PTSD Symptoms and Suicide Risk among Firefighters: The Moderating Role of Sleep Disturbance

Posttraumatic stress disorder (PTSD) symptoms are prominent among firefighters and related to suicidal ideation and behavior, a major public health concern among first responders. The role of sleep disturbance in the associations between PTSD symptoms and suicide risk is not well understood. The present study examined the moderating effect of global sleep disturbance and five disturbance facets (sleep efficiency, perceived sleep quality, daily disturbances, bad dreams, and pain), on the association between PTSD symptom severity and suicide risk among firefighters. This study was a secondary analysis of data from a larger ongoing project. The sample was comprised of 802 trauma-exposed firefighters, recruited from a large urban fire department in the southern U.S., who completed an online survey. Results indicated that there were significant interactive effects of PTSD symptom severity and global sleep disturbance, sleep efficiency, perceived sleep quality, and daily disturbances with regards to global suicide risk. These findings were maintained after adjusting for gender, prior suicide attempt history, years in the fire service, trauma load, and occupational stress. This study is the first to concurrently examine these variables among firefighters and this line of inquiry has the potential to inform evidence-based policy as well as prevention and treatment programs for this vulnerable, understudied population.