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Published on: August 8, 2019
Sleep and Substance Use Among Firefighters: Associations with Alcohol, Caffeine, and Nicotine Use
David A Reichenberger1,2, Lauren J Lee1, Joey Hebl1
1Oregon Institute of Occupational Health Sciences, Oregon Health & Science University, Portland, OR, USA.
Nature and Science of Sleep
|July 15, 2026
Summary
Firefighter sleep is disrupted by alcohol and nicotine. Daily alcohol use bidirectionally impacts sleep, while caffeine and nicotine effects vary by individual. Interventions can improve firefighter sleep and reduce alcohol risks.
Area of Science:
- Occupational Health
- Sleep Medicine
- Addiction Research
Background:
- Firefighters face significant sleep disruption due to demanding shift work schedules.
- Substance use, including alcohol, caffeine, and nicotine, is common and can further impair sleep quality.
Purpose of the Study:
- To investigate the daily, bidirectional relationships between substance use and actigraphy-measured sleep in firefighters.
- To identify specific patterns of substance use that affect firefighter sleep duration, timing, and quality.
Main Methods:
- Utilized micro-longitudinal data from 120 firefighters in the Shiftwork in Firefighters (SWIFT) Study.
- Employed multilevel models to analyze daily surveys on substance use and actigraphy data for sleep assessment (2,617 observations).
- Adjusted for covariates such as shift schedules, on-shift status, call volume, and naps.
Main Results:
- Alcohol consumption showed strong bidirectional effects: more alcohol predicted shorter sleep, while poor sleep predicted higher next-day alcohol use.
- Caffeine use was unexpectedly linked to improved sleep efficiency and longer sleep duration.
- Smokeless tobacco use was associated with reduced total sleep time, but lifetime cigarette use showed no significant sleep association.
Conclusions:
- Substance use has substance-specific and time-dependent effects on firefighter sleep.
- Daily alcohol use demonstrates consistent bidirectional impacts on sleep patterns.
- Findings suggest targeted interventions for sleep improvement and alcohol risk reduction in this population.
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