0346 Insomnia in the Initial Months of Emergency Work Is Associated with Future PTSD Symptoms in New Recruit Paramedics

Abstract Introduction New paramedics commencing emergency work and adjusting to shift work can experience an increase in sleep problems. Sleep disturbances have been closely associated with poor mental health in emergency personnel. It is unknown, however, whether poor sleep experienced in the initial months of emergency work represents an early risk factor for future mental health problems in paramedics. The present study examined whether sleep disturbances in paramedics after 6-months of shift and emergency work were associated with mental health symptoms later in their career. Methods Sleep disorder and mental health symptoms were examined in new recruit paramedics (n=105) after their first 6- and 12-months of shift and emergency work. At each timepoint, participants completed validated self-report measures of insomnia (Insomnia Severity Index), shift work disorder (SWD; SWD Screening Questionnaire), obstructive sleep apnoea (OSA; Berlin Questionnaire), depression (Patient Health Questionnaire-9), anxiety (Generalised Anxiety Disorder-7), post-traumatic stress disorder (PTSD; PTSD Checklist-5) and trauma exposure (Life Events Checklist-5). Linear regressions examined whether sleep at 6-months (i.e., insomnia, SWD, and OSA) predicted mental health symptoms (i.e., depression, anxiety, and PTSD) at the 12-month follow-up, while controlling for demographics (i.e., age and sex) and mental health symptoms at the 6-month timepoint. Additionally, the regression models examining sleep and PTSD also controlled for trauma exposure at 6-months via the Life Events Checklist-5. Results Increased insomnia symptoms at 6-months of emergency work and shift work significantly predicted higher PTSD symptoms at the 12-month timepoint (b=0.09 0.03,0.15, p=0.01) while controlling for trauma exposure, PTSD symptoms and demographics at 6-months. Insomnia at 6-months was not, however, related to depression (p=0.36) or anxiety (p=0.42) at follow-up, and OSA and SWD risk at 6-months were not related to any of the mental health outcomes at follow-up (all p0.05). Conclusion Our findings highlight insomnia symptoms in the initial months of emergency work as an early risk factor for the development of PTSD later in new paramedics’ careers. Given sleep is a largely modifiable factor, this finding highlights the need to investigate interventions that target insomnia early in paramedics’ careers to reduce the risk of future mental health problems in this high-risk occupation. Support (if any)