Mini G K, Sangeeth Krishna S, Gopika Gopinathan Bhaskaran, Anjana V M, Marthanda Pillai Anand, Sreedevi Aswathy, Marthanda Pillai A, Irazola Vilma
Global Institute of Public Health, Ananthapuri Hospitals and Research Institute, Thiruvananthapuram, Kerala, India.
Centre for Environment and Development (CED), Thiruvananthapuram, Kerala, India.
BMC Public Health. 2025 Jun 6;25(1):2119. doi: 10.1186/s12889-025-23292-0.
Globally, poor sleep is a significant public health problem. Healthy sleep is important for physical and mental well-being, particularly for individuals who work in environments with shift schedules. However, this issue has not been adequately addressed, especially in low-and-middle-income settings. This study examined sleep apnea and excessive daytime sleepiness among police officers in Kerala, India, and explored the factors associated with these conditions.
Using a cross-sectional study design, we collected data from 253 police officers selected from 14 police stations in Thiruvananthapuram district. Data on socio-demographic and occupational characteristics were collected using structured questionnaire and stress using the Police Stress Questionnaire. Sleep apnea and excessive daytime sleepiness (EDS) were assessed using the Berlin Scale and Epworth Sleepiness Scale, respectively. Both bivariate and multivariate analyses were used to identify associated factors with sleep apnea and EDS.
Participants were predominantly male (89%), aged 30-55 years (mean: 42 years, SD:±6). The prevalence of operational stress was 75.5% [95% Confidence Interval (CI): 69.7-80.6], organizational stress 65.6% (CI:59.4-71.4), sleep apnea 15.0% (CI:10.8-20.0), and EDS 56.5% (CI:50.1-62.7). Sleep apnea was significantly higher among alcohol or tobacco users [unadjusted odds ratio (UAOR):2.16, CI:1.07-4.34]. Both operational stress (UAOR:4.41, CI:1.30-14.89) and organizational stress (UAOR:4.06, CI:1.52-10.84) were significantly associated with sleep apnea. EDS was more likely to be reported by officers from rural police stations (UAOR:3.09, CI:1.82-5.24), those with fewer years of experience (UAOR:1.65, CI:1.00-2.73), and among civil police officers (UAOR:2.15, CI:1.23-3.76) compared to their counterparts. The regression results indicated that those with diabetes or hypertension were significantly more likely to have sleep apnea (Odds Ratio (OR):8.41 95% CI: 3.20-22.10) compared to those without these conditions. Police officers from rural stations were more likely to experience excessive daytime sleepiness compared to their counterparts from urban areas (OR: 3.14, 95% CI: 1.80-5.47).
A high prevalence of sleep disorders was observed among police officers, with strong associations to occupational stress and lifestyle factors. Based on the findings, we initiated behavioral interventions to improve sleep quality in this population.
在全球范围内，睡眠质量差是一个重大的公共卫生问题。良好的睡眠对身心健康至关重要，尤其是对于那些在轮班工作环境中工作的人。然而，这个问题尚未得到充分解决，特别是在低收入和中等收入地区。本研究调查了印度喀拉拉邦警察的睡眠呼吸暂停和日间过度嗜睡情况，并探讨了与这些状况相关的因素。
采用横断面研究设计，我们从特里凡得琅区14个警察局挑选的253名警察中收集数据。使用结构化问卷收集社会人口学和职业特征数据，并使用警察压力问卷收集压力数据。分别使用柏林量表和爱泼华嗜睡量表评估睡眠呼吸暂停和日间过度嗜睡（EDS）。采用双变量和多变量分析来确定与睡眠呼吸暂停和EDS相关的因素。
参与者主要为男性（89%），年龄在30 - 55岁之间（平均：42岁，标准差：±6）。工作压力的患病率为75.5% [95%置信区间（CI）：69.7 - 80.6]，组织压力为65.6%（CI：59.4 - 71.4），睡眠呼吸暂停为15.0%（CI：10.8 - 20.0），EDS为56.5%（CI：50.1 - 62.7）。饮酒或吸烟者的睡眠呼吸暂停患病率显著更高[未调整优势比（UAOR）：2.16，CI：1.07 - 4.34]。工作压力（UAOR：4.41，CI：1.30 - 14.89）和组织压力（UAOR：4.06，CI：1.52 - 10.84）均与睡眠呼吸暂停显著相关。与城市警察相比，农村警察局的警察更有可能报告EDS（UAOR：3.09，CI：1.82 - 5.24），经验较少的警察（UAOR：1.65，CI：1.00 - 2.73）以及民事警察（UAOR：2.15，CI：1.23 - 3.76）也更易报告EDS。回归结果表明，与没有糖尿病或高血压的人相比，患有糖尿病或高血压的人患睡眠呼吸暂停的可能性显著更高（优势比（OR）：8.41，95% CI：3.20 - 22.10）。与城市地区的警察相比，农村警察局的警察更容易出现日间过度嗜睡（OR：3.14，95% CI：1.80 - 5.47）。
在警察中观察到睡眠障碍的高患病率，与职业压力和生活方式因素密切相关。基于这些发现，我们启动了行为干预措施以改善该人群的睡眠质量。
