Administration and Leadership, Airway & Respiratory, Patient Care, Trauma

Some Providers Hide in the Station for Good Sleep

Issue 7 and Volume 36.

How many of you 24-hour-shift-worker EMT-Bees out there suffer from sleep deprivation? Hey, wake up! I asked you a question. I freely admit (well, not freely, because I’m getting paid to write this article) that slumber land and I have never really meshed well together whilst on duty after the sun doth set.

You see, I, for one, suffer from an alpha brainwave deficiency—unrelated to the cranial encephalopathy that goes with becoming a paramedic.

Seriously though, I’m lucky to get four hours of solid snooze time in a 24-hour time period, whether our station runs any zero-hour calls. The reason for this is purely psychological to be sure. My brain vault refuses to accept the idea that it can chill in an environment prone to tones.

Before the time we all had private rooms at the station, it was easy to blame a few co-workers for my sleeplessness. Their slothful soft palates noisily reverberated about the bunk-laden room with each inhale. Several of them unconsciously competed with each other for the supreme title of Narrowed Nasopharynx Head of State (or in this case state of head).

At least with rhythmic snorers, one could anticipate the next foreboding wave, assuming it wasn’t a tsunami, and seek to harmoniously settle into its predictable tempo. The sleep apneic individual, however, left the witness to anxiously await the next snort, which in turn forced the hypoxic soul to frantically gulp in oxygen. The longer the apneic infringement lingered, the louder the clatter, and the more useless the siren ear protection muffs became.

There are some out there—and you know who you are—who have no doubt been forced to sleep in their ambulance in search of a quieter ecosystem. Many of you pick shifts based on a snooze crew genetically free of partially occluded airways. And a few of you have even come within inches of placing a lubed NPA (nose hose) in these snort glottal nasal mongers.

As previously mentioned, I now work in an EMS/fire house that has individual quarters for each crew member. I no longer have the excuse of faulting my sleeplessness to secondhand snoring. Still, I find it difficult to doze off at night with any confidence.

I remain superstitious when it comes to being toned out of my bed, specifically considering not only what day of the week it is, but also star alignment, full moons and low/high-pressure weather patterns.

I never say, “It sure is quiet out there tonight.” I don’t believe I’ll ever get a full night’s sleep if there are no calls during the daylight hours. I still believe working with certain crew members is bad luck for me in getting any doze time, and I always assume I won’t get any sleep if I have something important to do the next day.

Despite my best laid plans to establish a sleeping environment worthy of REM (rapid eyelid meltdown), I still find myself unable to empty my head of any and all thoughts (like so many firefighters I know.) Ha ha, guys. You fire dudes and dudettes know I’m just kidding!

But seriously, to enhance my sleep potential I try to go to bed at different times each shift to train my body to fall asleep at any time, day or night. I try to keep my room at a cool and cozy temperature at which I can just barely see my breath (in the dark). I don’t indulge in caffeinated beverages one minute and 40 seconds before lights out. I don’t allow even a smidgen of light in my room so that when the tones go off, I’m completely disoriented to the point of running into walls that are opposite of where my doors are at home.

I restrict myself to watching only two horror movies a night while spin cycling. I keep myself hydrated by drinking at least one gallon of water just prior to sliding under the covers. I create white noise with a fan that’s loud enough to drown out the alarm tones.

I also surround myself with 13 pillows capable of immobilizing me to the point of waking up with one or more of my extremities completely paralyzed from having fallen asleep.

And lastly, as I lay my head down on one of my many pillows, I take a deep breath in … hold it for two minutes … and then breathe out for one minute. I’ll breathe in for two minutes, breath out for one minute and repeat as often as necessary while focusing on the thought, “If it’s true that we in EMS are here to help others, then what explicitly are the others here for?”

Until next time, keep your door locked at night in case of overly sensitive, revengeful firefighters. JEMS

This article originally appeared in July 2011 JEMS as “Snore Snore: How to get your Zs.”