By Dena Ali
现代火场的毒性增加使癌症成为当今消防员健康的最大威胁之一。虽然这项索赔已经得到了许多研究的支持，但许多人都有相互冲突的发现，因为没有收获数据的标准方法。例如，美国国家职业安全和健康研究所的1960 - 2009年为30,000名消防员的大规模研究报告了消防员的癌症死亡增加了9％。1Yet, another interpretation of the same study found just a small to moderate increase for certain cancers stemming primarily from the digestive, respiratory, and urinary systems.2Notably, this study found a two-fold increase in malignant mesothelioma from asbestos exposure. (2)
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SLEEP TO SURVIVE: HOW TO MANAGE SLEEP DEPRIVATION
The Sleepless Heart of the Fire Service
Conclusions from these types of studies suggest the need for future research to control for such variables as gender, race, number/type of calls, and use of respiratory protection. However, studies like these have also been limited in what they tell us about techniques for cancer prevention. We’re directing efforts at limiting exposure by keeping firefighters, gear, apparatus, and stations clean. But are we missing other critical pieces of the prevention puzzle?
效果Immune System
如果有一种简单的方法来加强免疫系统，以便你的身体的天然杀手细胞可能会攻击恶性（癌症）肿瘤细胞？有！人类自然有一个内置的系统来提升这些抗癌细胞，而是为了工作，系统需要每晚获得足够的睡眠 - 七到九个小时。通过限制暴露于毒素但未能获得适当的睡眠来防止癌症类似于通过运动来减肥但不能吃健康的睡眠。
在对睡眠和癌症抗药性免疫细胞的影响的地标研究中，迈克尔·伊尔文博士发现，只有一晚的睡眠（四小时相比，八个）消除了70％的这些细胞在免疫系统中循环。3.为了进一步证明对免疫系统睡眠不足的负面影响，近25,000人的大型欧洲研究发现睡眠六小时或更短程度与睡觉六小时或更长时间的人的风险增加了40％的风险。（3）
不仅仅是贫穷的抗癌细胞睡觉renders ineffective; studies of vaccines have found that insufficient sleep can also render the body too weak to produce an effective immune response. One study found that individuals who had their sleep restricted for just a week prior to getting a flu shot produced less than 50 percent of the immune reaction compared to the group that had adequate sleep. (3)
睡眠健康
First responders are well known for their poor sleep habits, and it doesn’t take too long to hear the adage, “I’ll sleep when I’m dead” tossed around. Sadly, if that’s a motto you live by, you may have the opportunity sooner than you’d prefer. “Like water from a burst pipe in our home, the effects of sleep deprivation will seep into every nook and cranny of biology, down into your cells, and even alter your DNA.” (3) Simply put, the less time you sleep, the less time you will live. In his research, sleep scientist Dr. Matthew Walker found that insufficient sleep was a slow form of euthanasia. Despite growing evidence for this, there is often an attitude of invulnerability in firehouses that suggests that those who need more sleep are weak or lazy. Jaqueline and Sean Toomey said it best in their article,“沉迷于清醒：消防服务中的睡眠剥夺，”which stated, “We are immersed in a culture that deems sleeping an indulgent, sinful activity at best.”4.
