The Development of a Sleep Intervention for Firefighters: The FIT-IN (Firefighter's Therapy for Insomnia and Nightmares) Study.

Eun Hee Jang,Yujin Hong,Hyejin Lim,Seockhoon Chung,Sooyeon Suh,Yeji Kim,Kyoung Sook Jeong,Eunha Jung,Tae-Won Jang,Sangha Lee,Yeonsoon Ahn

doi:10.3390/ijerph17238738

Abstract

Background: Firefighters are vulnerable to irregular sleep patterns and sleep disturbance due to work characteristics such as shift work and frequent dispatch. However, there are few studies investigating intervention targeting sleep for firefighters. This preliminary study aimed to develop and test a sleep intervention, namely FIT-IN (Firefighter’s Therapy for Insomnia and Nightmares), which was based on existing evidence-based treatment tailored to firefighters in consideration of their occupational characteristics. Methods: This study implemented a single-group pre-post study design, utilizing an intervention developed based on brief behavior therapy for insomnia with imagery rehearsal therapy components. FIT-IN consisted of a total of three sessions (two face-to-face group sessions and one telephone session). Participants were recruited from Korean fire stations, and a total of 39 firefighters participated. Participants completed a sleep diary for two weeks, as well as the following questionnaires to assess their sleep and psychological factors: insomnia severity index (ISI), disturbing dream and nightmare severity index (DDNSI), Epworth sleepiness scale (ESS), depressive symptom inventory-suicidality subscale (DSI), and Patient Health Questionnaire-9 (PHQ-9). These questionnaires were administered before the first session and at the end of the second session. Results: The FIT-IN program produced improvements in sleep indices. There was a significant increase in sleep efficiency (p < 0.01), and a decrease in sleep onset latency, number of awakenings, and time in bed (p < 0.05), as derived from weekly sleep diaries. In addition, significant decreases were shown for insomnia (p < 0.001) and nightmare severity (p < 0.01). Conclusion: There were significant improvements in sleep and other clinical indices (depression, PTSD scores) when comparing pre-and post-intervention scores. FIT-IN may be a feasible and practical option in alleviating sleep disturbance in this population. Further studies will be needed to ascertain FIT-IN’s effectiveness.

Highlights

Firefighters work in an environment that requires a rotating shift system, which leads to irregular sleep patterns and vulnerabilities to sleep disturbance and mental health issues, such as depression and suicidality [1,2,3]
This study focused on developing a sleep intervention targeting improvement for sleep disturbance commonly found in firefighters
This study was conducted as part of the sleep panel study (SLEPS) to improve sleep disturbance in Korean firefighters [36,37]

Summary

Introduction

Firefighters work in an environment that requires a rotating shift system, which leads to irregular sleep patterns and vulnerabilities to sleep disturbance and mental health issues, such as depression and suicidality [1,2,3]. Participants completed a sleep diary for two weeks, as well as the following questionnaires to assess their sleep and psychological factors: insomnia severity index (ISI), disturbing dream and nightmare severity index (DDNSI), Epworth sleepiness scale (ESS), depressive symptom inventory-suicidality subscale (DSI), and Patient Health Questionnaire-9 (PHQ-9). These questionnaires were administered before the first session and at the end of the second session. Further studies will be needed to ascertain FIT-IN’s effectiveness

Methods

Results

Conclusion