Improving Sleep for Firefighters Through Technology

Sleep is essential for everyone-but for firefighters, it's a matter of life and death. With shift work, high stress, and exposure to trauma, poor sleep quality is one of the most pressing health concerns among fire service professionals today.

At the Medical University of South Carolina (MUSC) College of Nursing (CON), a collaborative team led by Associate Professor and licensed clinical psychologist Tatiana M Davidson, Ph.D. and Dr. Angela Moreland Johnson, Ph.D, from the College of Medicine is taking bold steps to address this issue. Their latest project, funded by FEMA, focuses on developing and distributing technology-based resources to improve sleep quality in firefighters.

Why Sleep Matters in Firefighting

Nearly 60% of firefighters report that sleep issues significantly impact their mental and physical health. Poor sleep has been linked to slower reaction times, increased risk of injury, cardiovascular disease, obesity and mental health. For firefighters, it's not just about getting sleep, it's about making the most of the limited hours they can sleep. That's why this initiative is shifting the focus from sleep quantity to sleep quality.

Creating a Custom App for Firefighters

This project stands out for one major reason: it puts sleep at the center. While previous tools developed by the team incorporated sleep as one piece of broader stress management, this time, the mobile app focuses entirely on helping firefighters improve their sleep.

Grounded in cognitive behavioral therapy for insomnia (CBT-I), the gold standard for managing chronic sleep issues, the app helps users identify sleep challenges, set goals, track progress and receive real-time feedback. Features also include strategies tailored to firefighter life: managing shift work, noisy stations, trauma-related sleep disturbances like nightmares and the impact of substances such as caffeine and alcohol on sleep.

Unlike traditional clinical research, this FEMA-funded project operates as a rapid-service model. Firefighters are engaged from the start through focus groups, allowing researchers to refine tools based on direct feedback. Once developed, the app is immediately available—no years-long clinical trials are required.

From Local Support to National Impact

Since 2011, the MUSC team has developed a suite of self-help tools addressing everything from suicide prevention and alcohol misuse to family support. While these tools are freely available online and via app stores, the challenge remains: reaching more firefighters, especially in rural and under-resourced departments. The team is exploring new dissemination strategies, including national partnerships and awareness campaigns, to scale impact beyond the Lowcountry and ensure that life-saving resources are just a download away for firefighters nationwide.

Eye-Opening Findings

One of the biggest revelations for Dr. Davidson and her team has been firefighters' openness to using mental health tools, especially when delivered in a private, self-guided format like a mobile app. Firefighters understand the challenges they face. Many actively contributed to app design, choosing icons that wouldn't reveal the app's mental health focus, helping reduce stigma and encourage use.

These tools are not meant to replace therapy but serve as a first step. Every app includes a "Get Help" feature that connects users to crisis resources or licensed providers, acknowledging that mild-to-moderate symptoms can often be managed with self-help. At the same time, more serious conditions require professional care.

Looking Ahead

Dr. Davidson and her team continue to expand their work through strong partnerships, such as those with the National Fallen Firefighters Foundation and the Lowcountry Firefighter Support Team. Their goal remains clear: to improve the quality of life for the brave men and women who protect our communities.

Ready to Sleep Better, Perform Better, Live Better?

Firefighters, family members, and providers can explore and download free behavioral health tools at cffbh.org