Korean Journal of Psychosomatic Medicine (정신신체의학)

Korean Psychosomatic Society (한국정신신체의학회)
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Factors Affecting Sleep Quality of Firefighters

소방공무원의 수면의 질에 대한 영향요인

  • Oh, Jinuk (Department of Psychiatry, Myongji Hospital) ;
  • Ko, Miae (Department of Psychiatry, Myongji Hospital) ;
  • Song, Hoo Rim (Department of Psychiatry, Myongji Hospital) ;
  • Hong, Min Ha (Department of Psychiatry, Myongji Hospital) ;
  • Kim, Hyun Soo (Department of Psychiatry, Myongji Hospital) ;
  • Kim, Woo Jung (Department of Psychiatry, Myongji Hospital)
  • 오진욱 (명지병원 정신건강의학과) ;
  • 고미애 (명지병원 정신건강의학과) ;
  • 송후림 (명지병원 정신건강의학과) ;
  • 홍민하 (명지병원 정신건강의학과) ;
  • 김현수 (명지병원 정신건강의학과) ;
  • 김우정 (명지병원 정신건강의학과)
  • Received : 2017.11.15
  • Accepted : 2018.02.06
  • Published : 2018.06.30
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Abstract

Objectives : Firefighters frequently experience traumatic events, high-tension situations and shift work. Therefore, the prevalence of insomnia of firefighters is higher than one of general population. Not only does the quality of sleep affect the satisfaction of personal life, but it also influences their performance for the public's safety. We investigated which factors affect the quality of sleep of firefighters. Methods : After personally delivering 120 questionnaires to 3 fire stations, the survey was conducted when the consents were signed. It inquired about alcohol use, smoking, shift work, sleep quality, depression, anxiety, and experience of traumatic events. We then divided the firefighting officers in two groups according to the quality of sleep and compared the variables examined to conduct the logistic regression analyses according to the results. Results : The poor sleeper group reported a higher level of current alcohol consumption, depression, anxiety and experience of traumatic events. Logistic regression analyses showed that the current alcohol intake (Crude odds ratio=3.707, 95% confidence interval=1.288-10.672, p=0.015 ; Adjusted odds ratio=3.288, 95% confidence interval=1.011-10.694, p=0.048) has a significant effect on sleep quality. Conclusions : Current alcohol consumption, depression, anxiety and experience of traumatic events were respectively associated with sleep quality of firefighters. When all significant factors considered, the current alcohol use was the only statistically significant. To improve the quality of sleep for firefighters, it will be necessary to evaluate alcohol intake, educate the poor sleep quality caused by alcohol, and provide specific interventions to reduce consumption.

연구목적 소방공무원은 업무의 특수성으로 인해 충격적인 사건에의 잦은 노출, 업무 시 높은 긴장감, 교대근무 등을 경험하게 되며, 불면을 호소하는 비율도 일반 인구에 비해 높은 편이다. 소방공무원의 수면의 질은 개인적인 삶의 만족도에 영향을 줄 뿐만 아니라, 국민의 안전을 위한 업무수행에도 영향을 미칠 수 있다. 소방공무원의 수면의 질 개선을 위해, 수면에 영향을 미치는 요소를 알아보고자 하였다. 방 법 서울 및 경기 지역 3개 소방서에 120부의 설문조사지를 인편으로 전달 후, 서면 동의를 받고 설문을 시행했으며, 93부의 설문지를 수거하였다. 소방공무원을 대상으로 알코올 사용, 흡연 여부, 교대근무, 사회경제적 상태, 정신과적 치료 과거력 등을 조사했으며 수면의 질, 우울감, 불안감, 충격적인 외상의 경험 및 직무 관련 스트레스에 대해 자가보고식 설문을 시행하였다. 수면의 질에 따라 소방공무원을 두 그룹으로 나누어서 조사된 각 변수들을 비교하고, 그 결과에 따라 로지스틱 회귀분석을 실시하였다. 결 과 수면의 질이 불량한 군에서 현재 알코올 사용, 우울감, 불안감 및 충격적인 사건의 경험이 유의하게 높게 나타났으며, 다변량분석을 통해 현재 알코올 사용이 수면에 유의한 영향을 주는 요소로 나타났다(Crude odds ratio=3.707, 95% confidence interval=1.288-10.672, p=0.015 ; Adjusted odds ratio=3.288, 95% confidence interval=1.011-10.694, p=0.048). 결 론 알코올 사용, 우울감, 불안감, 충격적인 사건의 경험이 수면의 질에 각각 영향을 미치는 것으로 나타났으며, 개별적 연관이 있는 요인들을 함께 고려했을 때 현재 알코올 사용 여부가 수면에 질에 유의한 영향을 주는 것으로 나타났다. 소방공무원의 수면의 질 개선을 위해서는, 알코올 사용에 대한 평가, 알코올 사용으로 인한 수면의 질 저하에 대한 교육, 알코올 사용을 줄이기 위한 구체적인 방안들을 마련하는 것이 필요할 것으로 보인다.

