The Cost of Always Being “On.” Part 1 - Sleep Deprivation

Do you ever wake from a sound sleep at the slightest noise?

​Being a first responder can have hidden side effects that aren’t talked about in drill school.

​Do you remember Ivan Pavlov and his experiment in which he got dogs to salivate when they heard a bell? Pavlov would ring a bell while giving the dogs a piece of food. Over time, the dogs learned to associate the bell's sound with the food. They became conditioned to salivate when they heard the bell. This is known as classical conditioning.

​In our case, the bell is the station alarm, we are the dog, and the response is waking up.  Over a career of waking up to a station alarm, we have conditioned ourselves to wake to almost any noise. One problem this causes is the inability to get restorative sleep. Once we hear the alarm, our bodies go into sympathetic nervous system stimulation, the fight-or-flight mode, so we are ready to perform whatever task is required for this call. Our bodies are always waiting for the alarm to sound, and we constantly feel tired. Years after we retire, we still wake to sounds; we wake easily and have some difficulty getting back to sleep after waking.

​Sleep deprivation is one of the largest safety issues in emergency services. To reset our circadian rhythm and get the restorative sleep we need. Here are a few tips to help overcome the abrupt waking routine from the station:

​Set yourself up for success by creating a sleeping environment conducive to rest.

Using eye masks or blackout curtains will provide the darkness your body needs to signal sleep time. Body temperature decreases slightly when sleeping, so the optimal room temperature is cooler than you think. Some studies say 60-67°F is optimal for sleep, but others say that's too cold. Set your room thermostat to as cold as you can tolerate, not dropping below 60 °F. Use heavy blankets when sleeping. Blankets not only help regulate body temperature, but heavier ones also provide a sense of comfort. Weighted blankets are known to calm the nervous system, which, in turn, takes the body out of fight-or-flight mode.

Take naps.

Napping is beneficial. Well, strategic napping is beneficial. If you are tired in the middle of the day, take either a 20-30 nap, OR a 90 min nap. Do not go beyond 30 minutes. Between 30 and 90 minutes, you will be interrupted in the middle of a sleep cycle. Same thing from going past 90 minutes. The 20-30 window or 90-minute window increases alertness without disrupting sleep inertia.

Create consistent routines.

Consistent routines help reset our sleep cycles. When it is time for shift change, wake up at the same time every day. Splash cold water on your face. Drink some water. Get 30-60 minutes of sunlight in the morning. All of these are signals to the body that it is time to wake up. If you find yourself tired midday, see the paragraph above for how to take a nap. Ideally, you want to have the same wake-up time and bedtime every day, even when you are not on shift. Our bodies like routine, especially when it comes to sleep. Keeping a routine gets our bodies back on track with the circadian rhythm.

Get a daily cardiovascular exercise routine (if you don’t already have one). Daily cardio workouts help us feel physically tired when it is time to sleep. Even if it is just taking a walk around your neighborhood, getting up and moving around is essential to good sleep.

Sleep Hygiene

If you haven’t heard this already, leave your phone, tablet, or laptop alone at least one hour before you want to sleep. Preferably, keeping these devices out of the bedroom is best. If that is not possible, keep them out of reach of the bed. The blue light from screens tricks our brains into thinking it is still daylight outside. Which, in turn, prevents us from falling asleep at a decent time. Even if you have a blue light filter on your device, avoid looking at the screen at least an hour before sleep. Read a book. Listen to calming music or a guided meditation.

The importance of getting enough sleep is well known; yet many people don’t consider it when assessing stressors in life. First responders face additional stressors, such as running calls all night. Sleep, for us, is a safety factor.

​If you’re a firefighter, paramedic, or law enforcement officer in Orlando looking for support, I offer therapy specifically for first responders.