Cross-sectional analysis of sleep-promoting and wake-promoting drug use on health, fatigue-related error, and near-crashes in police officers

Abstract

ObjectivesTo examine sleep-promoting and wake-promoting drug use in police officers and associations between their use and health (excessive sleepiness, stress and burnout), performance (fatigue-related errors) and safety (near-crashes) outcomes, both alone and in combination with night-shift work.DesignCross-sectional survey.SettingPolice officers from North America completed the survey either online or via paper/pencil at a police station.Participants4957 police participated, 3693 online (91.9%, participation rate) and 1264 onsite (cooperation rate 63.1%).Main outcome measuresSleep-promoting and wake-promoting drug use, excessive sleepiness, near-crash motor vehicle crashes, dozing while driving, fatigue errors, stress and burnout.ResultsOver the past month, 20% of police officers reported using sleep-promoting drugs and drugs causing sleepiness, while wake-promoting agents were used by 28% of police (5% used wake-promoting drugs, 23% used high levels of caffeine and 4% smoked to stay awake). Use of sleep-promoting drugs was associated with increased near-crashes (OR=1.61; 95% CI 1.21 to 2.13), fatigue-related errors (OR=1.75; 95% CI 1.32 to 2.79), higher stress (OR=1.41; 95% CI 1.10 to 1.82), and higher burnout (OR=1.83; 95% CI 1.40 to 2.38). Wake-promoting drug use, high caffeine and smoking to stay awake were associated with increased odds of a fatigue-related error, stress and burnout (ORs ranging from 1.68 to 2.56). Caffeine consumption was common, and while smoking was not, of those participants who did smoke, one-in-three did so to remain awake. Night-shift work was associated with independent increases in excessive sleepiness, near-crashes and fatigue-related errors. Interactions between night-shift work and wake-promoting drug use were also found for excessive sleepiness.ConclusionsPolice who use sleep-promoting and wake-promoting drugs, especially when working night shifts, are most vulnerable to adverse health, performance and safety outcomes. Future research should examine temporal relationships between shift work, drug use and adverse outcomes, in order to develop optimal alertness management strategies.

Sleep Health Promotion in the Workplace

“…None of them suffered from obstructive sleep apnea syndrome, which is quite common among police officers [43], and all had good physical activity and a regulated diet. They did not use sleep-or wake-promoting drugs, which is a fairly frequent condition in police forces [44], Moreover, although they may they irregular shifts, they don't work night shifts, which are associated with poor sleep quality [45], altered cognitive performance [46] and disturbed feeding pattern [47] in police officers. Our observations, therefore, cannot be extended to all the police forces, but only to these special units devoted to the control of public order.…”

Fatores de risco e de proteção para doenças crônicas não transmissíveis na Polícia Militar do Estado de São Paulo

“…26 . Os males do tabagismo são amplamente descritos em diversos estudos, globais e nacionais, constituindo um dos principais fatores de risco para DCNT [40][41][42] .…”

“…Corroborando com esta análise, Ogeil RP et al (2018) analisaram 4957 policiais dos Estados Unidos (EUA) e Canadá, mostrando que 28% deles fazem uso de drogas promotoras de vigília, dentre elas o tabaco 42 .…”

“…Por se tratar de profissionais cuja aptidão física em determinadas circunstâncias pode contribuir com a preservação de vidas, é extremamente importante à atenção institucional para a diminuição da alta prevalência de excesso de peso e a obesidade entre seus profissionais. O inadequado consumo de frutas e hortaliças como um potencial fator de risco para as DCNT[39][40][41][42] . Os resultados mostraram que metade do efetivo da PMESP possuem AFI e que aproximadamente 70,2% deles estão acima do peso.…”

“…Os resultados mostraram que metade do efetivo da PMESP possuem AFI e que aproximadamente 70,2% deles estão acima do peso. Isso vai de encontro com o estudode Silva FM et al (2016), onde foi observado que o baixo consumo de frutas e vegetais tinha associação positiva com o sedentarismo, com o excesso de peso e com a obesidade42 . Nessa mesma linha, um estudo norte americano mostrou que a obesidade era bastante associada com o baixo consumo de frutas, verduras e legumes43 .…”