Operational and Military Support Factors
The research on operational and military support factors includes studies examining general military characteristics (e.g., officer status, Service branch) and unit- and deployment-specific factors (e.g., unit support, location of deployment).
General Military Characteristics
Post-deployment sleep disturbances are associated with several characteristics of military service. For example, those serving in the Army or Marine Corps, those on active-duty (versus Guard/Reserve), and those who are junior enlisted (versus officers, and, similarly, those with less education) are at risk for short sleep duration and global sleep problems post-deployment (Seelig et al., 2010; Swinkels et al., 2013; Lentino et al., 2013; Plumb, Peachey, and Zelman, 2014). Military occupational specialty categories at risk for insomnia, OSA, and poor sleep quality include those deployed in support and sustainment units (e.g., medics) and electronic equipment repair specialists (Armed Forces Health Surveillance Center, 2010b; Brundage, Wertheimer, and Clark, 2010; Seelig et al., 2010), perhaps because of the pressure from these demanding positions and the exposure to traumatic medical emergencies.
Unit- and Deployment-Specific Factors
A greater number of deployments, greater combat exposure while deployed, and deployment to Iraq or Afghanistan versus other locations are additional factors associated with an increased risk of poor sleep quality and short sleep duration post-deployment (Luxton, Greenburg, et al., 2011; Seelig et al., 2010; Swinkels et al., 2013; Wright et al., 2011b; Plumb, Peachey, and Zelman, 2014). For example, both one month and three months after deployment, approximately 40 percent of those deployed to Iraq or Afghanistan reported sleep problems, compared with 20-25 percent of those who had deployed to Kuwait or other places or who were shipboard—locations presumably exposed to less combat than locations in Iraq and Afghanistan (McLay, Klam, and Volkert, 2010). In addition, lower levels of unit support while deployed (i.e., amount of assistance or encouragement from unit members and leaders) and limited exposure to sleep management training in theater are associated with poor sleep quality among OEF/OIF officers and veterans (Miller, Shattuck, and Matsangas, 2011; Pietrzak, Morgan, and Southwick, 2010), while Army personnel who report positive sleep leadership from noncommissioned officers (NCOs) during deployments are less likely to report sleep problems (MHAT 9, 2013).