Sleep and mental health in recruit paramedics: a 6-month longitudinal study

• Published in: Sleep (New York, N.Y.) Vol. 46; no. 8; p. 1
• Main Authors: Nguyen, Elle, Meadley, Ben, Harris, Rachael, Rajaratnam, Shantha M W, Williams, Brett, Smith, Karen, Bowles, Kelly-Ann, Dobbie, Megan L, Drummond, Sean P A, Wolkow, Alexander P
• Format: Journal Article
• Language: English
• Published: US Oxford University Press 01-08-2023
• Subjects: Analysis; Female; Health aspects; Humans; Insomnia; Longitudinal Studies; Male; Medical research; Medicine, Experimental; Mental depression; Mental Health; Paramedics; Post traumatic stress disorder; Risk factors; Sleep; Sleep apnea syndromes; Sleep Initiation and Maintenance Disorders - complications; Sleep Initiation and Maintenance Disorders - epidemiology; Sleep, Health, and Disease; Australia; sleep; paramedic; actigraphy; longitudinal; mental health
• ISSN: 0161-8105; 1550-9109
• DOI: 10.1093/sleep/zsad050

Abstract
Study Objectives
To explore potential relationships and longitudinal changes in sleep and mental health in recruit paramedics over the first 6 months of work, and whether sleep disturbances pre-emergency work predict future mental health outcomes.
Methods
Participants (N = 101, 52% female, Mage = 26 years) completed questionnaires prior to (baseline), and after 6 months of emergency work to assess for symptoms of insomnia, obstructive sleep apnea, post-traumatic stress disorder (PTSD), depression, anxiety, and trauma exposure. At each timepoint, participants also completed a sleep diary and wore an actigraph for 14 days to assess sleep patterns. Correlations between baseline sleep and mental health were conducted and changes in these variables across timepoints were examined using linear mixed models. Hierarchical regressions assessed whether sleep at baseline predicted mental health at follow-up.
Results
Insomnia and depression symptoms, and total sleep time increased while sleep onset latency decreased across the first 6 months of emergency work. Participants experienced an average of 1 potentially traumatic event during the 6-month period. Baseline insomnia predicted increased depression symptoms at the 6-month follow-up, while baseline wake after sleep onset predicted follow-up PTSD symptoms.
Conclusion
Results highlight an increase in insomnia and depression across the initial months of emergency work, while sleep disturbances before emergency work were identified as potential risk factors for the development of depression and PTSD among paramedics in their early career. Screening and early interventions targeting poor sleep at the beginning of emergency employment may assist in reducing the risk of future mental health outcomes in this high-risk occupation.
Graphical abstract
Graphical Abstract