Prevalence and Mental Health Correlates of Sleep Disruption Among Military Members Serving in a Combat Zone

Abstract

Sleep disruption is an emergent military health issue, but remarkably little is known of its prevalence or comorbidities in the combat zone. This study was designed to quantify the prevalence and mental health correlates of sleep disruption among military personnel serving within a ground combat zone during Operation Enduring Freedom. This was a large, cross-sectional survey of active duty and reserve U.S. Navy personnel (N = 3,175). Self-reported sleep measures included total hours of sleep per day, total hours of sleep required to feel well-rested, difficulty falling asleep, and difficulty staying asleep. The survey also measured mental health symptoms, including post-traumatic stress symptoms, anxiety, and depression. Participants reported an average of 5.9 hours of sleep per day despite requiring on average 6.8 hours to feel well rested. More than half (56%) were classified as sleep deficient, and 67% reported 6 or fewer hours of sleep per day. Adjusted for covariates, individuals endorsing sleep disruption were at substantially elevated risk of meeting criteria for post-traumatic stress disorder, generalized anxiety disorder, and major depressive disorder. This study documents the prevalence of sleep disruption in a very large and difficult-to-access sample of military members serving in a combat zone, and details robust associations with mental health.

It's been a hard day's night: A diary study on hardiness and reduced sleep quality among naval sailors

“…Military service usually includes some inevitable reductions in sleep quality and restrictions in time available to sleep, and a buffering effect of hardiness might partly explain why hardy service members fare better during conditions of semi-sleep deprivation and low sleep quality. In addition, research shows that active-duty soldiers experience widespread sleep disruption (Taylor et al, 2014). Given this pattern, our findings provide a plausible explanation for why hardy military personnel display increased military performance.…”

Insomnia, psychiatric disorders and suicidal ideation in a National Representative Sample of active Canadian Forces members

“…[19, 20] As expected, from the univariate models the psychiatric disorders (PTSD, MDD, GAD, PD and AUD), as well as insomnia, each predicted SI on their own. However, these models do not account for the overlapping variance that is shared between disorders.…”

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