Warning! Your Police Officer's Sleep Disorder May Be Hazardous to Your Health

[McCamy Taylor]

JAMA the Journal of the AMA has an article in its December 21, 2011 issue about sleep disorders among U.S. police officers. It is called "Sleep Disorders, Health, and Safety in Police Officers". Here is the link. Read it fast. I think JAMA makes these articles public for only a short time.

http://jama.ama-assn.org/content/306/23/2567.full.pdf+html

The authors of the above article administered surveys to about 5000 police officers from different parts of the country, to see how many were likely to have sleep disorders and how much these sleep disorders might interfere with their job performance.

One of the most surprising findings---40% tested positive for at least one sleep disorder. Obstructive sleep apnea (OSA) was the most common of these sleep disorders. For anyone not familiar with OSA, here is a link to my old DU journal.

http://www.democraticunderground.com/discuss/duboard.php/www/photobucket.com/albums/v611/duboard.php?az=show_mesg&forum=222&topic_id=83019&mesg_id=83019

Sleep apnea is a syndrome in which a person is unable to move air during sleep. I.e. he or she chokes or strangles, anywhere from a few times an hour up to every few minutes. The disturbed sleep, low oxygen and elevated catecholamines (stress hormones) can cause a variety of medical problems. Some of these include poor attention, temper flare ups and falling asleep at inappropriate times (like on the road). Sleep apnea is a major public health problem because it is so common (up to 16% of men have it), so underdiagnosed (less 20% of those men know they have it) and because an untreated sleep apnea sufferer drives like a drunk driver---a drunk driver who thinks he is in perfect control.

According to the JAMA article, police officers have a relatively high rate of sleep disorders. Despite the fact that most police officers have good insurance, many of them do not know that they have a sleep disorder and are not being treated. And---most worrisome from a public health perspective---these officers with untreated sleep disorders are more likely to fall asleep while driving, more likely to be involved in motor vehicle accidents at work and more likely to act in an angry manner towards the public. They also make more administrative errors and safety violations. They are more likely to become depressed or "burned out" than those without a sleep disorder.

Factors that increase the risk of a sleep disorder such as sleep apnea include male gender, increasing age and obesity.

How many police officers who react in an angry, inappropriate manner to protesters suffer from a sleep disorder? How many police involved in high speed chases that end in accidents have OSA? How many innocent folks have been shot or tased or struck by a sleep deprived officer?

The solution is simple. Since police officers are public servants, screen them all annually, refer those who test positive for formal sleep studies (that can be paid for by their insurance) and start the appropriate treatment. Previous studies show that once you start treating a sleep disorder, function usually returns to normal.

The major flaw of the JAMA article. A sleep survey was used and only a small number of participants where given formal sleep studies (the gold standard test) to confirm that the "positive" surveys indicated actual disease. However, screening surveys have proved reliable in general population studies, and the use of these would allow police departments to address this problem in a relatively cheap and easy way.

[Brickbat]

1. It's not just police officers. Sleep disorders are misdiagnosed or go undiagnosed in every

profession, with dire consequences.

ETA: Workers are stuck with chronic fatigue or inadequate sleep because of harsh schedules, as well.

[CoffeeCat]

2. I suffer from sleep apnea...

I had sleep apnea that went undiagnosed for years. At the peak of it--I seriously thought
that I had early-onset Alzheimer's. I would be driving and forget where I was going--and
I would also forget where I was. Nothing looked familiar. I had to stop, get myself
grounded and reorient myself--and remind myself of where I was and where I was going.

I was only 45 when this was happening. I finally was diagnosed with a sleep disorder,
and the sleep test showed that I stopped breathing 25 times an hour. I looked like shit,
felt like shit and had gained a ton of weight.

I used a CPAP until I lost a lot of weight and was healthy and exercising. That lasted for a while.
Now, I'm gaining weight again, and guess what--the apnea has returned. I start a new exercise
program 1/7 and I cannot wait.

I feel shitty again and I have absolutely no energy. I'm starting to use the wrong words when
I talk and most times can't even find the words! After working in communications and journalism
for some time--it's really the worst.

Sleep apnea is a VERY, VERY serious disorder. I really think you can lose your mind if it goes
untreated. I can't imagine, in my current condition, being a police officer with a gun. You simply
cannot think straight or make cogent decisions. You're in a fog.

