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Cited by 405Sleep and Work-Related FatigueSleep and related disordersObstructive Sleep Apnea Research

Sleep disorders, health, and safety in police officers

Rajaratnam, Shantha M. W., Barger, Laura K., Lockley, Steven W., Shea, Steven A., Wang, Wei, Landrigan, Christopher P., O’Brien, Conor S., Qadri, Salim +6 more·2011·JAMA
DOI 10.1001/jama.2011.1851
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Abstract

CONTEXT: Sleep disorders often remain undiagnosed. Untreated sleep disorders among police officers may adversely affect their health and safety and pose a risk to the public. OBJECTIVE: To quantify associations between sleep disorder risk and self-reported health, safety, and performance outcomes in police officers. DESIGN, SETTING, AND PARTICIPANTS: Cross-sectional and prospective cohort study of North American police officers participating in either an online or an on-site screening (n=4957) and monthly follow-up surveys (n=3545 officers representing 15,735 person-months) between July 2005 and December 2007. A total of 3693 officers in the United States and Canada participated in the online screening survey, and 1264 officers from a municipal police department and a state police department participated in the on-site survey. MAIN OUTCOME MEASURES: Comorbid health conditions (cross-sectional); performance and safety outcomes (prospective). RESULTS: Of the 4957 participants, 40.4% screened positive for at least 1 sleep disorder, most of whom had not been diagnosed previously. Of the total cohort, 1666 (33.6%) screened positive for obstructive sleep apnea, 281 (6.5%) for moderate to severe insomnia, 269 (5.4%) for shift work disorder (14.5% of those who worked the night shift). Of the 4608 participants who completed the sleepiness scale, 1312 (28.5%) reported excessive sleepiness. Of the total cohort, 1294 (26.1%) reported falling asleep while driving at least 1 time a month. Respondents who screened positive for obstructive sleep apnea or any sleep disorder had an increased prevalence of reported physical and mental health conditions, including diabetes, depression, and cardiovascular disease. An analysis of up to 2 years of monthly follow-up surveys showed that those respondents who screened positive for a sleep disorder vs those who did not had a higher rate of reporting that they had made a serious administrative error (17.9% vs 12.7%; adjusted odds ratio [OR], 1.43 [95% CI, 1.23-1.67]); of falling asleep while driving (14.4% vs 9.2%; adjusted OR, 1.51 [95% CI, 1.20-1.90]); of making an error or safety violation attributed to fatigue (23.7% vs 15.5%; adjusted OR, 1.63 [95% CI, 1.43-1.85]); and of exhibiting other adverse work-related outcomes including uncontrolled anger toward suspects (34.1% vs 28.5%; adjusted OR, 1.25 [95% CI, 1.09-1.43]), absenteeism (26.0% vs 20.9%; adjusted OR, 1.23 [95% CI, 1.08-1.40]), and falling asleep during meetings (14.1% vs 7.0%; adjusted OR, 1.95 [95% CI, 1.52-2.52]). CONCLUSION: Among a group of North American police officers, sleep disorders were common and were significantly associated with increased risk of self-reported adverse health, performance, and safety outcomes.

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Crossref · 10.1001/jama.2011.1851

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  • Stress-impaired officers are more likely to make serious errors, and exhibit other adverse work outcomes including uncontrolled anger toward suspects, excessive use of force, and absenteeism.

    “Stress-impaired officers are more likely to make serious errors, and exhibit other adverse work outcomes including uncontrolled anger toward suspects, excessive use of force, and absenteeism [19, 20].”

    From Study protocol of a multicenter randomized controlled trial of mindfulness training to reduce burnout and promote quality of life in police officers: The POLICE study (2018) · cites this paper as [19]

  • Sleep disturbances are common among police officers.

    “Among law enforcement and first responders, several studies have shown that sleep disturbances are common among police officers198–203 and firefighters.204,205”

    From Sleep, Health, and Society (2017) · cites this paper as [198]

  • Sleep disturbances in police officers and firefighters are associated with reduced ability to maintain job performance and safety.

    “Studies have shown that sleep disturbances in police officers and firefighters are associated with reduced ability to maintain job performance and safety.198,203,207”

    From Sleep, Health, and Society (2017) · cites this paper as [198]

  • Police officers at greatest risk of sleep disorders were more likely to be at risk for job-related problems such as falling asleep at meetings and using unnecessary violence against citizens.

    “In a landmark study by Rajaratnam and colleagues,198 police officers who were at greatest risk of sleep disorders were also more likely to be at risk for job-related problems, such as falling asleep at meetings and using unnecessary violence against citizens.”

    From Sleep, Health, and Society (2017) · cites this paper as [198]

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Authors
Rajaratnam, S. M. W., Barger, L. K., Lockley, S. W., Shea, S. A., Wang, W., Landrigan, C. P., O’Brien, C. S., Qadri, S., Sullivan, J. P., Cade, B. E., Epstein, L. J., White, D. P., Czeisler, C. A., & Harvard Work Hours, H. A. S. G.
Affiliations
  • Brigham and Women's Hospital (US)
  • Harvard University (US)
Corresponding author
Czeisler, Charles A.
ORCID
Venue
JAMA
Publisher
American Medical Association (AMA)
Published
2011-12-21
Volume
306
Issue
23
Pages
2567
ISSN
  • 0002-9955 (ISSN-L)
  • 0098-7484
DOI
10.1001/jama.2011.1851
OpenAlex
W2114873866
Semantic Scholar
82aa0487a47ac1d6dd81b30569e7eff8cbf9f14a
Cited by
405
References
49
Citations by year
2026: 18 · 2025: 21 · 2024: 20 · 2023: 33 · 2022: 31 · 2021: 45 · 2020: 35 · 2019: 31 · 2018: 28 · 2017: 20 · 2016: 27 · 2015: 24 · 2014: 24 · 2013: 24 · 2012: 21
FWCI
28.86
Type
journal article
Language
en
Open access
closed
Locations
  • JAMA (publishedVersion)
  • PubMed (publishedVersion)
  • Surrey Research Insight Open Access (The University of Surrey) (submittedVersion)
Funders
National Institute for Occupational Safety and Health (R01 OH009403, R01 OH 008496)
Topics
  • Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and Work-Related Fatigue
  • Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
  • Health Sciences › Medicine › Physiology › Obstructive Sleep Apnea Research
Keywords
sleep disorders, police officers, obstructive sleep apnea, insomnia, shift work disorder, excessive daytime sleepiness, occupational safety, employee performance, fatigue, comorbid health conditions, diabetes mellitus, depression, cardiovascular disease, sleep disorder screening, public safety risk
MeSH terms
Adult, Cross-Sectional Studies, Female, Health Status, Humans, Male, Middle Aged, North America, Prospective Studies, Risk, Safety, Sleep Wake Disorders, Task Performance and Analysis, Comorbidity, Occupational Health, Police

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