虽然消防员很容易将他们的睡眠剥夺归因于无法控制的工作时间表，但许多消防员也忽略了睡眠期间也忽略了睡眠。例如，在转变变化期间常见的是谈论当天的计划;这些计划通常包围第二个工作岗位或儿童保育。很少有人听到任何人都承认需要“回家并小睡”，因为睡眠的必要性很少在消防服务中讨论。Toomeys认为，在消防服务中提高睡眠的第一步是承认，实际上存在问题，而不是避免这个问题并互相说服睡眠是不必要的。
当2016年全国对66个消防部门进行的7000名消防员发现的国家研究发现37％的消防员面临睡眠障碍的风险时，它毫不奇怪;尚未被诊断出来的81％的队列。5.本研究包括教育宿舍，睡眠障碍筛查，自由处理和结果措施。尽管自由待遇，但占据了风险的阳性的16.3％利用它。（5）该研究还发现，在睡眠障碍上实施方案可能会降低提交伤害报告的消防员的百分比。他们报告说，该部门的5,200名积极消防员可以每年节省约210万美元，从残疾和病时随着睡眠健康计划的实施时，每年损失。（5）
但是，如果筛选风险肯定的消防员不愿意追求自由待遇，我们如何预期所有成员都会积极筛选风险？唯一的方法是通过教育成员对他们的生物需求进行睡眠而暴露糟糕睡眠的破坏性影响。代理领导人必须通过优先揭露睡眠不足的危险来投资其成员。
The fire service must normalize the need for sleep in the same way it has normalized the use of self- contained breathing apparatus. This starts by recognizing that the leading causes of the diseases that are crippling health care systems and the fire service such as heart disease, obesity, depression,suicide, diabetes, and癌症对睡眠不良有因果关系。
在转移工人中，众所周知，心血管障碍，消化性溃疡和生殖功能障碍的增加，均归归因于睡眠障碍。6.转变工作与癌症密切相关，现在被世界卫生组织归类为“可能的致癌物”。（6）遗憾的是，虽然睡眠障碍是常见的，昂贵的和可治疗的，但许多人仍未诊断和未经治疗。（6）
2013年，美国医学会发出警告报告，该报告归因于某些癌症，肥胖，糖尿病和精神病患者，在夜间中断昼夜节律丧失。7.从手机，电视和室内灯发出的电光有效地抑制了褪黑激素并导致昼夜困惑。工作频繁扩展班次和长工作周会导致智能缺陷和昼夜阶段的未对准。
除了代谢障碍之外，睡眠不良还有助于所有主要的精神病疾病，包括抑郁症，创伤后应激障碍（PTSD），焦虑和自杀。快速眼睛运动睡眠的异常被认为是主要的抑郁症（MDD）和抑郁症的转移工作。（6）与与自杀相关的所有障碍相比，MDD赋予了最大的风险。8.虽然重大抑郁症的终身率为17％，但MDD人民的自杀率比没有它的人高20倍。与每天六到八小时的人相比，自杀率在每天睡不超过四小时的情况下比睡眠更高3.5倍。（6）
Connection to Cancer
However, of all the illnesses associated with poor sleep, learning about its connection to cancer was the most frightening. Epidemiological studies on shift work discovered that sleep disruption increases your odds of developing numerous forms of cancer, including breast cancer, prostate cancer, and colon cancer. (3) In fact, because of the increased evidence connecting sleep disruption with cancer, Denmark became the first country to pay workers’ compensation to a woman who had developed breast cancer after years of night shift work. A recent European study of almost 25,000 people found that sleeping fewer than six hours was associated with a 40 percent increased risk of developing cancer compared to those sleeping for seven hours or more. (3)
睡眠不足和癌症之间的联系与睡眠与炎症反应的联系有关。缺乏睡眠迫使交感神经系统过度驱动，从而导致免疫系统的炎症反应。在短期内，炎症是有助于您的身体对抗疾病;然而，它增加了几种慢性疾病的风险。睡眠不足持续时间较长，你的身体在一定程度上仍然在一定程度的战斗状态。这可能持续多年来与那些未经治疗的睡眠障碍或过度工作时间或者只是选择忽视他们的睡眠的人。
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According to Dr. Walker, “Like a car engine that is revved to a shrieking extreme for sustained periods of time, your sympathetic nervous system is floored into perpetual overdrive by lack of sleep. The consequential strain that is placed on your body by the persistent force of this sympathetic activation will leak out in all manner of health issues, just like the failed pistons, gaskets, seals, and gnashing gears of an abused car engine.” (3)
通过将炎症因素吸入肿瘤物质以引发血管的生长，癌症使用炎症反应它们的优势，以引发血管的生长，这些血管与更多的氧气和营养素饲喂它。肿瘤使用炎症反应来帮助进一步损害和突变其细胞的DNA，增加肿瘤的强度。（3）由于这一点，缺乏睡眠是因果关系的，使癌症蔓延到身体的其他部位。一旦癌症转移，干预变得更加复杂，死亡率增加。但是，如果转移可以延迟，则更容易消除局部癌症。
这种转移性关系是在芝加哥大学的芝加哥大学，用恶性细胞注入小鼠并跟踪肿瘤进展。在该研究中，允许一半的小鼠正常睡眠，而另一半的睡眠部分被破坏以降低睡眠质量。因此，与恢复的组相比，睡眠剥夺的小鼠的速度和大小增加了200％的速度和大小。
小鼠的后期研究发现，肿瘤在睡眠缺陷型动物中更具侵略性。他们的癌症通过扩散到周围的器官，组织和骨骼而转移。在这个实验中发现免疫细胞是睡眠损失导致的癌症影响的根本原因多年的工作。睡眠损失减少了免疫细胞对抗癌症，同时支持癌症生长替代细胞M2细胞的能力。（3）随着这一发现，戈萨尔意识到睡眠不良增加了癌症发展的风险，如果建立癌症，则为其快速和更猖獗的增长提供健康的环境。（3）沃克在将癌症倒入已经激进的火灾时倾倒汽油时没有充分睡眠。（3）
If we are serious about preventing cancer among first responders, we must prioritize changing the way we view sleep. Agency leadership must also prioritize finding ways to increase the quality of sleep among its members by encouraging them to be evaluated for sleep disorders; this evaluation should include educational sessions that will encourage better sleep hygiene practices and treatment.
