In recent years, the effects of sleep deprivation and its effects on EMS health and safety have come onto the radar. Depending on the area, it is not uncommon for EMS personnel to work 24-hour shifts. The responsibilities of EMS personnel require them to remain alert and attentive at all times in order to prevent procedural errors and avoid injury to themselves, co-workers, patients, and others.
Studies show that consistently working long shifts causes fatigue, which makes even simple tasks become difficult, drug calculations more challenging, and the overall environment more unsafe.
Sleep deprivation compromises brain and body systems, which prevents them from functioning properly and diminishing the quality of life. For their own health and safety, as well as the well-being of others, EMS professionals are required to be aware of the long-term effects of the lack of sleep and the effects of fatigue in the workplace.
Just like the body needs air and food to function properly– it also requires sleep. According to the Division of Sleep Medicine at Harvard Medical School, important restorative functions take place during the sleep state. When a person sleeps, the body performs tissue repair, muscle growth, and protein synthesis. EMS staff who consistently receive less than eight hours of sleep per night have an increased risk of succumbing to:
- Weight gain
- Cardiovascular disease
- Compromised immune system
- Common cold
During sleep, the body also rejuvenates the individual and helps them to recover from the wear and tear associated with their job and other aspects of day-to-day living.
Similar to the predicament of other sleep-deprived shift workers, the risk to EMS health and safety increases on the roadways and manifests in the form of driver impairment and motor vehicle crashes. According to the National Highway Traffic Safety Administration (NHTSA), drowsy drivers are involved in 100,000 collisions each year, which results in more than 1,500 deaths and 40,000 injuries. According to the NHTSA, 50 percent of EMS workers suffer from fatigue.
Often, EMS personnel must provide medication, lift patients, administer treatment or use certain medical equipment and devices, within a matter of minutes or seconds after coming into contact with a patient and making an assessment of the person and their condition. Studies show that poor sleep quality and consistent fatigue have a debilitating effect on the central nervous system, which can lead to:
- Impaired communication
- Reduced motivation
- Decreased alertness
- Memory lapse
- Slowed reaction time
- Impaired thinking and judgment
That last item, depression, is particularly troubling because its signs and symptoms can be so subtle. With 36 percent of paramedics afflicted, according to one 2012 study entitled “Are you under stress in EMS: Understanding the slippery slope of burnout and PTSD”, and sleep deprivation a major cause of burnout, it’s not all that surprising.
“The correlation between fatigue and wakefulness isn’t just about the number of hours you’re asleep; it’s the quality of that sleep as well,” said New Jersey EMT and author of the EMS Siren blog Amy Eisenhauer. “Whether you’re constantly interrupted, or you don’t sleep at all, you’re at greater risk for mental and physical health issues.”
The National Association of State EMS Officials has publicized research showing that “more than half of emergency medical services personnel report severe mental and physical fatigue at work, poor sleep quality, and inadequate recovery between shifts.”
Recovery actually takes longer after partial sleep deprivation – the kind many healthcare professionals are accustomed to – than after total sleep deprivation. Even three consecutive days of eight-hour sleep periods may not be enough to restore performance after a single week of wakefulness.
Eisenhauer cautioned EMS providers that superficial measures like blackout curtains aren’t going to solve this problem. Employers should have policies mandating:
- Regular patterns of work shifts and sleep periods.
- Strategic napping.
- Sleeping as much as possible between 2 and 5 a.m.
- High-efficiency sleep – i.e., solid blocks with few awakenings.
- At least seven hours of sleep per day.
“Fatigue management is a joint, ongoing responsibility,” she said. “Everyone involved has to be willing to change their ways.”