Episode 21: What Came First – Sleep Deprivation Or PTSD?

EPISODE TRANSCRIPT

What if there is a link between first responders who are sleep deprived and excessive use of force, alcohol or drug-related charges on responders, domestic violence or another charge that was unethical on first responders, depression, anxiety, suicides without PTSD being present? Welcome to episode 21 of the 911 Shift Ready Podcast where we are going to dive into what came first Sleep deprivation or PTSD.

In North America and the UK suicide rates are definitely on the rise with first responders. We are also hearing more cases of ethical mistakes in services, as well as an increase in health issues, anxiety, depression, and more. On LinkedIn, interestingly, as I was writing this podcast episode a colleague of mine posted an article from The Police Federation of England and Wales.

It’s stated that the record numbers of police officers are being signed off work suffering from mental health conditions. Figures show 13,263 were absent due to stress, depression, anxiety or post-traumatic stress disorder in the past financial year compared with 8,450 the year before. So that was 13,263 this past year, 8,450 the year before. That is a 57% increase.

Then they stated as well that after a decade of public sector cuts, police officers are picking up the workloads of other services. So we need to start having real conversations about priorities and what is expected of our burnt out officers. So this really does beg the question where a lot of burnout is happening in the entire first responder world with things that have happened in the last three years. COVID, we have Black Lives Matters. We’ve had so much going on, so much unrest. It’s been a very tough three years. Defunding that for all services, they have all been hit and we are starting to definitely see the collateral damage.

Whenever we hear on social media or the news of a situation such as one officer shooting another on scene. Excessive use of force, alcohol or drug related charges, domestic violence or something else that was unethical or against the law as well as a suicide. Often there are comments on the post or a person jumps into the conversation that this responder had PTSD or that everything that happened was due to a mental health issue.

And yes, traumas play a large role in PTSD and can absolutely affect a responder’s mental health. There’s absolutely no dispute on that but if we continue to solely blame excessive use of force, alcohol or drug-related charges, domestic violence and other charges that were unethical, depression, anxiety, suicide, if we continue to blame those solely on traumas and mental health struggles and we ignore all of the research on how sleep deprivation can also cause the same outcome then we are missing a very big piece of the puzzle to keep you strong throughout your career.

And it’s a piece of the puzzle that we have more control over than we do with traumas. Traumas are unfortunately going to always be a big part of your job. We can’t control each and every call that comes in that you attend to. Yes, there are ways that we can deal with traumas as soon as they happen. I laid out in episode 16, “You Are Not Broken. You Just Don’t Understand The Solution Yet.”, some of the things that can be done that you can do to have a therapist in your back pocket before anything happens.

So when something happens, you already have an action plan to take place. But other than that, like we don’t know what these traumas are going to be when they’ll pop up and everything. They are more out of your control than sleep deprivation. Sleep deprivation is something that you do have more control over than you may be aware of.

Even with all that is asked of you operationally, there are more aspects of your sleep that you do have control over than you may even realize. Dr. Kirk Parsley, he specializes in sleep with Navy Seals as well as other military and first responders. And he is quoted as saying, I quoted this from his book. During Optimal Sleep, you emotionally categorize the day’s events. This simple point has a huge implication for military, paramilitary, law enforcement, and any other type of emergency first responders works.

If you don’t sleep well then you cannot appropriately categorize events. You’re much more likely to get post traumatic stress disorder. When sleep deprived, you are also more likely to become an alcoholic or dependent upon other drugs to decrease your anxiety and stress levels. You’re even more likely to commit suicide and much more likely to engage in spousal abuse, child abuse, road rage, and just about any other socially unacceptable activity one can think of. Now this is a doctor that specializes in sleep. That is a big part of what he does and focuses on specifically with Navy seals and first responders.

And during optimal sleep, you emotionally categorize the day’s events. So when you’re sleeping, that’s when you’re able to make sense of what happened and give it a file in your brain, which you’ve heard me talk about in past episodes about that. And when you are sleep deprived, you’re not able to get those files in your brain and you’re more likely to get PTSD.

