Trouble sleeping/Insomnia

 First ask yourself some questions…

            • Do you trouble falling asleep or staying asleep?

• How long does it take you to fall asleep?

• How many times do you wake up a night?

• Have you found that you are having trouble concentrating or feel irritated because of your fatigue level?

• Do you have body aches, muscle tension or “heavy” feelings in your limbs?

• Do you feel rested after a night’s sleep?

Definition: The way the term “Trouble sleeping or Insomnia” is used here is meant to cover a wide range of issues around sleeping. There is a distinction between trouble sleeping and insomnia. Trouble sleeping can happen during times of stress or life disruption as your mind may be “busy” trying to digest the information of the day. An ongoing issue with sleep that is becoming disruptive to other parts of your life (i.e., work, relationships, etc.) is when insomnia may be the cause. With the disruptive nature of shift work to consistent sleep patterns the mind and body may have trouble relaxing or your circadian rhythms may have become off balance.

Signs (i.e. what may be observed by others) and Symptoms (i.e. what is reported by firefighter).

• The inability to obtain or maintain sufficient sleep.

• Body or leg discomfort during sleep, only relieved by frequent movement.

• Issues with breathing stopping involuntarily for brief periods of time during sleep.

• Excessive sleepiness when you need to be awake.

• Not feeling refreshed after sleep.

• Lack of energy.

• Irritability.

• Tossing and turning.

Other Issues to Consider:

In a recent study conducted by The Journal of Clinical Sleep Medicine (2015) more than 7000 firefighters across the United States, about 37% had been diagnosed with least one sleep disorder during their career. Examples of these diagnoses include: obstructive sleep apnea, insomnia, restless leg disorder and shift work disorder. Furthermore, they purport that firefighter sleep problems are a likely link for other health problems including cardiovascular disease, diabetes, depression and anxiety. This study also reasons that these sleep problems could explain why more than 60% of firefighter deaths are caused by either heart attacks or traffic accidents (Barger, 2015).

Healthy Sleep Practices:

Although these may be hard to completely follow especially while working, they are worth consideration.

• Try to go to bed and get up at the same time every day- whether on shift or not.

• Keep your bedroom quiet, comfortable and dark.

• Try to avoid caffeine at least 4-6 hours before bedtime.

• Try to exercise regularly, but finish at least 4-6 hours before bedtime.

• Try to avoid the use of nicotine close to bedtime or during the night.

• Try not to nap during the day, but if you do take a single nap less than 60 minutes before 3pm.

• Take a warm bath or shower 90 minutes before bed.

• Try to not read, eat or watch TV in bed for long periods of time, mostly use your bed for sleep, sex or when you are sick.

• Try to not go to bed completely full, a light snack (turkey, avocado, eggs, think “clean

protein”) can promote sound sleep.

• Do not use substances such as alcohol to help your sleep; they will impact your circadian rhythms.

• Try to relax your mind and body with light conversation, stretching, or massage before

bed.

• Avoid clock watching- not helpful.

• If not sleeping, get out of bed and stretch.

• Consider chamomile tea (do not use if you have a ragweed allergy) or a melatonin

supplement (two forms: immediate release for trouble falling asleep and extended release for trouble staying asleep).

Self Help Goals:

Thought Goal: I’m having trouble sleeping because I think… (Insert problematic thought here)… I can stop or lessen my issues with sleep by thinking… (i.e., Remembering I can only solve so much in one day, that I matter and sleep is important for my health, I’m going to be ok, etc.).

Feeling Goal: I’m having trouble sleeping because I feel… (Insert problematic feeling here)…. I can stop or lessen my issues with sleep by feeling… (That I am loved and important to my family, friends, etc., that I get to have time “off” and to myself where my body can be restored, etc.).

Behavior Goal: I’m having trouble sleeping because my behavior… (Insert problematic behavior here)…. I can stop or lessen my issues with sleep by behaving… (In ways that make you feel more like you (exercising, eating better, taking care of myself, etc.), reaching out when you need someone to talk to, taking care of yourself through regular medical checkups, etc.).

These goals are only examples; use them as guide not an absolute. You know if there is a problem, let now be the time to fix it.

Lastly:

Reaching out for help is never a sign of weakness, but rather one of strength. It may be intimating, annoying or frustrating to think about what to do and how to approach overcoming this, but it can be done. You do not have to do it alone. If you cannot reach or maintain all of these goals on your own, contact a peer supporter, medical provider and/or a psychology professional.

Written by: Brad Carter FF/PM ILFFPS Coordinator and Cody Todd M.A., L.C.P.C. FPS Therapist

References:

Barger, L., Rajaratnam, S., Wang, W. Conor, S., O’Brien, B., Sullivan, J., Qadri, S., Lockley, S., & Czeisler, C. (Jan, 2015). Common Sleep Disorders Increase Risk of Motor Vehicle Crashes and Adverse Health Outcomes in Firefighters. Journal of Clinical Sleep Medicine, 11. http://dx.doi.org/10.5664/jcsm.4534.