睡觉Education and Stages
我们对睡眠的漠不关心与我们的历史性未能解释和理解睡眠目的直接相关。今天，科学已经足够先进，我们理解睡眠是我们每天能够重置大脑和身体健康的最有效的东西。（3）睡眠通过丰富我们的学习，记忆，做出决策和流程事件来服务于我们的大脑。事实上，被发现梦想成为虚拟现实空间，即将痛苦的回忆。从本质上讲，梦想是创伤加工的内置治疗和预防投入前植。
睡眠进一步用于通过释放有毒废物和合成原因激素，组织修复以及重置大脑中的神经细胞的过程来重新校准身体，所有这些都有助于调节我们的血压，糖水平和免疫系统。没有必要的睡眠，激素水平急剧改变。在睡眠不佳的第一个响应者中，常见的是睾酮和皮质醇水平普及危险的范围。
Through advances in science and technology, we now understand that our bodies are designed to experience four stages of sleep each night. These stages progress through approximately four or five 90-minute cycles that rotate between a nonrapid eye movement (NREM) state and a rapid eye movement (REM) state. The first two cycles are primarily dominated by NREM deep sleep, while the last two cycles consist primary of REM sleep. Both stages of sleep serve different roles for the body and mind. NREM is necessary for mental and physical recovery, while REM is necessary for cognition and processing of memories.
如果你每晚平均睡觉平均七到九小时，那么你可能更有可能允许你的身体完成四个必要的睡眠阶段。熬夜的人抢劫他们的NREM睡眠尸体;那些醒来早起的人抢劫他们的重复睡眠。
那些患有睡眠疾病的人，如睡眠呼吸暂停和失眠症在这些阶段的缺乏，从而患有慢性睡眠剥夺。这种条件导致疲劳，这在许多心理和身体疾病中表现出来。
Walker recommends a few simple ways to evaluate if you are getting sufficient sleep. Number one is if you didn’t set an alarm clock, would you sleep past that time? If so, your body needs more sleep than what you are allowing it, and you should consider an earlier bedtime. Also, during the day, do you find yourself rereading the same sentence multiple times (fatigued brain)? Finally, do you sometimes forget what color the last few traffic lights were (distraction)?
If you regularly sleep seven to nine hours and still experience these symptoms, you should consider being evaluated for a sleep disorder that may be interrupting your sleep. If you experience these symptoms because you don’t sleep sufficiently, consider finding ways to get more sleep. Additionally, if you are using sleeping pills or alcohol as a sleep aid, understand that these substances work as a sedative and inhibit true restorative sleep. They inhibit the REM stage of sleep, which prevents the brain’s natural ability to recalibrate, regulate emotions, and process memories. The use of alcohol and sleeping pills has been found to contribute to early mortality, emotional dysregulation, and PTSD.
