Firemen and Support Staff
Firefighting is one of the most strictly regulated industries regarding sleep health due to the NFPA 1582 standard, which governs comprehensive occupational medical programs for fire departments.
Under this national standard, Obstructive Sleep Apnea is a Category B medical condition. This means if a firefighter is diagnosed with OSA, they are considered "unfit for duty" unless they can prove the condition is effectively treated and managed.
Most departments now use validated screening tools during annual physicals, such as the Berlin Questionnaire or Epworth Sleepiness Scale. A high score on these questionnaires will automatically trigger a mandatory clinical sleep test (Polysomnography).
Since sudden cardiac events are the leading cause of line-of-duty deaths for firefighters, and OSA is a major contributor to heart disease, medical examiners are highly aggressive in mandating tests for any firefighter with high blood pressure or a BMI over 35.
Firefighters must be able to operate heavy machinery and breathe through a Self-Contained Breathing Apparatus (SCBA). Untreated sleep apnea can cause respiratory complications that make wearing an SCBA mask dangerous under extreme heat.