Keywords

References

  1. Carey MG, Al-Zaiti SS, Dean GE, Sessanna L, Finnell DS. Sleep problems, depression, substance use, social bonding, and quality of life in professional firefighters. J Occup Environ Med 2011;53:928-933. https://doi.org/10.1097/JOM.0b013e318225898f
  2. Vargas de Barros V, Martins LF, Saitz R, Bastos RR, Ronazni TM. Mental health conditions, individual and job characteristics and sleep disturbances among frefghters. J Health Psychol 2013;18:350-358. https://doi.org/10.1177/1359105312443402
  3. Mehrdad R, Haghighi KS, Esfahani AH. Sleep quality of professional frefghters. Int J Prev Med 2013;4:1095-1100.
  4. Bonnet MH, Arand DL. Clinical effects of sleep fragmentation versus sleep deprivation. Sleep Med Rev 2003;7:297-310. https://doi.org/10.1053/smrv.2001.0245
  5. Akerstedt T, Knutsson A, Alfredsson L, Theorell T. Shift work and cardiovascular disease. Scand J Work Environ Health 1984;10:409-414. https://doi.org/10.5271/sjweh.2302
  6. Costa G. The impact of shift and night work on health. Appl Ergon 1996;27:9-16. https://doi.org/10.1016/0003-6870(95)00047-X
  7. Fung MM, Peters K, Redline S, Ziegler MG, Ancoli-Rsrael S, Barrett-Connor E, Stone KL. Decreased slow wave sleep increases risk of developing hypertension in elderly men. Hypertension 2011;58:596-603. https://doi.org/10.1161/HYPERTENSIONAHA.111.174409
  8. Luyster FS, Strollo PJ Jr, Zee PC, Walsh JK. Sleep: a health imperative. Sleep 2012;35:727-734. https://doi.org/10.5665/sleep.1846
  9. Redeker NS, Stein S. Characteristics of sleep in patients with stable heart failure versus a comparison group. Heart Lung 2006;35:252-261. https://doi.org/10.1016/j.hrtlng.2005.10.007
  10. Majde JA, Krueger JM. Links between the innate immune system and sleep. J Allergy Clin Immunol 2005;116:1188-1198. https://doi.org/10.1016/j.jaci.2005.08.005
  11. Mohren DC, Jansen NW, Kant IJ, Galama J, van den Brandt PA, Swaen GM. Prevalence of common infections among employees in different work schedules. J Occup Environ Med 2002;44:1003-1011. https://doi.org/10.1097/00043764-200211000-00005
  12. Knuston KL, Van Cauter E. Associations between sleep loss and increased risk of obesity and diabetes. Ann N Y Acad Sci 2008;1129:287-304. https://doi.org/10.1196/annals.1417.033
  13. Melamed S, Oksenberg A. Excessive daytime sleepiness and risk of occupational injuries in non-shift daytime workers. Sleep 2002;25:315-322. https://doi.org/10.1093/sleep/25.3.315
  14. Kim KH, Kim JW, Kim SH. Infuences of job stressors on psychosocial well-being, fatigue and sleep suffciency among frefghters. Korean J Occup Environ Med 2006;18:232-245.
  15. Yun JA, Choi KS, Ahn YS. The relationship between chronotype and sleep quality in Korean frefghters. Clin Psychopharmacol Neurosci 2015;13:201-208. https://doi.org/10.9758/cpn.2015.13.2.201
  16. Carpenter JS, Andrykowski MA. Psychometric evaluation of the Pittsburgh Sleep Quality Index. J Psychosom Res 1998; 45:5-13. https://doi.org/10.1016/S0022-3999(97)00298-5
  17. Buysse DJ, Reynold CF 3rd, Monk TH, Berman SR, Kupfer DJ. The Pittsburgh Sleep Quality Index: a new instrument for psychiatric practice and research. Psychiarty Res 1989;28: 193-213. https://doi.org/10.1016/0165-1781(89)90047-4
  18. Shon SI, Kim DH, Lee MY, Cho YW. The reliability and validity of the Korean version of the Pittsburgh Sleep Quality Index. Sleep Breath 2012;16:803-812. https://doi.org/10.1007/s11325-011-0579-9
  19. Beck SL, Schwartz AL, Towsley G, Dudley W, Barsevick A. Psychometric evaluation of the Pittsburgh Sleep Quality Index in cancer patients. J Pain Symptom Manage 2004;27:140-148. https://doi.org/10.1016/j.jpainsymman.2003.12.002
  20. Park KM, Kim WJ, Choi EC, An SK,1 Nam KK, Youm YS, Kim HC, Lee E. Prediction of sleep disturbances in Korean rural elderly through longitudinal follow up. Sleep Med Psychophy 2017;24:38-45.
  21. Lim SY, Lee EJ, Jeong SW, Kim HC, Jeong CH, Jeon TY, Yi MS, Kim JM, Jo HJ, Kim JB. The validation study of Beck Depression Scale 2 in Korean version. Anx Mood 2011; 7:48-53.
