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

Sleep disruption is a growing concern among military personnel. However, very little is known regarding sleep characteristics of military members serving in combat environments. To quantify the prevalence and mental health correlates of sleep disruption among military personnel serving in a combat zone during Operation Enduring Freedom. Design: Cross-sectional survey of expeditionary sailors. U.S. military personnel in Afghanistan combat theater. Participants: Active duty and reserve U.S. Navy personnel (N = 3175). Main Outcome Measures: Survey 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 posttraumatic stress symptoms, anxiety, and depression. Participants reported an average of 5.9 hours of sleep per night, despite requiring on average 6.8 hours to feel well-rested. More than half (56%) were classified as sleep deficient, and 67% endorsed 6 or fewer hours of sleep per night. Participants reported mild trouble falling and staying asleep. Adjusted for covariates, individuals endorsing sleep disruption were at substantially elevated risk of meeting criteria for posttraumatic stress disorder, generalized anxiety disorder, and major depressive disorder. This study documents sleep characteristics as well as odds of meeting criteria for probable mental health disorders as a function of sleep disruption among military members in a combat zone. Despite its unique strengths, key limitations involve its cross-sectional nature and plausible reciprocal relationships of sleep disruption and mental health. Published in Military Medicine, v179 n7 p744-751, 2014. Sponsored in part by the Bureau of Medicine and Surgery, Falls Church, VA.