Organization of This Report

Chapters Two and Three evaluate the prevalence and consequences of sleep problems in servicemember populations in the post-deployment period (addressing question 1) using a multi-method approach. Specifically, Chapter Two synthesizes research findings from a literature review with information garnered from key informant discussions and the working group meeting, and Chapter Three presents an overview of the development of the sleep survey and analysis of sleep problems and correlates in the Deployment Life Study servicemember cohort. Chapter Four reviews the current policies and programs to prevent and treat sleep problems among post-deployed service-members (question 2), using the results of the literature review, key informant discussions, and our expert working group. Chapter Five presents a review of evidence-based interventions to treat sleep problems among servicemembers (question 3), based on a literature review, key informant discussions, and the expert working group meeting. Chapter Six synthesizes identified barriers to the implementation of sleep-related policies and programs (question 4), based on key informant discussions and the expert working group meeting. Chapter Seven presents a summary of findings and recommendations for promoting sleep health in servicemember populations (question 5), based on a synthesis of findings from all methods used in the study.

This report contains eight appendixes that supplement the analyses presented here. Appendix A contains a list of sleep terms and definitions used throughout the report. It also includes information about the common ways that sleep disturbances are measured in the research literature on military sleep.

Appendix B contains four tables corresponding to the literature review presented in Chapter Two: (1) a table of search terms used for the literature review, (2) a detailed table of studies on the prevalence of sleep problems in the post-deployment period, (3) a detailed table of studies on purported risk factors for sleep disturbances and cross-sectional studies of correlates of sleep problems, and (4) a detailed table of longitudinal studies of sleep disturbances and mental and physical health and operational readiness.

Appendix C is divided into two sections. The first section outlines the methods used to review the literature on interventions for sleep disorders, referenced in Chapter Five. The second section offers additional detail on the studies included in our review of interventions for sleep disorders among military and veteran populations.

Appendix D provides more detail on the instruments used in civilian and military studies to assess sleep parameters and the sleep disturbances that commonly occur among military personnel. We used this information to develop the sleep survey included in the Deployment Life Study and described in Chapter Three. Appendix E includes a detailed description of the source measures included in the sleep survey.

Appendix F provides an overview of DoD policies and programs related to sleep in the Air Force, Army, Navy, Marine Corps, DoD, and VA. Appendix G presents the interview protocol used and described in Chapter Six, and Appendix H includes additional information about the expert working group sessions conducted on February 21, 2014, including meeting logistics and summaries provided by each of the subgroups.

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