As well as the alcohol dependent upon drugs, decreasing your anxiety and stress levels, committing suicide, spousal abuse, child abuse, road rage. These are things that you uphold the law about. And the thing is, is that sleep deprivation can actually put you into a place where you’re more likely to engage in those unacceptable activity And then we also think about Lieutenant Colonel Dave Grossman, who has spent his entire career decades and decades researching trauma in first responders and military. His books on combat, on killing, like he has dove into the psychology of killing like he has had a really large focus on stress and how stress affects the body and PTSD. And he is switching his focus of his research to sleep deprivation because of its link to many of the struggles first responders experience quoting him, he has said that sleep deprivation is the number one reason officers commit suicide, make ethical mistakes and use excessive force.

That’s quoted by Lieutenant Colonel Dave Grossman, who has studied PTSD immensely and first responders and stress responsers. He is saying that sleep deprivation is the number one reason officers commit suicide, make ethical mistakes, and use excessive force. So the term sleep deprivation, just want to make sure that we are clear about it. It is getting less than the needed amount of sleep for which adults ranges from seven to nine hours.

Chronic sleep deprivation is known as or is defined by the American Academy of Sleep Medicine as a sleep that has less than seven to nine hours, that persists for three months or longer. I’ve been wondering if the rise in Chicago police officers suicides is due to the fact that they have had a couple of very large blocks, three to six months, if I’m correct. Definitely if I’m not right on this, somebody let me know.

But I actually was personally speaking with a Chicago police officer and they were on month three at one point and then I heard that there was another stint. So I don’t know how long they were going because of the defunding and their short staffing that they were not allowed days off. So they were having 12 hour shifts. They’re also short staffed, a lot of overtime and then they still had to commute home and that doesn’t even make it possible to get eight hours of sleep by the time you commute home. Take your shower, eat, prep food for the next day, get your uniforms ready and see your family.

During COVID as well many fire and EMS stations, they would have an entire station out and neighboring stations would have to pull doubles and sometimes triples 48, 96 hours shifts at busy stations. Stations where there are calls 24 hours in order to cover for the short staffing. And added to that, they’re also all stressed over if they’re going to get COVID as well. Like how have the past three years been for you with COVID, with Black Lives Matters, with defunding? Everything has affected each service, each station differently.

How is your sleep? Have you been able to recover after you’ve had long blocks of shifts and tough operational demands? The operational demands on my husband these last three years has been huge. This year alone, you’ve heard me talk about it. If you’ve listened to this podcast 33 days straight during the truck rally averaging 18 hours. The last he just did what, September 4th until I think, September 21st, 24th. So yeah, 20 days straight but the hours he’s accrued have been astronomical. His regular full-time hours is almost what he has accrued and overtime hours. It’s been crazy.

So what I often hear as well is that four to six hours of interrupted sleep where you’re waking maybe every two hours is actually a good sleep for many, if not most of the responders that I speak with on a day off, even when they have seven to nine hours in bed. So that’s half the time that you’re actually in bed that you are awake, tossing and turning, trying to sleep.

And sleep deprivation is getting less than seven to nine hours at a time that puts you into sleep debt. Chronic sleep deprivation is three months of less than seven to nine hours a night. So how many hours do you get on average? What is your sleep light? And how long has it been that way? If it’s good, keep doing what you’re doing honestly and start sharing it. The compound effect.

Share what you’re doing because people need to hear it. If you’re not though, that’s the majority. And it really is hard. I do have other episodes I’ve gone into where I dive into sleep more. So check ones, there’s one on exhaustion. There’s one on snoring, different ones, and they all dive into different aspects as to why sleep is a struggle for you guys. So it really does make sense as to why it is, but once you can figure out the solution. That knowledge is always power if you put in the work and the effort.

So are you able to get a good, solid sleep on your days off and wake up with energy? A sleepy, stressed out brain decreases productivity by 30% when six hours of sleep is your norm. So say that again. When you’re having six hours or on average of sleep, and that’s not an interrupted sleep, that’s just like a solid six hours of sleep, your brain decreases productivity by 30%. So this explains why sometimes your to-do list never gets done and why we start perceiving the work as being more stressful and and making it less enjoyable.

