Sleep Deprivation: EMS Enters The Dr. Chris Nollette, NREMTP, LP Mr. Chris Leon, BS, EMTP

Myths or Reality about sleeping? You can you bank your sleep You only need 8 hours of sleep – no more no less You can take a power nap of 20 minutes and restore your activity level

Sleeping can reduce your waistline There is no direct link to Alzheimer's and sleeping Sleeping only 4 hours a night can lead to a 70 year old brain by the end of the week Myths or Reality about sleeping?

Your are more emotional without sleeping Increasing age requires more sleep Slap some water on your face, turn the temperature down, sing to the radio, talk to yourself in the car – will keep you awake and alert Myths or Reality about sleeping?

The Science of Sleep: Under the Bed Exxon Valdez – happened after midnight with the man at the helm only getting 4 hours of sleep Chernobyl and Three Mile Island – occurred late at night Staten Island Ferry crash – exhausted assistant captain

American Cancer Society Study 1960 survey asked 1 million Americans how much sleep they were getting each night Answer: medium of 8 hours Today the medium of 6.7 hours “Four to six hours of sleep in just six days put one on the road to a pre – diabetic state…contributing to an epidemic of obesity (hormone leptin)” Eve Van Cauter, endocrinologist University of Chicago School of Medicine

Sleeping is for the young Infant – hours of sleep a day Adolescents – 8-12 years of age hours Adolescents – over 12 same as adult 8 hours Aging – over 65 years – sleep decreases Kerry Kuehl, MD, Dr.PH, Associate Professor of Medicine Oregon Health Sciences University As we age our time in deep sleep decreases – can some problems of aging be attributed to less sleep? “We lose deep sleep at a very early age. So a young healthy person may have 100 minutes of deep sleep, and at 50 years old it may be as little as 20 minutes” Eve Van Cauter, endocrinologist University of Chicago School of Medicine

The Science of Sleep: Under the Bed REM versus Non REM Sleep Non REM – 4 stages Stage 1 Stage 2 Stage 3 Stage 4 Lay down Brain waves Deep Delta <HR <BP Tissue / Heart repair Stage 3 & 4 you may get sleep inertia – hard to get up

The Science of Sleep: Under the Bed REM versus Non REM Sleep REM – dream state Mental health is restored during the night Medications may knock out REM sleep and increase depression Driving yourself to an early grave?...

Effects of Sleep Deprivation on Fire Fighters and EMS Responders Study…..Long work hours often are associated with chronic sleep loss, which may result in decreased ability to think clearly, depression, irritability, health complaints, higher body weight, cardiovascular disease and cancer Circadian Rhythms – we are day creatures Sleeping in another bed – quality of sleep is affected – station or hotel

Effects of Sleep Deprivation on Fire Fighters and EMS Responders Acute Slow reaction time & thinking is impaired Reduced psychomotor vigilance Chronic Increased accidents / work related errors Chronic sleep deprivation = depression & decrease in sense of well being Kerry Kuehl, MD, Dr.PH, Associate Professor of Medicine Oregon Health Sciences University

Effects of Sleep Deprivation on Fire Fighters and EMS Responders Firefighters and Heart Disease Leading cause of death over fighting fires NE Journal of Medicine March 22, 2007 Deep sleep needed for cardiac repair Averaging less than 6 hours of sleep a night for 6 days is = one pack of cigarettes a day Kerry Kuehl, MD, Dr.PH, Associate Professor of Medicine Oregon Health Sciences University

Effects of Sleep Deprivation on Fire Fighters and EMS Responders Obesity Sleep loss = weight gain Kerry Kuehl, MD, Dr.PH, Associate Professor of Medicine Oregon Health Sciences University Cancer Meta analysis of 32 studies showed an increase in testicular, prostrate & lymphomas Journal of Occupational & Environmental Medicine November, 2006 World Health Organization study on night shifts for nurses and firefighters – increase in colon, prostate, and breast cancer Lancet, Oncology December 7, 2007

Sleep and our Mental Health Mood swings common: short tempered and giddy within seconds Hyperactive brain Disconnect between the amygdala and the frontal lobe Brain scans look similar between those with a lack of sleep and those with a psychiatric disorder Matthew Walker, Director Sleep and Neuroimaging Lab University of California, Berkeley

Sleep and our Memory Sleep enhances memory Study subjects participated in a sleep research and memory study Students did 40% worse on memorization after being up for 24 hours without sleep Matthew Walker, Director Sleep and Neuroimaging Lab University of California, Berkeley

Driving Drowsy: Micro-sleeping at the wheel 241 volunteers agree to have their cars wired with five cameras each Over one years time the study found that driving drowsy (micro-sleeping) was the riskiest behavior of all Virginia Tech’s Transportation Institute

NIH funded study at the University of Pennsylvania’s School of Medicine Chronic partial sleep deprivation Stay awake till 4 a.m. then woken up at 8 a.m. Findings: cumulative impairment First night – thinking and memory slows down Second and third night – deficit to cognitive ability No bright lights or caffeine allowed – the counter measures

Epworth Sleepiness Scale Never dose off> Doze off Sit and read0123 Watch TV0123 Sit and talk0123 Ride in car0123 Lying down0123 After lunch0123 Sitting traffic0123 This talk0123 Where are you at?…low number? Maybe your safe

Obstructive Sleep Apnea (OSA) Affects 2% of men and 1% of women 12 fold increase in: Increased blood pressure Weight gain Sexual dsyfunction Sudden death May require positive pressure breathing apparatus

Obstructive Sleep Apnea (OSA) Oh….the number is only one measurement! Score greater than 16 on the Epworth Scale Snore Fatigue related crashes Overweight or Obese Greater than 17 inch neck Increased blood pressure

Myths or Reality about sleeping? You can you bank your sleep You only need 8 hours of sleep – no more no less You can take a power nap of 20 minutes and restore your activity level

Sleeping can reduce your waistline There is no direct link to Alzheimer's and sleeping Sleeping only 4 hours a night can lead to a 70 year old brain by the end of the week Myths or Reality about sleeping?

Your are more emotional without sleeping Increasing age requires more sleep Slap some water on your face, turn the temperature down, sing to the radio, talk to yourself in the car – will keep you awake and alert Myths or Reality about sleeping?

Do we hide under the bed? Health lifestyle changes – Sleep, diet and exercise Do we really want 24 / 36 or 72 hour shifts? Cool, quite, dark place with no stimulants Naps 90 minutes Limit alcohol and caffeine What is the alternative?

The End ….or is it? Sleep well …. Sleep tight…. We thank you for letting us be a part of your day