Sleep, Alcohol, and Cancer Prevention: A Playbook for Firefighters

“Sleep, and enough of it, is the prime necessity. Enough exercise, and good food and enough, are other necessities. But sleep – good sleep, and enough of it – this is a necessity without which you cannot have the exercise of use, nor the food.” –

Edward Everett Hale, American Author

By Justin D. Cooke

As Edward Everett Hale has eloquently stated, sleep is vital for our overall physical and mental health. Through the last 40 years alone, more and more empirical research has come out showing that adequate, undisrupted sleep is just as important (if not more important) as proper nutrition and regular exercise. There have been numerous studies showing that the lack of sleep does the following:

disrupts our endocrine system that regulates our hormones,
leads to obesity,
diminishes our overall brain development and growth, and
increases the risk for cancer.

Those are just a few of the negative side-effects from the lack of sleep, or better known as sleep deprivation.

A person who works a 9-to-5 job can recover from a bad night of sleep much easier than firefighters who work our shift-work style schedule, where sleep can be a luxury. However, we can adjust our personal life to allow us to have better deep-sleep at home to reduce our risk of cancer.

For our profession as firefighters, we must live with many variables that are completely out of our control. We cannot control the new synthetic furniture that is being made, the weather we respond in, or the call volume of the shift that affects our sleep.

Fortunately, there are plenty of variables in our lives that we can control to improve our overall health and also have a positive impact on our job, variables such as simply eating right and getting plenty of exercise. In the last 20 years, firefighters in general have made good progress in leading healthier lives by exercising and eating healthier diets. At the same time, data has shown a decline in heart disease among firefighters. Unfortunately, over that same time we’ve seen a steady increase in cancer in the fire service.

The increased rate of cancer does have some obvious sources, like the increased amount synthetic material that burns during fires and having PFAS in our turnout gear. Two less-obvious factors that also contribute to increased cancer rates are the inconsistent sleep patterns in the firehouse and alcohol use. Both are independently linked to increased cancer, but for this article I want to talk about the relationship between the two, in hopes of giving you the tools to improve your overall health.

The reasons why we sleep is still not fully understood by researchers, but we know the benefits of plentiful sleep and the consequences of the lack of it. The process of sleep can be broken down into two types: non rapid eye movement (NREM) sleep and rapid eye movement (REM) sleep (4)(5)(6). They can be further broken down into four stages with NREM being the first three stages, and REM sleep being the fourth (5). The two stages where the body and brain do most of their healing are the Stage 3 NREM deep sleep (N3) and the REM sleep (13). During N3 sleep, the human body is repairing muscle tissue, building up bones and muscles, improving the immune system, and overall cleaning the body at the cellular level (13). REM sleep is the last stage of sleep before the body repeats the sleep cycle and that’s when the brain is most active during sleep. This is your “dream sleep,” and this when your brain processes memories and consolidates them. To keep it simple, stages 3 and 4 of sleep are very critical for mind and body health. As previously stated, sleep is often a luxury in a firehouse, so we must do our best to get adequate sleep outside of work.

Alcohol and the fire service have been intertwined for a long time, and we should know the obvious negative side effects of it. From causing legal problems to substance abuse issues, we have seen its detrimental effects too often in the fire service. We should also know the lesser-known effects of it as well, because over time it can cause bigger issues for our mental and physical health. I personally have used alcohol myself as a sleep aid, thinking it will put me in a deep sleep much quicker and feeling rested the next day. I am sure others do the same by having beer or whiskey at the end of the day as we are trying to wind down from a busy shift. Although I fell asleep much faster, I was not aware at the time that the alcohol was preventing me going into REM sleep and most of my N3 sleep. This is one of the lesser-known negative side effects of alcohol; the prevention of going into deep and REM sleep, and you spend more time in Stage 1 light sleep.

The point of the article is not to preach permanent sobriety, but to bring awareness of the effects of alcohol on your sleep. There is plenty of peer reviewed data showing a correlation between sleep disturbances (not reaching N3 sleep or REM sleep primarily) and cancer. Some data suggests that the lack of deep sleep suppresses the hormones of testosterone, the thyroid-stimulating hormone (TSH), and increases levels of progesterone in women. The suppression of testosterone alone has been linked to increase chances of getting testicular cancer and prostate cancer for men. This is critical since firefighters already have a significant increased chance of getting cancer when compared to the civilian population due to the carcinogens we come in contact with. Now we are compounding this with sleep deprivation along with hormonal imbalances that just increase our chances even more. The culture of the fire service has taken many positive steps forward in addressing the increased rate of cancer among us. These steps include the clean cab initiatives, cleaning our turnout gear more frequently, installing equipment to better mitigate exhaust from our apparatus, and advances in medicine that can assist in early detection of cancer.

What can we do to help ourselves outside of the firehouse? Our bodies need to recover from long shifts with proper rest and sleep. When possible, take advantage of sleeping a full night at home, and do not use alcohol as a sleep aid. We must allow our body to reach the deep-sleep state and the REM cycles for it to repair itself. It is easy to find ourselves in a continual cycle of only getting light sleep (stage 1 or 2), feeling drowsy the following day, combating it with excessive caffeine, and finally using our sleep aids to help us fall asleep. By skipping a few nights from drinking, we can allow ourselves to get the much-needed deep sleep. These are small, but very beneficial, steps we can take on our own to better prevent the development of cancer.

Bibliography

Effects of Alcohol on Sleep