Reports, I hear so often how reports that used to take you no time at all. Now are a struggle to take so much energy to be able to pull the details out, remember the details, and write them all down. And then we add to that the moods that come along with more sleep debt you incur and your relationship with your spouse, your kids, colleagues. And performance on the job are all at risk when you are decreasing your productivity by 30% from six hours or less of sleep.

And the thing is for civilians is that sleep deprivation does cause all of these issues as well. But sleep deprivation for a first responder is very serious. It can mean the difference between life or death in certain situations for you on the job. Which absolutely makes sense why Lieutenant Colonel Dave Grossman, who spent a lot of his career on what stress does to you in combat and PTSD has been switching his focused recently to sleep deprivation.

The impact of those that I’ve worked with on sleep has had such a huge effect on not only their physical health, which is my area of expertise, but also mentally. Their mood, regulation, happiness, their calmness. Many responders have told me after about six months in my program that they had suicidal ideations before joining. A few had actually almost gone through with it.

For many, not all the suicidal tendencies went away once we got their sleep back on track and resting system strong. I don’t work on PTSD. I don’t work on traumas or mental health. I work on sleep and strengthen your physical stress system. And I’ve had many guys tell me that after going through my program, getting their sleep back on track, their suicide ideations went away..

When I have these guys telling me this, telling me that these suicidal ideations went away once they got their stress system stronger and their sleep back on track, how can the statement that PTSD, traumas and mental health struggles are the sole reason for suicides and first responders be true? It can’t.

Through my research, I have learned that PTSD has four specific symptoms. And these symptoms have to be showing for more than 30 days in order to be diagnosed by a medical professional as having PTSD. If you don’t have these four symptoms then a PTSD diagnosis should not be given. So the first two are intrusive memories. Where you’re having daydreams or nightmares, flashbacks, but it’s a reoccurring memory or memories of one or multiple traumas. And remember, this has to happen for more than 30 days straight in order to be diagnosed.

Also, avoidance. Avoiding situations or talking about it, the places where it happened. Anything that puts you out or not dealing with the traumas. I’ve had guys who have told me that they do avoid certain streets on their beat as much as they possibly can. They drive home a different way in order to avoid certain scenes that have happened, calls that have happened in their past. So the other two are also symptoms of sleep deprivation.

So cognition and moods is one, and arousal and reactivity. And if we go back to those symptoms that we were talking about where we’re saying the what was it? Excessive use of force, that’s arousal and activity. Alcohol and drug related charges that can get into numbing things out as well. The domestic violence, arousal and reactivity. Depression, anxiety, suicides, those can all be cognition and moods, arousal and reactivity as well. Which fall under sleep deprivation as well as PTSD. So there’s an overlap as well in certain signs and symptoms and criteria that defined both of those.

I do break down in episode two, “I’m not the person my husband married.” I changed more about these PTSD symptom. Since working with first responders in 2018, I’ve been told by some that they went in for a PTSD diagnosis in order to get help and off on medical leave. They were having severe anxiety. They couldn’t sleep. They’re having suicidal thoughts but they did not have the four defining criteria and they were told that they did not have PTSD. They could not get a diagnosis in order to get medical leave.

After asking them questions and, sorry, I’m stating medical leave because certain services, even if you have these symptoms in certain services, not all. You can only get leave if you have a PTSD diagnosis. You cannot get leave in some services if you are still struggling mentally. Whereas other services will say this person is not or should not be on duty and they do need a break. And some services will accept that without a PTSD diagnosis. I do want to put out that out there.

So when I did ask some of these responders that told me that this did happen to them they did fit the criteria of sleep deprivation though. PTSD is horrible and I am definitely not taking anything away from it. It is a beast. And to get back out the other side takes strength and I’m not sure I would have that strength. It’s tough. PTSD is real. PTSD is valid, just as valid as the symptoms of sleep deprivation are.

Have you ever considered the criteria required for a PTSD diagnosis? I didn’t know this until I learned it from somebody who is an officer who through his PTSD traumatic experience now has his PhD in studies along with this. And he helps run a program for officers with PTSD. I learned about all of this criteria through him. If anybody would like, should actually make a note on that as well. I can post actually his video where he dives deep into that. I’m going to write that down now, so gimme a sec.

