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Sleep Survey Added to the Deployment Life Study

At the start of our study in August 2012, the Deployment Life study (which began approximately 18 months earlier) had already collected four waves of data for the Army, Air Force, and Marine Corps and was about to begin baseline data collection on the Navy. Prior to developing and launching our study, we systematically reviewed the literature on sleep metrics and designed a survey that incorporated multiple domains of sleep while minimizing participant burden by keeping the instrument brief. We presented a proposed set of sleep measures to the Deployment Life Study team and received approval to include the sleep survey in the overall Deployment Life Study survey in October 2012. As a result, we were able to administer the sleep survey concurrent with the launch of the baseline assessment for the Navy in November 2012 and with wave 5 data collection in the Army, Air Force, and Marines, beginning in December 2012. Given that the sleep study was a two-year project, we were only able to analyze data from a single wave of data collection from the Deployment Life Study. Therefore, findings presented herein are cross-sectional.

As noted earlier, based on the literature review of existing survey and administrative data, we identified self-report measures that have been used to assess sleep symptoms (e.g., sleep quality, quantity, nightmares) and sleep-related behaviors (e.g., use of sleep medications or stimulants, inconsistent bedtimes, frequent napping) and that specifically focus on conditions relevant to servicemembers (see Chapter Two). Appendix D presents the common sleep metrics used in the literature and describes the measures, psychometric properties, and advantages and disadvantages of each measure. Although that list is not exhaustive—as there are numerous study-specific instruments used in the literature—it includes the most commonly used, validated instruments.

For the sleep survey, we selected a set of items and full scales (i.e., the PSQI) that assess important and relevant components of these sleep domains and sleep disorders and that could be completed in five to ten minutes (to reduce participant burden). Most items were self-reported by the servicemembers; however, we also included items requesting the spouse's assessment of the servicemember's sleep behavior. Table 3.1 outlines the domain, number of items (with descriptions for each of the selected measures included in the final analyses of the sleep survey data reported here), and source. Appendix E provides further description of each selected source and the additional items collected in the survey (but not reported here), including psychometric information and support for using these measures with our targeted population.

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