Sleep health education shows promise in improving sleep quality, fatigue in emergency clinicians

Among clinicians working in emergency medical services (EMS), sleep health education may lead to better sleep quality and lower fatigue levels, a recent study has found.

Researchers conducted a cluster-randomized, two-arm, waitlist control study enrolling 678 clinicians from 36 EMS agencies. The primary outcome was sleep parameters, as measured by the Pittsburgh Sleep Quality Index (PSQI). Assessments were conducted at the 3-month follow-up.

The health education intervention included 10 brief modules that provided information and guidance on fatigue mitigation topics. Materials were based on the American College of Occupational Environmental Medicine. Interventions were made available online and could be completed asynchronously.

In the intention-to-treat analysis, researchers found no significant impact of the educational intervention. PSQI scores at 3 months were comparable between clinicians who received education and those who were assigned to waitlist (p=0.74). The same was true for fatigue.

However, in per-protocol analysis, the educational intervention led to a significant 3-month improvement in PSQI (p=0.02). For every module completed, sleep quality improved by a significant 0.12 points (p=0.0048), though this magnitude was considered small and unlikely to be clinically meaningful.

Of note, those who completed eight to 10 modules saw the greatest improvement in sleep quality (p=0.0024). Fatigue likewise improved by 0.074 points for every module completed (p=0.04).

“These findings suggest that the program is beneficial when the target population engages with the education,” the researchers said. “These findings may be useful to EMS administrators when designing fatigue risk management programs.”