Sleep and mental health in recruit paramedics: a 6-month longitudinal study

Abstract

Study Objectives To explore potential relationships and longitudinal changes in sleep and mental health in recruit paramedics over the first 6-months of work, and whether sleep disturbances pre-emergency work predict future mental health outcomes. Methods Participants (N=101, 52% female, Mage=26 years) completed questionnaires prior to (baseline), and after 6 months of emergency work to assess for symptoms of insomnia, obstructive sleep apnea, post-traumatic stress disorder (PTSD), depression, anxiety, and trauma exposure. At each timepoint, participants also completed a sleep diary and wore an actigraph for 14 days to assess sleep patterns. Correlations between baseline sleep and mental health were conducted and changes in these variables across timepoints were examined using linear mixed models. Hierarchical regressions assessed whether sleep at baseline predicted mental health at follow-up. Results Insomnia and depression symptoms, and total sleep time increased while sleep onset latency decreased across the first 6 months of emergency work. Participants experienced an average of 1 potentially traumatic event during the 6-month period. Baseline insomnia predicted increased depression symptoms at the 6-month follow-up, while baseline wake after sleep onset predicted follow-up PTSD symptoms. Conclusion Results highlight an increase in insomnia and depression across the initial months of emergency work, while sleep disturbances before emergency work were identified as potential risk factors for the development of depression and PTSD among paramedics in their early career. Screening and early interventions targeting poor sleep at the beginning of emergency employment may assist in reducing the risk of future mental health outcomes in this high-risk occupation.

Firefighters’ medical use and Korean Medicine experience in Korea: A qualitative study protocol

“…Most studies on firefighters in Korea and overseas aimed to investigate their health status. For example, there has been a qualitative study on firefighters’ experiences of PTSD due to work [ 70 ], experiences and coping with emotional labor [ 71 ], a questionnaire study [ 72 , 73 ], and a prospective study [ 74 ] on fatigue, insomnia, and psychiatric health problems due to work stress, and a study analyzing work-related injuries [ 75 ]. However, there have been no in-depth studies on firefighters’ experiences of KM.…”

Understanding the Occupational Factors that Influence Paramedic Health and Wellbeing

“…Shift work has been identified as hurting sleep quality resulting in increased levels of fatigue and on perceived wellbeing, mental health, and job satisfaction (Dawson, Ferguson, & Vincent, 2021;E. A. Donnelly et al, 2019;Kirby, Moreland, & Pollard, 2016;Nguyen et al, 2023;Ramey et al, 2019;Sofianopoulos et al, 2011;Yung, Du, Gruber, & Yazdani, 2021). The impact of shift work on sleep and fatigue have been widely reported among professionals across multiple occupations, with negative effects often more pronounced in those working in high-pressure, cognitively demanding occupations such as healthcare and emergency services roles (Courtney et al, 2013;Okechukwu et al, 2023;Sofianopoulos et al, 2011).…”

“…Fatigue has been shown to have negative impacts on physical health, contributing to increased rates of chronic illness, cardiovascular conditions, obesity, chronic sleep deprivation, and poor general health (Barth, Greene, Goldstein, & Sibley, 2022;Nguyen et al, 2023). There are several studies reporting high levels of fatigue among shift workers (Dawson et al, 2021;Kirby et al, 2016;Shriane, Russell, Ferguson, Rigney, & Vincent, 2023) with Richter, Acker, Adam, and Niklewski (2016) reporting almost 90% of shift workers suffering from fatigue and sleepiness at work.…”

“…Paramedics are reported to have poor levels of physical health with an increased risk of shift work disorder (Barth et al, 2022;Nguyen et al, 2023;Pallesen et al, 2010), chronic illness, cardiovascular conditions and hypertension (MacQuarrie et al, 2018;Torquati, et al, 2018), and obesity and cancer (Gan et al, 2018;Pahwa, Labr che, & Demers, 2018). As shift workers, paramedics are also at higher risk of other health problems such as metabolic disease, disorders of the immune system, and depression (Wolkow, Ferguson, Aisbett, & Main, 2015).…”

Sleep disorder risk, perceived control over sleep, and mental health symptoms in paramedicine students

“…This is concerning, as paramedic students (and students entering healthcare more broadly) will most likely be required to work shift work, and the combination of sleep disorder risk and shift work could contribute to increased health safety risks. Given recent longitudinal findings suggest that paramedics who start employment with poor sleep are at risk of poorer mental health early in their careers 33) , there is a strong case for intervening during the tertiary education period to better support mental wellbeing in our future paramedic workforce.…”