Posttraumatic stress disorder and sleep quality among urban firefighters in Thailand

Background: Urban firefighters are at risk of posttraumatic stress disorder (PTSD) because of their occupational exposure to trauma events. Little is known, however, about the effects of exposure to trauma events on sleep quality among firefighters in Thailand. Purpose: The objective of this study was to find an assocaition between PTSD and sleep quality among firefighters. Methods: A cross-sectional study was conducted among active male firefighters in Bangkok. Participants completed the Posttraumatic Stress Disorder Checklist - Civilian Version (PCL-C-THAI) and the Pittsburgh Sleep Quality Index (PSQI-THAI) questionnaires. Multivariable logistic regression models were performed to estimate adjusted odds ratio (AOR) and 95% confidence intervals (95% CI). Results: A total of 1215 firefighters participated, of which 78 (6.4%) met the suggested PCL cut-point criteria for civilians (PCL-C scores >44). In addition, 596 (49.1%) had poor sleep quality (PSQI >5). PTSD firefighters had increased 6.49 fold odds of poorer sleep quality (AOR =6.49, 95% CI 3.13-13.44). Conclusion: Firefighters with PTSD had a significantly higher probability of experiencing poor sleep quality than those without. In response, a psychological health intervention may be needed to enhance the firefighters' health.