  22. Beck AT, Steer RA. Internal consistencies of the original and revised Beck Depression Inventory. J Clin Psychol 1984;40: 1365-1367. https://doi.org/10.1002/1097-4679(198411)40:6<1365::AID-JCLP2270400615>3.0.CO;2-D
  23. Beck AT, Steer RA, Ball R, Ranieri W. Comparison of Beck Depression Inventories-IA and -II in psychiatric outpatients. J Pers Assess 1996;67:588-597. https://doi.org/10.1207/s15327752jpa6703_13
  24. Lee EH, Lee SJ, Hwang ST, Hong SH, Kim JH. Reliability and validity of the Beck Depression Inventory-II among Korean adolescents. Psychiatry Investig 2017;14:30-36. https://doi.org/10.4306/pi.2017.14.1.30
  25. Beck AT, Epstein N, Brown G, Steer RA. An Inventory for measuring clinical anxiety: psychometric properties. J Consult Clin Psychol 1988;56:893-897. https://doi.org/10.1037/0022-006X.56.6.893
  26. Lee HK, Lee EH, Hwang ST, Hong SH, Kim JH. Psychometric properties of the Beck Anxiety in the community- dwelling sample of Korean adults. Korean J Clin Psychol 2016;35:822-830. https://doi.org/10.15842/kjcp.2016.35.4.010
  27. Eun HJ, Kwon TW, Lee SM, Kim TH, Choi MR, Cho SJ. A study on reliability and validity of the Korean version of Impact of Event Scale-Revised. J Korean Neuropsychiatr Assoc 2005;44:303-310.
  28. Creamer M, Bell R, Failla S. Psychometric properties of the Impact of Event Scale-Revised. Behav Res Ther 2003;41:1489- 1496. https://doi.org/10.1016/j.brat.2003.07.010
  29. Chang SJ, Koh SB, Kang D, Kim SA, Kang MG, Lee CG, Chung JJ, Cho JJ, Son M, Chae CH, Kim JW, Kim JI, Kim HS, Roh SC, Park JB, Woo JM, Kim SY, Kim JY, Ha M, Park J, Rhee KY, Kim HR, Kong JO, Kim IA, Kim JS, Park JH, Huyun SJ, Son DK. Developing an Occupational Stress Scale for Korean employees. Korean J Occup Environ Med 2005;17:297-317.
  30. Fullerton CS, Ursano RJ, Wang L. Acute stress disorder, posttraumatic stress disorder, and depression in disaster or rescue workers. Am J Psychiatry 2004;161:1370-1376. https://doi.org/10.1176/appi.ajp.161.8.1370
  31. Roehrs T, Roth T. Sleep, sleepiness, sleep disorders and alco- hol use and abuse. Sleep Med Rev 2001;5:287-297. https://doi.org/10.1053/smrv.2001.0162
  32. Graham K, Massak A, Demers A, Rehm J. Does the association between alcohol consumption and depression depend on how they are measured? Alcohol Clin Exp Res 2007;31:78-88. https://doi.org/10.1111/j.1530-0277.2006.00274.x
  33. McFarlane AC. Epidemiological evidence about the relationship between PTSD and alcohol abuse: the nature of the association. Addict Behav 1998;23:813-825. https://doi.org/10.1016/S0306-4603(98)00098-7
  34. Wilk JE, Blises PD, Kim PY, Thomas JL, McGurk D, Hoge CW. Relationship of combat experiences to alcohol mis- use among U.S soldiers returning from the Iraq war. Drug Alcohol Depend 2010;108:115-121. https://doi.org/10.1016/j.drugalcdep.2009.12.003
  35. Belleville G, Guay S, Marchand A. Impact of sleep distur- bances on PTSD symptoms and perceived health. J Nerv Ment Dis 2009:197;126-132. https://doi.org/10.1097/NMD.0b013e3181961d8e
  36. Hartwell EE, Bujarski S, Glasner-Edwards S, Ray LA. The association of alcohol severity and sleep quality in problem drinkers. Alcohol Alcohol 2015;50:536-541. https://doi.org/10.1093/alcalc/agv046
  37. Greene-Shortridge TM, Britt TW, Castro CA. The stigma of mental health problems in the military. Mil Med 2007:172;157-161. https://doi.org/10.7205/MILMED.172.2.157
  38. Lind MJ, Baylor A, Overstreet CM, Hawn SE, Rybarczyk BD, Kendler KS, Dick DM, Amstadter AB. Relationships between potentially traumatic events, sleep disturbances, and symptoms of PTSD and alcohol use disorder in a young adult sample. Sleep Med 2017;34:141-147. https://doi.org/10.1016/j.sleep.2017.02.024
  39. Lusa S, Hakkanen M, Luukkonen R, Viikari-Juntura E. Perceived physical work capacity, stress, sleep disturbance and occupational accidents among firefighters working during a strike. Work Stress 2002;16:264-274. https://doi.org/10.1080/02678370210163301
  40. Baik JH, Jung YE, Chae JM, Myong JP, Yim HW, Chae JH. Effects of vicarious trauma on mental health in frefghters. Anx Mood 2010;6:65-70.