03/08/2013 08:16 am ET Updated May 08, 2013

Soldiers Short on Sleep

Of all the dangers faced by soldiers, sleep is not likely to top many people's lists. But soldiers, like the rest of us, face risks to health and safety from poor and insufficient sleep. And new research indicates they may be at significantly elevated risk for sleep problems, and sleep-related health issues.

A new study shows high rates of sleep disorders among active duty military personnel. The study also found that a majority of the soldiers suffering from sleep problems are also coping with one or more additional illnesses, including depression, anxiety, post-traumatic stress disorder (PTSD), and brain injuries.

Researchers at Madigan Army Medical Center in Washington examined the sleep of 725 active duty military personnel from the US Army, Navy and Air Force. Most of those who participated -- 93.2 percent -- were male. And the majority -- 85.2 percent -- had served in combat positions. All had been referred for sleep evaluation using polysomnography, a standard test used in the diagnosis of sleep disorders.

Researchers looked to determine the frequency of sleep disorders among these active duty soldiers, and also to identify other potentially sleep-related health problems. They found most soldiers suffering some type of disrupted sleep and having insufficient levels of sleep. Many of these soldiers were also coping with other medical conditions that are influenced and exacerbated by sleep problems.
  • 85 percent of the soldiers had some type of sleep disorder
  • Obstructive sleep apnea was diagnosed in 51.2 percent of the participants. This was the most common sleep disorder among the soldiers in the study
  • 24.7 percent of soldiers were found to be suffering from insomnia
  • On average, soldiers were sleeping 5.7 hours per night.
  • 42 percent reported sleeping fewer than five hours per night
A majority of soldiers were coping with some type of health issue:
  • 58 percent had at least one other medical condition
  • 23 percent were suffering from depression
  • 17 percent had anxiety
  • 13 percent were suffering from PTSD
  • 13 percent had mild traumatic brain injuries
  • 25 percent were taking medications for pain
The soldiers with these medical problems were more likely to also have sleep problems, according to the study results. Military personnel with depression or chronic pain were 1.5 times as likely to have a sleep disorder. Those with PTSD were twice as likely to have disrupted sleep. The health problems common among the active-duty military personnel are all conditions that have a complicated relationship to sleep:
  • There is a substantial body of research showing links among depression, anxiety and sleep. Sleep problems are widespread among people with depression and anxiety. More than three-quarters of patients with depression also experience disrupted sleep, according to research. And among patients with major depression, suicide rates are higher for those who also suffer from sleep problems.
  • The relationship between sleep and pain is an important and growing area of research. As is the case with all of these health problems, the association between pain and sleep is complex, with influence running in both directions. Research shows that sleep deprivation reduces tolerance for pain, and also that pain itself can cause sleep problems.
  • PTSD is a complicated and all-too-common health risk for combat soldiers. Sleep problems are also common among those who suffer from PTSD. Studies show that two-thirds of patients with PTSD also have sleep problems. And research indicates that disrupted and insufficient sleep can exacerbate the anxiety that is often present with PTSD.

These conditions are dangerous to health and can be profoundly disruptive to life and relationships. Combat soldiers are at particular risk for these types of medical conditions, given the intense, prolonged and dangerous conditions under which they work. Lack of sleep can elevate their risk even further, and can complicate these health problems once they've begun.

As researchers in this current study suggest, we need further investigation into the sleep problems associated with military duty, and also the health and safety risks associated with sleep deprivation and sleep disorders. Our military personnel do our nation a great service. It's our duty to do all that we can to protect their health on the battlefield and when they come home. Paying greater attention to soldiers' sleep is one important way to do that.

Sweet Dreams,
Michael J. Breus, PhD
The Sleep Doctor™

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