Many veterans have disturbed sleep for months or even years after they return home from service, but the lack of sleep can lead to accidents and injuries, cardiovascular morbidity, and other mental and physical health problems. Moreover, sleep disturbances are a core feature of posttraumatic stress disorder, depression, and traumatic brain injury, the 3 most prevalent mental health diagnoses among active-duty military and veterans following deployments. Researchers from the RAND National Defense Research Institute say part of the problem is that “resistance to recognizing the importance of sleep is deeply embedded in military culture.” Prioritizing sleep can be met with such sentiments as “Sleep is for the weak.” In essence, the researchers say, sleep is considered a luxury, not a biologic need.
Related: Management of Comorbid Sleep Disorders in Patients With Posttraumatic Stress Disorder
Is there a way to help? The researchers reviewed the literature and military policies and programs related to sleep, conducted interviews with policy makers and experts in sleep research, and collected primary data on sleep problems from 1,957 service members across all military branches to find out. Their report is the first comprehensive review of sleep-related policies and programs across DoD, RAND says.
The researchers found inconsistent sleep-related policies, which could impede efforts to promote sleep health. “Military policies on prevention of sleep problems are lacking, and medical policies focus on treating mental disorders that are often linked with sleep problems, instead of sleep itself,” said Regina Shih, project co-leader and a senior social scientist at RAND. This, even though “we know that sleep problems may precede the onset of mental disorders,” she added.
Related: DVBIC Guidelines on Concussion and Sleep Disturbance
The RAND study offers recommendations that include educating families about the signs and symptoms of sleep disturbances, improving screening for sleep disturbances in primary care settings, and increasing the use of mobile technology for assessing and managing sleep disorders (eg, monitoring sleep and alertness). The researchers also suggest revising training and operational policies to minimize inconsistencies and align with current clinical guidelines and research about optimal sleep duration and circadian rhythms.
A key to preventing sleep problems, the researchers conclude, is self-awareness and knowledge about the factors that inhibit or promote adequate, restful sleep. They point to a study of U.S. Army officers that found 80% reported not receiving sleep management briefings during deployment. The researchers suggest that the most effective way to disseminate sleep information is to provide it throughout training and in different operational contexts.
Sources
Troxel WM, Shih RA, Pedersen E, et al. Sleep in the Military Promoting Healthy Sleep Among U.S. Servicemembers. Santa Monica, CA: RAND Corporation; 2015.
RAND Corporation. Sleep problems prevalent for military servicemembers [press release]. Santa Monica, CA: RAND Corporation; April 6, 2015.
