Trauma Exposure, Insomnia, and Fatigue: A Cross-Sectional Study of the Pathways to Burnout Among South African First Responders.

BACKGROUND AND AIMS: First responders are disproportionately vulnerable to the development of insomnia, fatigue and burnout, due to chronic exposure to trauma inherent in their occupational roles. This study examined the mediating roles of insomnia and fatigue in the relationship between trauma exposure and burnout among South African first responders.

METHODS

Participants included police officers (n = 309) and paramedics (n = 120) in the Western Cape province of South Africa. They completed an online survey comprising the Life Events Checklist, the Insomnia Severity Index, the Chalder Fatigue Questionnaire, and the Maslach Burnout Inventory. Mediation analyses were conducted using the Hayes PROCESS macro in SPSS Version 30.

RESULTS

Mediation analysis provided evidence of both parallel as well as serial mediation roles for insomnia and fatigue in the relationship between trauma exposure and burnout. Insomnia fully mediated the relationships between trauma exposure and emotional exhaustion as well as personal accomplishment and partially mediated the relationship with depersonalization. Fatigue fully mediated the relationships between trauma exposure and emotional exhaustion and depersonalization but did not mediate the relationship with personal accomplishment. Serial mediation analysis indicated that insomnia and fatigue, in sequence, fully mediated the effects of trauma exposure on emotional exhaustion and depersonalization.

CONCLUSIONS

Insomnia and fatigue are critical pathways linking trauma exposure to burnout among South African first responders. Early identification and treatment of sleep disturbances may be crucial for preventing burnout and enhancing resilience in this population.