It’s moral injury, compassion fatigue and PTSD. He dives into the defining criteria of all of those in an interview that I did with him. I’ll add that to the show notes of this. Until I’d met him, I had never really understood the defining characteristics of PTSD. So with what you do know now, when you come across someone who is experiencing suicidal thoughts or struggles with mood regulations, substance abuse, unethical behaviors, will you assume that they have PTSD?

I’m going to hope that’s a no. And if you came across somebody though with PTSD, who after asking questions about their sleep, you find out that their sleep number that it is less than the six hours or seven hours for three months fits the sleep deprivation definition, would you think that PTSD is the only reason why they are feeling the way they’re feeling? I hope not.

Which is why this episode is actually titled, What Came First – Sleep Deprivation Or PTSD?. We may never know and it’s not really important. The important piece that I hope you take away from this episode is realizing that both PTSD and sleep deprivation play a large part as to why first responders are struggling.

From a health perspective, Sarah Mednick, she’s a PhD who specializes in sleep, in naps specifically. Talks about how heart attacks go up in those who have slept less than seven hours a night. We hear a lot of heart attack struggles. Our heart attacks, heart issues in the first responder world. Those with five hours of sleep at a higher rate of coronary artery disease and heart attacks. Immune system suffers, risk of cancer increases. We do hear a lot about cancer in first responders as well. There definitely are risks with the toxins and everything, especially with fire but not all are toxic related.

Immune system as well. We hear a lot about autoimmune diseases. Mental health links, sleepiness to anger, irritability, anxiousness and depression. Stress and sleep deprivation are pretty much aligned. There is a chance we are confusing them both. And that is quoted by a doctor who specializes in sleep. She’s saying that there’s a chance we are confusing them both with stress and sleep deprivation.

Sleep deprivation is very serious, so depriving yourself of two hours of sleep leads to a performance decline on par with a blood alcohol level of 0.05%. So that’s just two hours deprived one night. If a person is deprived two hours a night for 11 nights in a row, their performance declines compared to their ideal sleep adapted self, it’s on par with a blood alcohol level of approximately 0.08 or 0.1%. So it’s as if you are drunk.

When you’re sleep deprived, that means getting five hours of sleep a night or six, six to five hours of sleep a night for 11 nights in a row. Being drunk doesn’t correlate often with knowing that you are drunk. That was a quote as well by Dr. Kirk Parsley, who we talked earlier about that works with Navy Seals.

When you are sleep deprived, we often don’t realize our actions. I hear all the time that spouses or colleagues mention symptoms to responders and the responders don’t believe they’ve noticed. I’ve heard from so many spouses that are like, I’ve tried to tell my spouse that we’re walking on eggshells around them. The kids are afraid to go into a room with them or that they’re not noticing that things are declining at work or they’re getting shorter on calls but colleagues are noticing it, spouses are noticing these things. And that happens when we are sleep deprived cause we don’t notice the same as alcohol, intoxicates our viewpoint of what’s going on. So does sleep deprivation.

And let’s dive a little bit now into relationships and sleep. How many first responder families do you know are sleep deprived? I’m going to tell you this last block that my husband went through, I was pushing hard that both of us ended up with sleep debt and it wasn’t pretty for a few days. There is an interesting study that took monogamous couples where both parties felt that they had a good, healthy, stable relationship and they tested what sleep deprivation did to their relationship.

One person got their regular amount of sleep and the other two hours less. Now this is only one night of sleep. So one night of sleep, somebody got two hours less. The next day they got to go on a date together. No responsibilities, all activities paid for. The conclusion was really interesting. Both partners, both of them rated the other as performing below average.

Regardless which one was sleep deprived, both couples reported that their significant other wasn’t as present, connected, communicative, fun, and in a good mood as they usually were. So the one who was sleep deprived was seeing that the other was grumpy and the one that wasn’t was seeing that the sleep deprived person was grumpy. Relationships are based on communication, the physical, nonverbal body language, facial expression, tone, and voice and more.

