The prevalence of sleep problems in emergency medical technicians
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To investigate the prevalence, demographic, and work associations of self-reported sleep complaints in US emergency medical technicians (EMTs)
The mailed 2005 Longitudinal Emergency Medical Technician Attributes and Demographics Study (LEADS) questionnaire was distributed to selected EMTs that included 35 sleep-related questions. Questions were adapted from previously validated sleep medicine surveys, including the Epworth Sleepiness Scale (ESS), and were used to estimate the prevalence of different sleep problems. These sleep problems were analyzed in relation to demographic, health, satisfaction, and workplace characteristics. Responses of individuals who were not working as EMTs were used as a comparison group.
Sleep problems in working EMTs were more prevalent than in a comparison group. Seventy percent of working EMTs had at least one sleep problem. The most common sleep problem was a risk of long sleep onset disorder (50%). EMTs with tiredness-related work difficulties were more than 50% as likely to report this problem. The prevalence of excessive daytime sleepiness (ESS > 10) was 36%; 6% of the EMTs had an ESS > 16. EMTs reporting tiredness-related work difficulties were more than twice as likely to have ESS scores >10 and more than three times as likely to ESS scores >16. Symptom-defined risk of sleep apnea was present in 5%. Risks of sleep onset and maintenance disorder problems were more prevalent among those who worked longer shifts and had longer work weeks and were associated with poorer job satisfaction and poorer health.
Severe sleep problems and severe sleepiness at a level that may contribute to health and job issues are common in US EMTs. Although breathing disorders are common, behaviorally related sleep issues are more prevalent. These data support an increased focus on sleep onset and maintenance disorders.
KeywordsInsomnia Obstructive sleep apnea Excessive daytime sleepiness Emergency medical technician Sleep disorders Prevalence
This study was supported in part by the National Highway Traffic Safety Administration (NHTSA) with in-kind contributions by the National Registry of Emergency Medical Technicians (NREMT). The article does not, however, necessarily reflect the views of NHTSA or NREMT. The authors thank the many nationally registered emergency medical technicians who have completed surveys for the LEADS project. Additionally, the authors thank Humberto A. Battistini, MD for his assistance with the study design.
Conflict of interest
This study was supported in part by the National Highway Traffic Safety Administration (NHTSA), through a technical assistance contract with Dr. Levine. The other authors have no financial conflicts of interest.
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