Sleep Problems in Police Officers Take Heavy Toll

More than a third of police officers have a sleep disorder, and those who do are more likely to experience heart disease, problems with job performance and rage toward suspects and citizens, a new study suggests.

The research is one of the most extensive looks to date at the toll of sleep deprivation on police officers, a group for which overnight shifts, long hours and fractured sleep are all too common. About 5,000 state and local police officers in the United States and Canada, most from Massachusetts and Philadelphia, elected to take part in the study; roughly 40 percent of them were found to have a sleep disorder. That figure is at least double the estimated 15 to 20 percent rate of sleep disorders seen in the general population.

The most common disorder identified in the study was obstructive sleep apnea, which causes dangerous pauses in breathing during sleep. Sleep apnea, common in the obese, is tightly linked to hypertension, heart disease and a higher risk of accidents on the road. A third of the officers in the study screened positive for the condition, including many who had no idea they had it and were not receiving treatment.

“This seems to be an underrecognized and important public health problem,” said Dr. Charles A. Czeisler, chief of the division of sleep medicine at the Brigham and Women’s Hospital in Boston and an author of the study, published in the latest issue of The Journal of the American Medical Association.

Though the study did not look at cause and effect, it was clear that sleep problems and poor health were entwined. On almost every aspect of health and job performance that was measured, the officers who had sleep problems fared far worse than their peers. After adjustments were made for age, sex and other variables, having a sleep disorder raised the odds of heart disease by 45 percent, for example, and the odds of depression by 120 percent. It also raised the odds of being injured on the job by 22 percent and falling asleep while driving by 51 percent. Nationwide, from 2009 to 2010, more than a third of officers who died in the line of duty were killed in motor vehicle crashes, a problem that is widely overlooked.

But the drowsiest officers in the new study were not just a danger to themselves. The officers who had sleep disorders reported more instances of “uncontrolled anger” toward suspects and citizens and increased absenteeism and serious administrative errors. Part of the reason, imaging studies at Brigham and Women’s suggest, is that sleep deprivation may affect the amygdala, a part of the brain where emotion is governed.

“You’re dealing with a suspect, maybe they say something nasty or they insult you, and there’s a greater likelihood of being unable to control your emotional response,” Dr. Czeisler said. “Being sleep-deprived would impair your ability to hold your emotions in check. It could also account for the self-reported increase in the number of citizen complaints filed against those officers.”

Buried in the findings, however, was at least one bright spot. The Massachusetts state police were far less likely than officers in Philadelphia and other area to have sleep apnea, which Dr. Czeisler attributed to their better overall fitness. They had lower rates of obesity than other police officers, and smaller body mass indexes — and the reason was no mystery, Dr. Czeisler said. State police officers in Massachusetts have to pass regular fitness tests to keep their jobs, and they are given one hour of paid exercise time four days a week to help them stay fit.

“The three most important risk factors for sleep apnea are obesity, obesity and obesity,” Dr. Czeisler said. “The data we collected suggests that this fitness program has paid for itself many times over, because the health care costs associated with untreated sleep apnea are substantial.

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