Individuals and company- and agency-level members can take many actions to improve their sleep. At the individual level, work on consistent bedtimes and rid sleeping areas of any distractions. When your body recognizes you are in bed solely to sleep, you fall asleep easier. Other suggestions include the following:
- 在上床睡前时刻限制电子设备的使用。
- 将你的体温减少了两度，这让您可以更轻松地睡着了。找到减少卧室温度的方法。
- 每天锻炼，这激励身体更好地睡觉。但是，尽量不要在睡眠三个小时内锻炼身体。
- 停止使用时钟上的“贪睡”按钮。如果您打盹30分钟，您已抢劫大约25％的REM睡眠。（REM睡眠腹部睡眠结束。）
- 如果你辗转反侧,无法平静你的心while attempting to sleep, there are ways to calm your mind. First, hide any time-keeping devices to reduce stress. Practice mindfulness by doing a simple breathing exercise. One of the simplest is the Navy SEALs’ breathing technique where you inhale for four seconds, hold your breath for four seconds, exhale for four seconds, and hold your breath for four seconds. By focusing on your breath, you start to calm the mind. This technique also reduces your respiratory rate and activates the parasympathetic nervous system. Using the sleep stories included in the calm and head- space apps are extremely helpful.
- If you are still unable to fall asleep, get out of bed and go to another room. Keep the light dim and engage in a calming activity (not television).
- 小睡！Allison Brager博士，睡眠科学家为国防部建议敲打20至30分钟。她分享的伎俩包括在躺下睡午觉之前消耗一剂咖啡因。因为咖啡因需要30分钟才能踢进，你应该在醒来时立即感受到其影响。午餐后或在傍晚休息90分钟。如果您在一家繁忙的公司工作，可能是大部分夜晚，这样做允许您完成一个完整的睡眠周期，从而在过夜时间变得更加警觉。
- 限制接管柜台睡眠丸。
- Eliminate alcohol within four hours of bedtime.
- Establish a consistent nighttime routine that is free of light and low in mental and physical intensity.
- 午餐后消除咖啡因摄入量。咖啡因的平均半衰期为五到七个小时。这意味着如果你有一杯咖啡，那么下午7点，你仍然可以在上午1点在你的系统中有一半的咖啡因。
- Encourage members to practice sleep hygiene techniques. One of the greatest things a company officer can do for his crew is recognize the need for sleep and
- 鼓励他的成员改变他们的习惯，包括睡午觉，安静的宿舍，并仅为贵公司的回应而被唤醒。
- 消除宿舍中的电话使用，电视观看和其他电子设备。当你的身体识别一个区域只是睡眠时，它能够更快地睡着了。
- 保持宿舍温度约为2°F至3°F冷却器比消防屋的其他区域更冷。
- 睡在私人宿舍里，没有分心和打鼾的声音。
- Use dim lighting in the dorm.
- Replace trip lights with a calmer red light.
- In multicompany stations, awaken only the crew being dispatched for a call.
- 专注于查找换档后允许更多恢复时间的计划。目前的56小时工作周不是最佳的。一项研究发现，需要一到两晚的恢复睡眠，从24小时轮班造成的赤字中恢复。
- 如果您患有失眠，请在培训的治疗师寻找培训，以对失眠的认知行为疗法。
- If you rarely feel refreshed after sleeping, be evaluated for a sleep disorder.
- Tart cherry juice is a natural sleep aid and an anti-inflammatory. You can purchase concentrated versions at your local grocery store.
- 对于更多提示，去https://www.sleepfoundation.org/。
消防员患癌症的风险和许多其他代谢和心理障碍的风险增加。这些中的每一个都被发现因睡眠不足而导致连接。消防员对他们中断的睡眠和漠不关心令人震惊，需要睡眠。现在我们了解到睡眠是一种生物学必需品，并且缺席是一种缓慢的安乐死形式，我们必须改变我们认为需要睡眠的方式。
必须鼓励消防员在睡眠中置于睡眠状态，他们的雇主必须在方法上接受教育，以鼓励睡眠卫生技术，同时减少其成员在不响应紧急情况时的中断次数。
最后，为了了解癌症背后真正的罪魁祸首，并在预防迈出的进步，我们必须强调不仅控制人口统计和暴露，还要强调控制睡眠和营养的个人健康因素。
参考
1，Niosh Scients Blog（2018年5月18日）。从...获得https://blogs.cdc.gov/niosh-science-blog/2017/05/10/ff-cancer-facts。
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3.。Walker MP (2018).为什么我们睡觉：解锁睡眠和梦想的力量。纽约，纽约：Scribner，Simon＆Schuster的印记。
4.。Toomey S and J Toomey (2018, November 15). “Addicted to Awake: Sleep Deprivation in the Fire Service.” Retrieved from//www.sacthai.com/articles/2018/11/addicted-to-awake.html
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