evaluating worksite sleep health coaching in firefighters: the sleep assistance for firefighters study

Conditions: Cognitive Behavioral Therapy; Sleep Initiation and Maintenance Disorders; Sleep Deprivation; Sleep Disorders, Intrinsic

Summary: insufficient sleep is a significant public health issue, particularly affecting shift workers like firefighters, nearly half of whom report short or poor-quality sleep, with 35-40% screening positive for sleep disorders. cognitive behavioral therapy for insomnia (cbti) is a recommended and effective treatment, but access to such interventions remains low. this study will recruit 20 fire agencies in arizona (400 firefighters) to test if a cbti-informed intervention, including sleep health coaching and agency-wide promotion, improves sleep more effectively than usual care. the trial will also explore factors that influence successful implementation across agencies.

insufficient sleep is a major public health crisis in the united states and worldwide, disproportionately affecting shift workers and other at-risk groups. firefighters are one such group at heightened risk for disturbed sleep. almost half of career firefighters report short sleep and poor sleep quality, and 35-40% of firefighters screen positive for a sleep disorder. evidence-based sleep health interventions are available and highly effective in eliciting behavioral change. the american college of physicians recommends cognitive behavioral therapy for insomnia (cbti) as the first-line treatment for insomnia disorder, and substantial evidence supports the efficacy of this therapy with comorbid conditions, including shiftwork and obstructive sleep apnea. unfortunately, access to cbt-informed sleep health interventions remains low. workplace wellness programs could be one way to help more firefighters receive sleep intervention. this study will recruit 20 fire agencies in arizona (n = 400 career firefighters) to examine whether a cbti-informed intervention is more effective than usual care in reducing sleep disturbances or improving multidimensional sleep health. the intervention will last one year and will include telephone-administered sleep health coaching to firefighters, sleep health promotion to the agency and agency leaders, and external/internal facilitation strategies for implementation. the trial will also examine which combinations of factors are associated with successful agency implementation of the intervention. all participating agencies will receive the intervention; however, some agencies will wait longer to receive the intervention than others.

Eligibility criteria:
inclusion criteria: * required to be employed as career (paid), uniformed fire service workers that must work in a participating fire agency. * must have moderate or more severe levels of sleep disturbances \[item-level calibrated t-score of 55 or higher on the 8-item patient-reported outcomes measurement information system (promis) sleep disturbance (sd) questionnaire\]. * must have private access to a computer or phone for sleep health coaching. exclusion criteria: * children younger than 18 years of age.

Keywords: cbti sleep deprivation sleep disorders firefighters sleep health coaching