title: Critical incident exposure and sleep quality in police officers.
abstract: OBJECTIVE
  Police officers face many stressors that may negatively impact sleep quality. This study compares subjective sleep quality in police officers with that in control subjects not involved in police or emergency services. We examined the effects of critical incident exposure (trauma exposure) and routine (nontraumatic) work environment stressors on sleep quality after controlling for the effects of work shift schedule.
  
  
  METHODS
  Subjective sleep disturbances were measured by the Pittsburgh Sleep Quality Index in police officers (variable-shift workers, N = 551; stable day-shift workers, N = 182) and peer-nominated comparison subjects (variable-shift workers, N = 98; stable day-shift workers, N = 232). The main predictor variables were 1) duty-related critical incident exposure to on-line policing and 2) work environment stress related to routine administrative and organizational aspects of police work.
  
  
  RESULTS
  Police officers on both variable and stable day shifts reported significantly worse sleep quality and less average sleep time than the two corresponding control groups. Within police officers, cumulative critical incident exposure was associated with nightmares but only weakly associated with poor global sleep quality. In contrast, the stress from officers' general work environment was strongly associated with poor global sleep quality. Sleep disturbances were strongly associated with posttraumatic stress symptoms and general psychopathology.
  
  
  CONCLUSIONS
  A large percentage of police officers report disturbances in subjective sleep quality. Although the life-threatening aspects of police work are related to nightmares, the routine stressors of police service seem to most affect global sleep quality in these subjects. These findings may have implications for health and occupational performance.
authors.affiliation: Department of Psychiatry, University of California San Francisco, San Francisco, CA, USA. neylan@itsa.ucsf.edu
authors.forename: Thomas C
authors.initials: TC
authors.lastname: Neylan
authors.forename: Thomas J
authors.initials: TJ
authors.lastname: Metzler
authors.forename: Suzanne R
authors.initials: SR
authors.lastname: Best
authors.forename: Daniel S
authors.initials: DS
authors.lastname: Weiss
authors.forename: Jeffrey A
authors.initials: JA
authors.lastname: Fagan
authors.forename: Akiva
authors.initials: A
authors.lastname: Liberman
authors.forename: Cynthia
authors.initials: C
authors.lastname: Rogers
authors.forename: Kumar
authors.initials: K
authors.lastname: Vedantham
authors.forename: Alain
authors.initials: A
authors.lastname: Brunet
authors.forename: Tami L
authors.initials: TL
authors.lastname: Lipsey
authors.forename: Charles R
authors.initials: CR
authors.lastname: Marmar
mesh_terms: D000328:Adult; D004630:Emergencies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009784:Occupational Diseases / Q000175:diagnosis / Q000523:psychology*; D016495:Police; D012307:Risk Factors; D012893:Sleep Wake Disorders / Q000175:diagnosis / Q000523:psychology*; D013313:Stress Disorders, Post-Traumatic / Q000175:diagnosis / Q000523:psychology; D014940:Work Schedule Tolerance