New research shows EMS workers' anger levels rise when sleep quality falls

It's no secret that sleep and emergency medical services (EMS) work do not go hand in hand. The profession is notorious for long and oftentimes odd hours, with overnight shift work a part of the job. It's bound to effect one's mood and now, new research shows just how much.

Led by Bryce Hruska, assistant professor of public health in the Falk College, investigators looked at the sleep patterns of 79 EMS workers from Central New York. The results were published in Sleep Health: Journal of the National Sleep Foundation. They found that EMS workers who typically experienced poorer sleep quality reported greater anger levels. Workers who routinely experienced poor sleep quality reported anger levels that were 18 to 35 percent higher compared to workers receiving fair sleep quality. Regardless of their typical sleep quality, days when workers experienced poorer sleep than usual were characterized by higher levels of anger. On a day when a worker experienced poorer sleep quality than usual for them, their anger levels were five percent higher on that day regardless of their typical sleep quality.

"We examined sleep quality as opposed to sleep quantity. This was intentional," says Hruska. "While both sleep quantity and sleep quality are important sleep metrics, research indicates that sleep quality may be a superior predictor of many health and emotion related outcomes."

What might this mean for patient care? "There are documented connections between anger in the workplace and the impact that it has on organizational function, work climate and employee satisfaction," says Hruska. "For example, when supervisors use anger to influence employees' behaviors, it may promote retaliatory behaviors and lead to strained interpersonal relationships. This could be really problematic for a field like emergency medicine because high functioning teams are crucial for ensuring effective patient care."

As for what's causing poor sleep and more anger, Hruska says it's likely the difficult nature of EMS work during the pandemic. "Even though we are transitioning out of the 'emergency' phase of the pandemic as COVID-related hospitalizations continue to decline, many EMS workers are simply tapped out. The long hours that are a routine feature of the profession are being felt more deeply," says Hruska.

With this in mind, Hruska says it's critical that sleep quality is considered crucial for EMS workers. "Our research suggests that habitual experiences and behaviors might be important targets compared to impactful, yet more infrequent day-to-day experiences. For example, some EMS workers tend to take more overnight shifts than others. Establishing an agency policy that limits the number of consecutive overnight shifts might be important. Sleep hygiene habits are also important. Regular over-caffeination, sugary snack consumption, or lack of physical exercise can detract from sleep quality. Sleep hygiene education training during employee onboarding may help to raise awareness around the importance of practicing habits that promote sleep quality."