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Firefighter sleep: 7 ways to improve your crew’s sleep and safety

With sleep deprivation being directly linked to poor decision-making, physical ability and communication, firefighters must be well-rested on and off the job

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Sleep deprivation can lead to real problems, including safety concerns, for firefighters.

Firefighters don’t get enough sleep. For anyone who has worked in the fire service for any time at all, this is hardly news.

Sleep deprivation can lead to real problems, including safety concerns. And as firefighters age, sleep disorders can lead to serious health problems for them. Even though these issues may seem obvious, it is surprising how little attention has been given to the role of sleep for firefighters. Fortunately, that is starting to change.

Firefighter sleep studies and scary results

Some studies have been done over the years. A study published in the Journal of Clinical Sleep Medicine looked at a nationally representative sample of 7,000 firefighters in 66 fire departments for obstructive sleep disorder, insomnia, restless leg syndrome and shift work disorder. Researchers found that about 37% of the firefighters screened positive for at least one sleep disorder.

After controlling for sex, race, body mass index, smoking and other factors, the researchers found that compared with sound sleepers, those with a sleep disorder were about twice as likely to have a motor vehicle crash, to nod off while driving, and to have cardiovascular disease or diabetes. They were more than three times as likely to suffer from depression and anxiety.

Additionally, the study revealed that more than 80% of firefighters who screened positive for a common sleep disorder were undiagnosed and untreated.

These are significant findings. Heart attack is still the leading cause of firefighter death. Vehicle accidents involving emergency apparatus not only cause damage and bodily injury, but also delay necessary response and weaken public confidence in the agency.

The sleep expert details three factors to manage within the shift work system to maintain proper day/night sleep signals

Poor sleep history

Few fire departments have linked poor sleep to these issues. When I first became a firefighter in 1980, helping members to sleep better was not the first thing on my department’s mind. We slept in large open dorms with poor ventilation, and the mattresses were often old and saggy, with pillows smelling of cigarette smoke and aftershave. But asking for improvements in this area was futile and only led to being told, “We’re not paying you to sleep.”

Over the years, things improved — new mattresses, better air circulation, to name a couple. Now many fire department dorms are being split up into separate sleeping cubicles, which depending on the design, may or may not improve the quality of the sleep experience.

What is still mostly not addressed in the fire service is the linkage clearly shown in the aforementioned study between sleep and safety and behavioral health issues. But the U.S. military has made this linkage strongly through decades of research.

Military research on sleep

In his book “Dreamland: Adventures in the Strange Science of Sleep,” author David K. Randall details clear outcomes of military sleep research. Research on military pilots has shown that cognitive performance declines by about one-fourth for every 24 hours spent awake.

Analysis of altercations between soldiers and civilians in Iraq shows that 20% of soldiers who are sleeping less than four hours a night reported having an altercation with a civilian, whereas only 4% of those who slept eight hours a night reported such conflicts.

In 1996, crew fatigue was blamed for 32 accidents that destroyed American military aircraft, including three F-14 fighter jets that cost $38 million each. Sleep deprivation has been identified as a factor in a number of friendly fire incidents that led to injury and loss of life.

The U.S. Armed Forces have invested many decades and enormous sums of money into trying to find a workable substitute for actual sleep. In 2007, the Defense Advanced Research Projects Agency essentially gave up. Their conclusion was that the only way to recover from lost sleep was to get more of it later.

7 steps for better sleep

The implications for the fire service are clear: If you want people to make good decisions, they have to be adequately rested. If you want them to communicate effectively, they must sleep regularly.

Research shows that soldiers deprived of sleep for 48 hours significantly lost their ability to understand context in communication from others or to include appropriate context in their own. People were unable to adapt to changing circumstances. They made increasingly bad decisions.

All of these conclusions apply equally to firefighters, and can lead to equally bad outcomes. But what can fire service leaders do given the reality of the job and the need for round-the-clock response capability? Here are a few ideas:

  1. Departments must recognize that adequate sleep is a wellness and performance issue equal to other priorities such as strength fitness, diet and agility.
  2. Departments should evaluate current logistics for sleep and consider changes. Some positive changes can be made quite simply — installing fans or white noise generating machines in common dorms, for example. Other changes are more costly, such as retrofitting common dorms into individual sleeping pods.
  3. Do an assessment of the current state of sleep fitness among members. As much as possible, gather data anonymously to get an honest picture of how department members manage sleep both on and off the job.
  4. Allow appropriate naps on duty. Numerous studies have shown that brief naps of 30 minutes or less can make a positive difference in cognition and reflexes for someone who is exhausted.
  5. Make resources available for those who are suffering from sleep disorders. Do not stigmatize the use of these resources.
  6. Reconsider shift scheduling and overtime rules to diminish the effects of sleep deprivation on emergency response.
  7. Look ahead to new technology to help manage sleep and performance. The Army is currently developing a wristwatch-style sleep monitor for all soldiers that will monitor sleep/wake cycles and can be directly linked to predicted performance. They expect these devices to be standard issue gear by 2020.

Sleep is a necessary bodily function that cannot be replicated through any other means. Fire service leaders need to let go of the attitude that “we don’t pay you to sleep,” and firefighters need to lose the idea that they can function just as well in the 48th hour being awake as they did in the first.

Ensuring quality sleep for firefighters is a health and wellness issue whose time is long overdue. Lives depend on it.

This article, originally published in 2014, has been updated.

Sleep resources for firefighters
How one department added a shift to improve its members’ work-life balance
Dr. Matthew Walker’s book puts the power of sleep into perspective for all first responders who struggle to sleep
What first responders can learn about fatigue management from the U.S. Army’s doctrine on readiness
Non-sleep deep relaxation can help you navigate the sleep troubles that often come with shift work

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Linda Willing is a retired career fire officer and currently works with emergency services agencies and other organizations on issues of leadership development, decision-making and diversity management. She was an adjunct instructor and curriculum advisor with the National Fire Academy for over 20 years. Willing is the author of On the Line: Women Firefighters Tell Their Stories and was co-founder of Women in the Fire Service. Willing has a bachelor’s degree in American studies, a master’s degree in organization development and is a certified mediator. She is a member of the FireRescue1/Fire Chief Editorial Advisory Board. Connect with Willing via email.