Similar active hours and diurnal stress profiles but higher mobility in frontline male officers
Across the different hierarchical levels of law enforcement officers (LEOs), the first responders, irrespective of their sex or other demographics, are issued considerable amounts of physical work6. So, we first quantified the daily physical activity parameters of our cohort of 17 police officers, out of which 70.6% were males (N=12) and 29.4% were females (N=5). Figure 1 shows the active hours, as defined by hours with greater than 500 steps moved, of the male and female police personnel, monitored by their Ultrahuman Ring AIR. The median values of active hours were observed to be the same between male and female officers (Male: 9 h, Female: 9 h; Figure 1A). The overall movement indices (which is an aggregate of active hours, steps, workouts, etc.) for the two groups showed men had a significantly higher movement index (Male: 77, Female: 74; p = 0.02; Figure 1B).
Besides physical activity, first responders constantly encounter stressful scenarios at work8. The Ultrahuman Stress Rhythm Score (SRS) is a metric that maps cardiac demands across the day. A high score corresponds to better stress management. Comparing the daily stress score between groups showed a relatively higher median value of the stress score in women officers. However the female group had higher variation in stress scores, and hence the results did not meet statistically significant criteria when compared to the male group (Male: 77 + 18, Female: 81 + 25.25; Figure 1C).
Figure 1: Daily physical activity and stress monitoring averaged over 6 weeks across police officers [N(Men)=12, N(Women)=5]. a) Active hours, b) Movement index, c) Stress score. * represents p<0.05. Whiskers represent 1.5 times the interquartile range (IQR).
Sleep and recovery
Sleep quality and recovery are directly related to stress levels and physical activity17. Therefore, we next examined how the officers slept over a period of 6 weeks as monitored by the Ring AIR. The median sleep efficiency was not only similar for the female and the male groups (Male: 89 + 10, Female: 90 + 11; Figure 2A), but also reflected a healthy level of the metric for both the groups. Further, the median sleep duration, though slightly higher for women in median values, had a similar range between the men and women officers (Male: 430 min, Female: 444.5 min; Figure 2B). Thus, the male and female first responders were able to achieve the basic and necessary sleep goals after their day-shifts across all the weeks.
We next examined how well the body recovered during sleep for the men and women officers. The recovery score, which depends on the cardiac rhythm, sleep temperature, and general sleep volume, was similar for both sexes (Male: 76 + 9, Female: 76 + 9; Figure 2C). The bodies of the male and female police officers thereby were engaging the recovery mechanisms to comparable capacities during sleep.
Figure 2: Sleep monitoring and recovery averaged over 6 weeks across police officers [N(Men)=12, N(Women)=5]. a) Sleep efficiency, b) Sleep duration, c) Recovery score. Whiskers represent 1.5 times the interquartile range (IQR).
Conclusions, Limitations and Future Directions
The routine work of the first responders in the police force comprises constant exposure to unpredictable, often dangerous and uncontrollable stressors9. In the past, various studies have reported high stress levels in the police workforce10, 11. Repeated exposure to high stress levels can be detrimental to overall well being. The adverse effects of stress can be observed directly on sleep and recovery profiles of the individuals and these profiles are known to differ between men and women12, 13. Information on police officers, however, states that male and female officers on duty often report similar levels of stress14, 15, 16. Equipped with the latest wearable technology, we took a broader and deeper take on this question: do the physical wellbeing parameters of male and female first responders differ? Herein, using the Ultrahuman Ring AIR, we examined not just stress, but also sleep and recovery scores, both of which are highly correlated to stress levels.
It is also known that sleep and recovery are impacted by levels of physical movement17. Therefore, we sought to compare the movement index and daily active hours between the male and female groups. The number of active hours was similar for the two groups whereas the movement index was higher for the men. The male officers had a higher movement index because they could engage in workouts outside their office hours, which were logged in the Ultrahuman mobile app. On the contrary, the women reported that they were invested in the household chores besides office work, and therefore could not take out time for exercise. This trend is perhaps a larger phenomena than limited to south Asian LEO forces.
Interestingly, we noted a slight reversal in the sleep data of the two groups. First, the sleep duration was slightly higher for women and so was the sleep efficiency. As shared by certain women participants, they actively engaged with the Ultrahuman application for gaining daily insights and making slight adjustments when possible to their sleep schedules (sleeping earlier when given time or engaging in some restful exercises when not able to nap). These small adjustments may have shown the minor improvement of their sleep schedules. We did not receive a similar feedback from male officers. It is pertinent to note that qualitative feedback was not sought but voluntarily shared, hence may not be generalizable. Being a pilot study, the trends are not applicable for a wider force without expansion studies. Another limitation was that we did exclude night shifts across the six weeks since data was not available.
This study is an initial data gathering pilot to understand the gender differences in stress and recovery markers using wearables and continuous remote monitoring. First responder law enforcement is fundamental to the fabric of a safe society, and their wellbeing has wide implications for all of us.
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