Obstructive Sleep Apnea Clinical Trial
Official title:
Fire Fighter Fatigue Management Program: Operation Fight Fatigue
Firefighters frequently work extended duration shifts and long work weeks which have adverse effects on alertness, health, safety and performance. This protocol uses a survey instrument to examine the effects of extended duration shifts on safety outcomes (e.g., motor vehicle crashes, accidents, injuries), health (e.g., diagnosis and treatment of sleep disorders, improved general health indices, decreased number of sick days), and performance (e.g., decreased response time). This study will expand understanding of the nature, scope, etiology and consequences of firefighter fatigue and increase our ability to develop guidelines that can be generalized across fire departments throughout North America. This study could provide an avenue to make lasting policy improvements that could enhance the safety, health, and performance of firefighters.
Firefighters work some of the most challenging schedules known under highly stressful and
demanding conditions. The need to work frequent extended shifts leads to acute and chronic
sleep deficiency as well as disruption of circadian rhythms. Firefighters on-call overnight
are also particularly susceptible to sleep inertia, the neurocognitive impairment
experienced immediately upon waking. In addition, it is likely that a significant proportion
of firefighters suffer from undiagnosed sleep disorders, which further impair sleep and
exacerbate fatigue.
The proposed fatigue countermeasure aims to increase sleep opportunities, and thereby
improve firefighter safety and health. We will be conducting a station-level, randomized
clinical trial of policies designed to maximize sleep opportunities during current 24-hour
shifts to improve alertness, performance, health and safety in firefighters.
We will leverage the comprehensive fatigue management program we developed and the web-based
technology we implemented in previous Federal Emergency Management Agency projects, and will
continue to offer our web-based education program and sleep disorders screening. By
conducting a collaborative study involving sleep medicine clinicians, sleep researchers, a
consultant on alarms, together with the representatives from the management, and union
leadership of the fire department, we expect we will develop a sleep optimization program
with a high probability of success and test the hypotheses that increasing the sleep
opportunity of firefighters will improve the alertness, performance, safety and physical and
mental health of firefighters. The results of this study will provide policy makers with the
scientific evidence they require to develop effective fatigue countermeasure programs for
firefighters.
We will be conducting a randomized clinical trial, providing the most rigorous evaluation
possible in an operational setting. Half the fire stations in a department will be randomly
assigned to complete the intervention, termed Operation Fight Fatigue, in the first year of
the study. The other half of the fire stations will complete the intervention in the second
year. In this way, all firefighters will have the chance to benefit. We expect the fatigue
countermeasure intervention to improve the alertness, performance, health and safety of
firefighters. We will be evaluating a cost-effective intervention to improve the safety and
health of firefighters in departments throughout the United States.
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Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Treatment
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