Many police officers are putting themselves—and the public—at risk by failing to address their sleep problems and excessive fatigue, a new study suggests.
By Anne Harding
TUESDAY, December 20, 2011 (Health.com) — Many police officers are putting themselves—and the public—at risk by failing to address their sleep problems and excessive fatigue, a new study in the Journal of the American Medical Association suggests.
Of the nearly 5,000 officers surveyed, 40% screened positive for a sleep disorder such as insomnia or sleep apnea, and the vast majority had never received treatment for their problem. Most alarming of all, 46% of the officers acknowledged nodding off behind the wheel, and 26% said they did so at least once or twice a month.
Falling asleep at the wheel wasn't the only hazard posed by tired police. Compared to their well-rested colleagues, officers who met the criteria for a sleep disorder were more likely to make serious administrative or safety errors and exhibit "uncontrolled anger" toward suspects, the study found.
"Four out of five of these individuals were undiagnosed and untreated," says lead author Charles A. Czeisler, MD, a professor of sleep medicine at Harvard Medical School, in Boston. "This is a very important clarion call to initiate these kinds of workplace screening programs, not just in police forces but in workplaces throughout the nation."
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The study, the first to examine the rate of sleep disorders among police, included about 4,800 U.S. officers and 150 Canadian officers who completed online or in-person questionnaires about their sleep and work habits. Roughly 70% also took part in monthly follow-up surveys.
The participants weren't necessarily representative of police officers as a whole, nor did the study include people in other professions, so it's difficult to draw broad conclusions about the prevalence of sleep disorders in police versus civilians. The rate among the officers in the study, however, was much higher than those seen in the general population, Dr. Czeisler says.
The long hours and irregular shifts often required in police work may partly explain the unusually high rates. Fifteen percent of the officers reported working 14 to 16 hours at a stretch, and roughly one-quarter worked rotating day and night shifts, which can disrupt sleep-wake cycles and lead to a condition—found in 5% of the officers—known as shift work disorder.
Poor overall health also appeared to go hand-in-hand with sleep problems. Officers with sleep disorders were more likely to experience other health problems, including diabetes, heart disease, depression, and burnout. One-third of the officers were obese and 79% were overweight, and the most common sleep problem in the study, which affected 34% of the officers, was obstructive sleep apnea—a breathing disorder that causes frequent waking and is strongly linked to obesity.
Next page: Is macho police culture partly to blame?
Sleep problems had a noticeable impact on the officers' work. Eighteen percent of the officers who screened positive for a sleep disorder reported making serious administrative errors (versus 13% of those without a sleep disorder), while 24% (versus 16%) made other errors or safety violations attributable to fatigue. And 34% percent of officers with a sleep disorder reported losing their temper with civilians, compared to 29% of those without a disorder.
People who are sleep deprived are very poor judges of how sleep deprived they actually are, says Michael A. Grandner, PhD, a researcher at the University of Pennsylvania's Center for Sleep and Circadian Neurobiology, in Philadelphia.
"They can fall in and out of sleep and have no idea it's happening," says Grandner, who cowrote an editorial accompanying the study. "Those sorts of things are likely what's happening when people fall asleep at the wheel."
Promoting better sleep among police officers—or people in any line of work—will require dissuading employers, employees, and the public in general from the idea that sleep deprivation is a mark of strength or dedication, Grandner says.
"We say, 'I'm so important and I'm so busy, I only get four hours of sleep—but that's all I need to function,'" Grandner says, adding that this mindset may be especially entrenched in professions, such as policing or commercial trucking, that have a macho culture or that financially reward long hours (as with overtime pay).
The study findings do offer a clue to how local governments might encourage healthy sleep habits in police officers, Dr. Czeisler says. One of the departments that participated in the survey, the Massachusetts State Police, had lower rates of sleep disorders and obesity than the study population as a whole, perhaps because the department pegs pay increases to fitness testing, provides a gym in every barracks, and offers one hour of paid exercise time on every shift.
"We can't say that that's cause and effect, but there have been plenty of studies that show exercise reduces obesity," he says. "These data suggest that there may be many positive steps that employers can take to prevent sleep apnea."