A new study found a high prevalence of sleep disorders and a startlingly high rate of short sleep duration among active duty military personnel. The study suggests the need for a cultural change toward appropriate sleep practices throughout the military.
"While sleep deprivation is part of the military culture, the high prevalence of short sleep duration in military personnel with sleep disorders was surprising," said Vincent Mysliwiec, MD, the study's principal investigator, lead author and chief of Pulmonary, Critical Care and Sleep Medicine at Madigan Army Medical Center in Tacoma, Wash. "The potential risk of increased accidents as well as long-term clinical consequences of both short sleep duration and a sleep disorder in our population is unknown."
Results show that the majority of participants (85.1 percent) had a clinically relevant sleep disorder. Obstructive sleep apnea (OSA) was the most frequent diagnosis (51.2 percent), followed by insomnia (24.7 percent). Participants' mean self-reported home sleep duration was only 5.74 hours per night, and 41.8 percent reported sleeping five hours or less per night. According to the AASM, individual sleep needs vary; however, most adults need about seven to eight hours of nightly sleep to feel alert and well-rested during the day.
According to the authors, this is the first study to systemically describe primary sleep disorders and associated comorbidities in accordance with standardized diagnostic criteria in a large cohort of military personnel referred with sleep complaints.
The study, appearing in the February issue of the journal Sleep, involved a retrospective cross-sectional cohort analysis of 725 diagnostic polysomnograms performed in 2010 at Madigan Army Medical Center. Study subjects were active duty military personnel from the U.S. Army, Air Force and Navy, comprising mostly men (93.2%) and combat veterans (85.2%). Sleep disorder diagnoses were adjudicated by a board certified sleep medicine physician.
Results also show that 58.1 percent of the military personnel had one or more medical comorbidities, determined by medical record review. The most common service-related illnesses were depression (22.6%), anxiety (16.8%), post-traumatic stress disorder (13.2%), and mild traumatic brain injury (12.8%). Nearly 25 percent were taking medications for pain. Participants with PTSD were two times more likely to have insomnia, and those with depression or pain syndrome were about 1.5 times more likely to have insomnia.
"Mysliwiec and colleagues have made a significant contribution to our understanding of the link between sleep disorders and service-related illnesses associated with combat operations," Nita Lewis Shattuck, PhD, and Stephanie A.T. Brown, MS, postgraduate students at the Naval Postgraduate School in Monterey, Calif., wrote in a commentary on the study. "Their findings highlight the need for policy and culture change in our military organizations and continued research to understand and ameliorate the injuries these veterans have sustained. Better appreciation of the causal factors associated with veteran's health will lead to better policies for transition to civilian life and ultimately minimize the cost of veterans' health care to society."
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"Sleep Disorders and Associated Medical Comorbidities in Active Duty Military Personnel," Sleep, 2013.
Commentary: "Wounded in Action: What the Sleep Community can Learn from Sleep Disorders of US Military Service Members," Sleep, 2013.