I hope there is more education about sleep apnea, because I think many people (as I did) suffer
needlessly.

[Skittles]

5. I am just curious but

why are you waiting until 1/7 to exercise? You don't need to be in a PROGRAM to exercise.

[CoffeeCat]

8. Sure, I don't NEED a program...

I could get off of my butt and go exercise. We belong to a health club and I could go outside and
walk/jog--it's been unseasonably warm here.

I am in a really bad place right now. I signed up for this 10-week boot camp program. I did it last
year and had terrific results. I am excited about it. That's all. It's the light at the end of the tunnel
for me.

True, I could be doing other things--but I'm not. It is what it is.

[REP]

7. It is seriously under diagnosed in women

I start having severe symptoms in my 20s, but when I went to see a doctor, I was told that I was "too young, too thin and too female" to have sleep apnea. By the time I finally found a doctor who would take my symptoms seriously, I was blacking out without notice - mid-sentence, while driving, etc - and having hallucinations. My study results were the worst they'd seen; my oxygen saturation rate was under 60% and I never went beyond Stage 2 sleep. I have Mixed Apnea, which is both obstructive (I have a concha bullosa) and central (my brain 'forgets' to breathe).

Anyone can have sleep apnea. It is not something that happens to just older, heavier men.

[CoffeeCat]

9. YES...

...and I would like to add that I was in the normal weight range. However, when my apnea started, my
weight climbed and of course, worsened the apnea.

You make a good point. Just because you are thin or of normal weight--doesn't mean you can't have sleep apnea.
And if it goes undiagnosed, it can cause weight gain, which only exacerbates the apnea.

I hear you, regarding the horrible symptoms. I was "cured" of the apnea, after I lost 50 lbs. Now, I'm sliding
backward and the apnea is returning and I'm starting to feel all of those old symptoms again. I talk and I
have trouble finding words for what I want to say. It's very bizarre.

I am NOT going back there though. After getting well, and now I'm backsliding--I'm going to scratch and claw my
way back to normal again.

I wish you the best and I am glad you finally got your diagnosis. You must have been so incredibly tired and
debilitated when you went undiagnosed for so long. It's so difficult isn't it? Every day is a foggy struggle
when you have untreated apnea.

[spinbaby]

10. Women have different symptoms, too

Men tend to be sleepy; women tend to be irritable insomniacs. Also, women tend to have upper airway resistance syndrome that interrupts sleep without showing up as frank apnea. I had it for decades--but didn't have apnea on a sleep study--and was told that I was depressed (not sleeping will certainly depress you) before finally being diagnosed and put on a CPAP. Now I can finally sleep without waking up all night long.

[mopinko]

3. sleep is all.

have about every flavor of sleep disorder in my family, including a kid with a free running circadian clock. the degree of havoc that this can cause is seriously underestimated.
i cannot even imagine being a cop in the fugue that i exist in at times. it is hard enough being a mom.
shift work for the sake of shift work, or as punishment, is costing lives, without a doubt.

[Skip Intro]

4. Yes, police are people, with dangerous stressful jobs. That only 40% have a sleep disorder

is shocking.

[Fumesucker]

6. Police officer isn't even in the top ten of dangerous jobs..

http://staffingtalk.com/top-ten-most-dangerous-jobs-2011/

[Skip Intro]

11. CNN says different -

http://money.cnn.com/galleries/2011/pf/jobs/1108/gallery.dangerous_jobs/11.html

I'm pretty sure responding to murders, robberies, domestic violence situations, shootings, gang-related violence, hostage situations, bomb-threats, endless 911 calls, not to mention walking up to a car that has been pulled over for whatever reason - never knowing what you will walk into from call to call, day to day, year to year, your life always on the line, is a relatively safe job from your perspective. My guess is that your opinion would likely change were you actually doing the job.

[Fumesucker]

12. Police officer is number 11 on that list..

Which from where I'm sitting is not part of the top ten.

I've done two of the more dangerous jobs than police officer on that list, I suppose if you've worked in an office all your life then being a cop looks quite dangerous but so many things are a matter of perspective.

[Skip Intro]

13. Um, no, it isn't.

Look again.

If you say you've done more dangerous jobs than being a police officer, then who am I to question that?

However, if you are arguing that being a police officer is not a dangerous and stressful job, you are sorely detached from reality, imho.