Well-Being//

Sleep and Mental Health Problems are Associated with an Increased Risk of Burnout in Firefighters

A new study shows the emotional exhaustion of the high-stress profession can be amplified when sleep and mental health are compromised.

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A new study from our research group has found that sleep disorders and mental health conditions among firefighters could be raising their risk of occupational burnout. Burnout is a three-dimensional syndrome characterised by emotional exhaustion, depersonalisation (i.e., negative attitudes about one’s clients and/or job) and low personal accomplishment (i.e., reduced sense of personal satisfaction and achievement at work) resulting from chronic exposure to workplace stressors (Maslach et al. 1997). Left unchecked, burnout can have a negative impact on the individual worker, the people they provide a service to and their organisation, with possible consequences including increased absenteeism, job turnover (Crowe et al. 2017), other health problems (Salvagioni et al. 2017) and reduced performance (Dewa et al. 2014; Smeds et al. 2017).

The research, which was conducted by Monash University (Australia) in collaboration with the Brigham and Women’s Hospital (USA), investigated burnout, sleep disorder risk and self-reported habitual sleep characteristics (i.e., sleep duration, sleepiness) and mental health conditions in North American firefighters. Of the 6,307 firefighters from 66 fire departments across the USA that took part in this cross-sectional study, 48% exhibited high levels of burnout on at least one of the three dimensions.

The study, published online in the Journal of Sleep Research in May 2019, showed that firefighters who screened positive for a sleep disorder, in particular insomnia, had a threefold increased risk of emotional exhaustion. Those with a self-reported diagnosis of post-traumatic stress disorder (PTSD), depression or anxiety had up to four times increased risk of burnout. Sleepiness and short sleep, even in firefighters who did not screen positive for a sleep disorder, were also associated with high levels of burnout.

In an important step forward, this study also provides evidence that sleep during an overnight shift may explain the link between both sleep disorder risk and high burnout, and mental health conditions and increased burnout. A large percentage of firefighters in the USA are scheduled to work extended-duration shifts of 24 or more hours (Barger et al. 2015; Billings et al. 2016). The findings in this study highlight the need to trial workplace strategies which maximise sleep opportunities during overnight shifts to reduce the risk of burnout in vulnerable personnel. For instance, fire department policies that encourage sleep – such as, permitting and encouraging napping and having black-out shades for sleep quarters, may increase firefighters’ sleep at work (Barger et al. 2017). Another important step for this area of research in firefighters involves testing the observed relationships using a longitudinal design to better understand causation. Such a study may involve repeated assessments of sleep and burnout in firefighters as they progress through their career.

Recently, the World Health Organisation announced that burnout would be included in the 11th Revision of the International Classification of Diseases (ICD-11) as an occupational phenomenon, highlighting the significance of this issue in the workplace and the need to address it.

Sleep and mental health disturbances are costly in terms of risk of burnout, but these problems are also treatable. The findings from this study suggest that reducing sleep and mental health disturbances should be a focus of fire departments’ occupational health screening programs, along with trialling interventions designed to maximise sleep during overnight work to reduce burnout risk in vulnerable personnel.

The research paper can be accessed online at the Journal of Sleep Research at: https://onlinelibrary.wiley.com/doi/abs/10.1111/jsr.12869

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