The Development of a Sleep Intervention for Firefighters: The FIT-IN (Firefighter's Therapy for Insomnia and Nightmares) Study.
Eun Hee Jang, Yujin Hong, Yeji Kim, Sangha Lee, Yeonsoon Ahn, Kyoung Sook Jeong, Tae-Won Jang, Hyejin Lim, Eunha Jung, Shift Work Disorder Study Group, Seockhoon Chung, Sooyeon Suh
International Journal of Environmental Research and Public Health November 24, 2020 DOI: 10.3390/ijerph17238738 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Single-group pre-post study Peer reviewed |
|---|---|
| Sample size | 39 |
| Population | Korean firefighters |
| Interventions | FIT-IN (Firefighter's Therapy for Insomnia and Nightmares) brief behavior therapy for insomnia with imagery rehearsal therapy components |
| Duration | Three sessions (two face-to-face group sessions and one telephone session), with a two-week sleep diary period |
| Topics | Dreaming |
| Keywords | Firefighters Imagery rehearsal therapy Insomnia |
| Key points | FIT-IN produced significant improvements in sleep efficiency and reductions in insomnia and nightmare severity among firefighters. |
Abstract
Background: Firefighters are vulnerable to irregular sleep patterns and sleep disturbance due to work characteristics such as shift work and frequent dispatch. However, there are few studies investigating intervention targeting sleep for firefighters. This preliminary study aimed to develop and test a sleep intervention, namely FIT-IN (Firefighter's Therapy for Insomnia and Nightmares), which was based on existing evidence-based treatment tailored to firefighters in consideration of their occupational characteristics.
Methods: This study implemented a single-group pre-post study design, utilizing an intervention developed based on brief behavior therapy for insomnia with imagery rehearsal therapy components. FIT-IN consisted of a total of three sessions (two face-to-face group sessions and one telephone session). Participants were recruited from Korean fire stations, and a total of 39 firefighters participated. Participants completed a sleep diary for two weeks, as well as the following questionnaires to assess their sleep and psychological factors: insomnia severity index (ISI), disturbing dream and nightmare severity index (DDNSI), Epworth sleepiness scale (ESS), depressive symptom inventory-suicidality subscale (DSI), and Patient Health Questionnaire-9 (PHQ-9). These questionnaires were administered before the first session and at the end of the second session.
Results: The FIT-IN program produced improvements in sleep indices. There was a significant increase in sleep efficiency (p < 0.01), and a decrease in sleep onset latency, number of awakenings, and time in bed (p < 0.05), as derived from weekly sleep diaries. In addition, significant decreases were shown for insomnia (p < 0.001) and nightmare severity (p < 0.01).
Conclusion: There were significant improvements in sleep and other clinical indices (depression, PTSD scores) when comparing pre-and post-intervention scores. FIT-IN may be a feasible and practical option in alleviating sleep disturbance in this population. Further studies will be needed to ascertain FIT-IN's effectiveness.