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• Medical Director
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Stretcher Kits &
The name in Safety, Rescue and Survival.
The adrenaline kicks in, but at the same time
you know you’re not up to standard.”
Some in EMS may believe that seven to
nine hours of sleep is unnecessary and they
can get by with less sleep. This may be true.
Every person is different. There’s evidence of
individual differences in sleep need and the
impact of sleep deprivation on outcomes.
Nancy describes how people in her organization approach sleep. She says, “People are
just different and they need to know their own
tolerance levels.” She states that after 15 years,
“I’m just now getting to know my own tolerance. I know that I’m getting tired when I start
making stupid mistakes or am forgetful, then I
know that it’s time when I’m done. When I’m
getting short tempered, I know I need to sleep.”
Scott is a paramedic with more than 12 years
of experience in EMS and the fire service, most
recently as a supervisor in a busy urban EMS
system. He believes that most people in EMS
would love to sleep if given the opportunity.
“We’re not afforded the opportunity to obtain
sufficient or adequate sleep. People are just try-
ing to make ends meet. It’s cultural in EMS that
sleep deprivation is a part of the job.”
Although many in the profession are severely
deprived of adequate sleep, we as a society are
just now beginning to appreciate that sleep is
vital to health.
17 Insufficient sleep has been
linked to cardiovascular disease, obesity, met-
abolic disorder, gastrointestinal conditions,
hunger/appetite and changes in emotion.
A single night without sleep can manifest as
greater resistance to insulin, which is a key indi-
cator of Type 2 diabetes.
22, 24 The longer-term
impact includes of sleep deprivation includes
increased risk of cardiovascular events and other
ambulatory sensitive conditions.
Many EMS clinicians are at increased risk
of health problems related to sleep deprivation. More than half report less than six hours
of sleep per night.
12 Three-quarters of EMS
personnel are classified as obese or over weight,
and most fail to meet recommendations for
exercise and physical activity.
25 Half of EMS
clinicians report being told by a physician that
they have at least one health condition (e.g.,
hypertension, sleep apnea, breathing problems,
diabetes, depression and other conditions).
Sleep is also important for performance.
Hans Van Dongen, an internationally renowned
fatigue scientist, led a 14-day experiment with
48 healthy adults to determine the impact of
different durations of sleep per night on performance.
26 Study participants were stratified
into four groups, with Group 1 sleeping eight
hours per night, Group 2 sleeping six hours per
night, Group 3 sleeping four hours per night,
and Group 4 being kept awake for 88 hours
straight. The study showed a dose-response
pattern, with worsening performance on standardized tests over 14 days. Groups with less
sleep showed worse performance than groups
with more sleep per night. Notably, the study
showed that among participants in the four-hour and six-hour groups, performance over 14
days was equivalent to performance reported in
prior studies that tested the effects of just one
to two days of total sleep restriction.
Admittedly, there’s limited research involving EMS clinicians that explore the relationships between sleep, indicators of health and
performance. With respect to performance,
one study shows that the odds of a medical