Patterson Paul D, Martin Sarah E, MacAllister Sean A, Weaver Matthew D, Patterson Charity G
Department of Emergency Medicine, School of Medicine, University of Pittsburgh, Pittsburgh, PA 15213, USA.
Department of Community Health Services and Rehabilitation Science, School of Health and Rehabilitation Sciences, University of Pittsburgh, Pittsburgh, PA 15213, USA.
Int J Environ Res Public Health. 2025 Apr 6;22(4):573. doi: 10.3390/ijerph22040573.
We sought to characterize momentary changes in fatigue, sleepiness, and difficulty with concentration during short and long duration shifts worked by emergency medical services (EMS) and fire personnel across the United States. In addition, we tested for differences in pre-shift and on-shift sleep stratified by shift duration. We examined real-time mobile-phone text message queries during scheduled shifts from the EMS Sleep Health Study, a nationwide, cluster-randomized trial (ClinicalTrials.gov Identifier: NCT04218279). Linear mixed effects models were used and Bonferroni -values reported for multiple comparisons. In total, 388 EMS clinicians from 35 EMS/fire agencies documented 4573 shifts and responded to 64.6% of 161,888 text message queries. Most shifts (85.5%) were 12 or 24 h in duration. Mean sleep hours pre-shift was 6.2 (SD1.9) and mean sleep hours on shift was 3.4 (SD2.9) and varied by shift duration ( < 0.0001). The highest level of fatigue, sleepiness, and difficulty with concentration during any shift occurred during 24 h shifts and corresponded to the early morning hours at 03:00 or 04:00 a.m. The real-time assessments of sleep hours and fatigue in this study revealed deficits in sleep health for EMS and fire personnel and critical time points for intervention during shifts when the risk to safety is high.
我们试图描述美国各地紧急医疗服务（EMS）人员和消防人员在短时间和长时间轮班期间疲劳、困倦和注意力不集中的瞬间变化。此外，我们还测试了按轮班时长分层的班前和班中睡眠差异。我们检查了来自EMS睡眠健康研究的预定轮班期间的实时手机短信查询，该研究是一项全国性的整群随机试验（ClinicalTrials.gov标识符：NCT04218279）。使用线性混合效应模型，并报告用于多重比较的Bonferroni P值。共有来自35个EMS/消防机构的388名EMS临床医生记录了4573个轮班，并回复了161888条短信查询中的64.6%。大多数轮班（85.5%）时长为12或24小时。班前平均睡眠时间为6.2（标准差1.9）小时，班中平均睡眠时间为3.4（标准差2.9）小时，且因轮班时长而异（P<0.0001）。在任何轮班期间，疲劳、困倦和注意力不集中的最高水平出现在24小时轮班期间，对应于凌晨03:00或04:00。本研究对睡眠时间和疲劳的实时评估揭示了EMS人员和消防人员的睡眠健康缺陷，以及在安全风险较高的轮班期间进行干预的关键时间点。
