they worked overnight or 24-hour shifts, and 32% reported short sleep during the period following an overnight or 24-hour shift. More than a third of firefighters screened positive for a sleep disorder, particularly obstructive sleep apnea or insomnia. About half of firefighters also experienced high burnout.

Those who screened positive for insomnia had triple the risk of those without sleep problems for emotional exhaustion. Those who reported a current mental health condition also had triple the risk of emotional exhaustion. Sleepiness and a sleep deficit were associated with an increased risk of burnout, exhaustion, depersonalization and low personal accomplishment, even among those without a sleep disorder.

At the same time, the research team found that getting sufficient sleep during the period a firefighter worked an overnight or 24-hour shift lowered these risks. Sleep quantity when working these shifts was the primary driver of the association between burnout and having a sleep disorder or mental health condition, the researchers calculated, and was more important than getting more sleep following an overnight shift or during days off.

“This finding is interesting, as it could suggest that maximizing sleep opportunities during overnight shifts may be one possible way to reduce burnout risk among vulnerable personnel,” Wolkow said.

These findings could help other workers as well, including those who must be on call at night or have high-stress jobs, he noted.

“In particular, efforts that are tailored to the unique needs and work schedules of first responders may be especially helpful,” said Melanie Hom of Florida State University in Tallahassee, who wasn’t involved in the study.

“I think it is also critical to note that burnout is a malleable factor that can be intervened upon and prevented,” she told Reuters Health by email. This could include non-medication options, such as cognitive behavioral therapy for insomnia, Horn added.

“Practicing mindfulness may decrease physiological stress reactivity and increase resilience to stress,” said Kia Gluschkoff of the University of Helsinki, who also wasn’t involved in the study.

Public service occupations such as teaching and firefighting are often emotionally taxing and stressful, and workers in these jobs need to relieve the stress in order to prevent it from building up and turning into burnout, she noted.

“Successful recovery from work demands is crucial for health,” Gluschkoff said in an email. “Sleep is a fundamental part of recovery, and getting good quality sleep in sufficient amounts helps to maintain physical and mental health.”

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