0294 Sleep Quality Ratings Predict Disagreement Between Daily Objective and Subjective Evaluations of Total Sleep Time in Firefighters

Abstract

Abstract Introduction Accurate sleep assessment in firefighters is necessary to predict risk for error and also to identify sleep disorders like shift work disorder. Unfortunately, the primary tools for sleep assessment, actigraphy and sleep diaries, are sometimes discordant leaving interpretation of sleep unclear. This analysis sought to examine determinants of daily discrepancies between actigraphy and sleep diaries in firefighters to further understand the validity of these measures in an on-call, high risk occupation. Methods Daily sleep observations (n = 329) were collected from 60 firefighters over the course of a 6-day recovery period after working 5 non-consecutive 24-hour shifts (5/6 tour). Firefighter subjective sleep was measured using the consensus sleep diary, and objective sleep was measured via wrist-worn actigraphy (Actiwatch-2). Mixed linear modeling (MLM) was employed with purposeful selection of covariates to test which day-level variables (day of recovery, emotional state, sleep quality rating) and person-level variables (burnout, age, gender, minority status) best predicted disagreement in total sleep time (TST) between the sleep diary and actigraphy. Results The best-fitting model indicated that TST incongruency (subjective > objective) occurred on days when individuals reported better sleep quality than their own average (Estimate = 19.87, SE = 5.02, p < .001), more feelings of restfulness than their own average (Estimate = 22.70, SE = 4.77, p < .001), less objective TST than their average (Estimate = -.37, SE = .04, p < .001) and for persons with higher duration subjective TST (Estimate = 1.02, SE = .07) and lower duration objective TST (Estimate = -1.00, SE = .08, p < .001). Neither burnout nor daily emotions predicted discrepancies in the two methods of assessment. Conclusion Employees most at-risk for potential overestimation of sleep duration were those that habitually received less objective TST or who habitually reported more TST. A discrepancy in measurement occurred on days when employees reported better-than-usual sleep quality and restfulness after sleep. These robust findings demonstrated that positive perception of sleep quality is a potential indicator of sleep overestimation in firefighters. Further research is necessary to examine the short- and long-term consequences of sleep overestimation in this occupation. Support (if any) #1R01HL117995-01A1