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Sleep is a vital health behavior, and lack of sleep is reliably and prospectively linked with a host of adverse mental and physical health outcomes, including an increased risk of depression, suicide, accidents and injuries, cardiovascular morbidity, and mortality. Research has shown that sleep problems are prevalent in military populations— particularly among servicemembers who have deployed to combat operations in Iraq and Afghanistan, which is perhaps not surprising, given that sleep problems are a common reaction to stress. Research further suggests that, for many servicemembers, sleep disturbances persist for months or even years after deployments have ended. Thus, it is critical to understand the individual- and system-level factors that contribute to the onset, persistence, and exacerbation of sleep problems, as well as the downstream consequences for servicemembers' mental and physical health and operational readiness. However, no study to date has comprehensively examined the types of sleep problems servicemembers are experiencing, the programs available to servicemembers to promote healthy sleep and treat sleep disorders, or the policy-level factors that may contribute to servicemembers' sleep health across the deployment cycle and specifically in the post-deployment period, when sleep problems may have lasting implications for servicemember resilience.

To address these gaps, a team of researchers from the RAND National Defense Research Institute conducted reviews of the peer-reviewed academic literature and military policies and programs related to sleep. The research team also drew on both quantitative and qualitative data sources, collecting primary data on sleep problems and behaviors from a large sample (N = 1,957) of servicemembers across all Service branches and components; conducting interviews with health policymakers and personnel who work in military medical, operational, and training settings across the U.S. Department of Defense (DoD); and convening a panel of experts in military sleep research and policy. This multimethod approach provided insights and recommendations regarding the prevalence and consequences of sleep problems in military settings, as well as available programs and policies related to sleep. The ultimate goal of this research was to identify promising policy options and best practices for DoD to mitigate the negative consequences of sleep problems and promote greater sleep health among servicemembers.

This report will be of interest to Service and DoD line leaders who are responsible for developing policies and guidance to prevent and address sleep-related problems in the force, as well as sleep researchers and medical professionals who are involved with identifying and treating servicemember sleep problems and educating military personnel on healthy sleep practices and behaviors.

This research was sponsored by the Defense Centers of Excellence for Psychological Health and Traumatic Brain Injury and conducted within the Forces and Resources Policy Center of the RAND National Defense Research Institute, a federally funded research and development center sponsored by the Office of the Secretary of Defense, the Joint Staff, the Unified Combatant Commands, the Navy, the Marine Corps, the defense agencies, and the defense Intelligence Community, under contract number W91WAW-12-C-0030. For more information on the Forces and Resources Policy Center, see or contact the director (contact information is provided on the web page).

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