Improving Sleep Among Frontline Workers
Frontline workers are exposed to varying degrees of traumatic situations almost daily, increasing the prevalence of mental health issues and associated sleep disorders. Indeed, 2017 research from Johnson & Johnson shows that Canadian military service members and first responders struggle to get support for their own health needs.
The study, which looked at Canadian military service members, first responders, and members of the public, found that 40% were concerned about the risk of mental illness in frontline workers and 37% were concerned about sleep disorders.
Achieving good quality sleep can be greatly impacted by your circadian rhythm – also known as the sleep/wake cycle, which is a 24-hour cycle controlled by the hypothalamus in the brain. It is responsible for the phases of sleep and wakefulness we experience and tends to coincide with day time and night time. This is because factors like light and darkness affect the circadian rhythm, with light releasing hormones that cause wakefulness and darkness releasing hormones that encourage sleepiness. For frontline workers exposed to night shifts or rotating shifts, this natural rhythm is altered dramatically.
When police officers, firefighters, hospital workers or paramedics respond to a call for help, they could be faced with harrowing situations. These, coupled with unstable circadian rhythms due to shift work, can lead to difficulty sleeping, insomnia, or nightmares during sleep. As a result, frontline workers who suffer from sleep disorders can have difficulty focusing at work, leading to lapses in judgement and accidents. They may also develop further psychological issues, including post-traumatic stress disorder (PTSD), depression, and eating disorders.
One factor that could greatly facilitate better sleep is thought acceptance, which is a component of Acceptance and Commitment Therapy (ACT) – an alternative to the traditional and better-known Cognitive Behavioural Therapy (CBT). While CBT teaches individuals to challenge their thoughts and emotions, ACT teaches them to embrace and accept them.
Achieving better sleep via ACT is all about thought acceptance, which can encourage frontline workers to accept any difficult thoughts, feelings and memories, rather than attempt to bury them. Dr. John Morrissey, a member of the College of Psychotherapists of Ontario, says, “Thought acceptance as I use it acknowledges that, as humans, we need to process our life experiences. It has the person focus on what is reality, what can be changed, what needs to be attended to, and what is a permanent condition or circumstance.” This can be achieved with a therapist and on one’s own. With thought acceptance, patients learn to face their experiences head on, leading up to a point where they can relive their experiences without becoming emotionally overwhelmed.
However, as is the case with most types of therapy, it may not be effective for some. Dr. Morrissey points out that some of the people he has treated had difficulty focusing on the process, leading him to include additional techniques such as focusing on positive life experiences. So, if ACT isn’t for you, there are other basic steps to better sleep. Dr. Morrissey recommends a regular sleep schedule; even for those working on rotating shifts. “The human body is a habit-forming organism and benefits from repetitive behaviour. I ask people to choose the most appropriate times for them to have a good sleep pattern and to maintain that pattern. I also suggest that they learn about their circadian rhythm and make the room they sleep in as dark as possible while sleeping, and very bright when they choose to be awake.”
The importance of a good sleep pattern cannot be overemphasized. Frontline workers, both those on rotating shifts and regular day workers, must maintain a healthy sleep pattern for the body to refresh itself and be ready for action. In the case of emergency workers, snap judgment calls can occur at any time, and a lapse in judgment due to fatigue can literally be the difference between life and death.
When a sleep disorder is diagnosed, it is important to overcome any prejudices and fears, and seek the help you need. Seeking help is a first step towards the aim of thought acceptance. Ultimately, good sleep is an important part of a healthy lifestyle, and as such, should be recognized by frontline workers, their employees, unions, and the government.
What exactly is Good Quality Sleep?
According to the U.S. National Sleep Foundation, the key determinants of good quality sleep include:
|Acceptance and Commitment Therapy
2. Cognitive Defusion
3. Being Present
4. Self as Context
6. Committed Action
Dr Nicola Davies is a Psychologist and writer with an interest in the psychology behind frontline work.