As we’ve covered lack of sleep impairs the ability to communicate effectively, and both parties perceive this. The snowball effect of mirroring body language and the tone of somebody can turn a fun, enjoyable relationship into miscommunication and disagreements. Statistics on first responder families staying together are not great.

For so many reasons, stress and sleep deprivation definitely play their part. I do wonder how much does sleep deprivation play in the statistics of first responders success in relationships? It is amazing watching the impact that my 911 Elite Performance program makes on families getting messages from spouses. And having kids hop on coaching calls.

Sometimes I have a couple of times had some kids hop on coaching calls to thank me for giving their mom or dad back. And kids pop on and just say, “My dad’s happy when he comes home now. And he plays with us. Thank you.” And that’s exactly why I do what I do. But man, it is getting the sleep back on track. It’s getting their stress system sorted out again.

what drives me, and that is a big motivating factor as to why I did start 911 Lifestyle and to help you sleep and get your life back. The impact of those that I have worked with on sleep has had such a huge effect, not only on their physical health, which is my area of expertise, but it is also mentally. Their mood regulation, their happiness, their calmness and as I mentioned, many of them had suicidal thoughts or ideations before they joined.

They never told me. Had they? I may have had them do some different things before they joined my program but that would’ve actually stopped me from being able to even see and realize how much that sleep deprivation, that getting their sleep back on track really does play a part in their wellbeing and their happiness and being able to manage everything that’s going on around them.

Sleep quality and getting yourself out of sleep deprivation is something you definitely have control in. It’s tough hearing the responders trying all of the remedies that they know that work for some civilian. Over the counter sleep aids, natural remedies, prescriptions, making changes to their diet, adjusting exercise, creating a sleep routine, cool dark rooms. There’s so many things out there that you can Google online. And when those strategies don’t work often, the next step for many responders that I’ve worked with, they end up resorting to over the counter cold and flu remedies, often with a shot of alcohol without success.

From trying everything they find online, they’ve resigned to the fact that exhaustion is just a part of the job. And if that is the resignation then sleep debt will increase and that will result in excessive use of force, alcohol or drug related charges of responders, domestic violence, other charges that were unethical, depression, anxiety, and suicides.

With what is asked of you operationally, there are times where you will not be able to get enough sleep even if you are the best sleeper there. That’s just a fact. My dream is for services to start looking at other services where they have less sick time and less suicides and see what they are doing different.

There’s a book that I love, it’s called Switch by Dan and Chip Heath. It’s about looking at a problem from the lens of what is already working. And you start implementing what’s working somewhere versus looking at a problem and trying to solve it. There were so many situations in there that I was looking at and I kept thinking of services and how it would work so well in services to be adapting a lot of the strategies that do work in this book.

There are services out there with less sick leave and suicides than other services. What is the difference? What are they doing? Can we emulate that? I often ask responders what their shift schedules are like and it amazes me how many different schedules there are out there. And some do make more sense for your body to adapt to a sleep schedule.

I’ve heard of even some eight hour shifts. It was in Boston. I didn’t dive deep enough to find out if it was a specialized unit or actual, like officers on the road. There are some shifts where they stay on a shift schedule for six months for a year. And their body adapts to that instead of two days, two nights.

There are different ways that you can work them. Find out what others are doing. There are so many different varieties. I’ve always wondered why fire and EMS are 24 hours. My guess, absolute guess, is that calls were not as frequent 24/7 as they used like in the past as they are now. And at one point it may have made sense because they could sleep at the station and been near the truck if they needed to be to head out on the rare location that a call went out.

But if that’s the reason things have changed. Call volumes have definitely increased 24/7. I may be wrong about that and I’m very curious as to why at busy services, they’re still doing 24 hour shifts. Sometimes even doubles are being pulled when they’re short staffing. If you do know why there’s 24 hours, definitely fill me in. I’d love to hear about.

We can also look through the lens of what is working with wellness programs. They differ so much for each service. Which wellness programs have the higher buy-in from their members or highest satisfaction rates? You may think that you have like amazing services for your members but if your members aren’t buying in then why aren’t they? And why are members buying in to certain services that other services provide?

What can you do more like that other service? I have so many ideas like what if sleep did become a priority for services? As soon as you make something a priority, solutions start to appear. And this includes teaching guys that when they have a two thirty wake up, for a tactical call out and their body has anxiety, it’s because the body is telling them that they should not be getting up so early and that’s okay.

Teach them what to do as soon as the operation is complete so that they can recover from the debt that they just incurred and that they’re ready for the next time that it’s going to happen cause there is going to be a next time. Sleep debt, it’s really just going to be a part of your job forever. What about teaching you guys how to work with it instead of against it? Track the hours of each division or specialty unit and see how many OT hours each person is putting in.

Are there divisions or specialty units where OT is very high to the point where members will not be able to get enough sleep and are creating chronic sleep deprivation over a three month period of time? Would it be more economical? Which services like to dive down that road too. That’s usually a motivating factor. Would it be more economical to bring in another responder into that division or unit or whatever to pick up some work so you’re not paying time and a half for overtime? What service wouldn’t want that?

The next problem though that we need to solve is the short staffing. I have so many ideas that services can do to start making realistic changes in services in order to improve sleep debt. But if you solely rely on services, you will be waiting a while as even for those services who are ready to make the changes. Change still takes time to research, plan and implement. And your service can only make change at work while you’re on the job. They can’t make change while you’re at home.

And if you’re not working on sleep that you have control over. It’s like hiring a personal trainer to work with you, like one to three hours a week and you’re not adding in any healthy habits in all of those other hours of the week. But you’re still expecting a change. If you’re still going home and eating fast food on your way home and not at all doing any moving at all or doing anything else. If you keep eating that junk food, not fueling yourself correctly after your workouts or do what your body needs in order to heal and repair post workout then you’re not going to make the gains from your personal training sessions.

And this is the same at sleep. Your service can only do so much. They can make changes to how your shift runs and work hard to decrease OT where possible within their means. But if responders don’t put in the work to personally support their own sleep at home, while on shift, especially all of the operational stressors thrown at them then sleep will continue to spiral, increasing their sleep deprivation, leaving them more susceptible to exhaustion, short fuse and mood swings where your family’s walking on eggshells.

Anxiety, depression, hypervigilance where you can’t turn it off, health issues and then those can eventually lead to excessive use of force, alcohol or drug related charges, domestic violence and other charges that are unethical for responders and suicides. I’m not really sure if it matters what came first. Sleep deprivation or traumas, including PTSD. What matters is that you now know that both sleep deprivation and traumas are risks of your job that can lead to struggles that can end your career and tear apart your family.

And you also know that my 911 Elite Performance Program has proven since 2018 that it can help first responders get their sleep back on track for those who are willing to put in work. So you do know that there is at least one solution that you have not tried yet to get your sleep back on track. Sleep and strengthening your stress system is the main focus of my 911 Elite Performance Program.

It’s not easy managing sleep with all of the operational stressors that push your stress and sleep to the max in your career. And working days and nights but it’s possible. The doors are opening in our 911 Elite Performance Program this week, and they will only be open for five days and they will not open again this year. I only open up 911 Elite Performance three to four times a year maximum to allow me time in between to coach those in the program and make sure that they get my time and attention that they deserve.

This time round, the price is discounted because I’m rolling out an updated version of the program with new research and learnings as well as new videos, audio and written options for you to be able to go through the lessons the way that you learn best. We want to make sure that all of the videos are running smooth, that I didn’t accidentally put the wrong video in the wrong lesson. And we didn’t mix up any of the tech. That the tech is working the way it is designed.

We’ve already tested ourselves but there may be one or two things we missed, so I am keeping the price down. But it will go back up as soon as we have had a block of you go through it to make sure that all of the kinks are out. So take advantage if you do want this deep discount now. It’s good discount as it will not be back in 2023 or ever.

Taking advantage now does also mean that you will know what steps need to be taken to get your sleep back on track in 2023. And 2023 is only a couple months away. So go to 911 shift ready.com and then go to the Work With Us page to learn about the program and join today. The doors are closing soon, so 911ShiftReady.com and go to the Work with Us page. And I’ll see you in the next episode.