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Associations Between Sleep Measures and Outcomes Among Previously Deployed Servicemembers

In this subsection, we discuss findings for each outcome separately. Tables 3.8 and 3.9 show the multivariate regression results examining the association between our sleep measure and the outcomes for the linear and logistic models, respectively, based on the distributions of the outcomes.

Table 3.8. Summary of Linear Regression Model Results for Self-Rated Physical Health and Unit Readiness

Summary of Linear Regression Model Results for Self-Rated Physical Health and Unit Readiness

NOTE: Shading indicates joint p-value < 0.01.

* p < 0.05, ** p < 0.01, *** p < 0.001, where joint p-value < 0.01.

Table 3.9. Summary of Logistic Regression Model Results for Probable Depression and Probable PTSD

Summary of Logistic Regression Model Results for Probable Depression and Probable PTSD

NOTE: Shading indicates joint p-value < 0.01.

a The item assessing distressing dreams/nightmares was drawn from the PTSD measure and thus was not included as a predictor of probable PTSD.

* p < 0.05, ** p < 0.01, *** p < 0.001, where joint test < 0.01 only.

Physical Health

Overall, most of the sample reported that their physical health was "very good" or "excellent" (mean for the physical health item = 3.8; range of 1-5) . As shown in the first column of Table 3.8, five different measures of sleep problems were associated with poorer physical health after adjusting for the sociodemographic and military characteristics, depressive symptoms, and presence of TBI. Specifically, there was a significant association between sleep duration and physical health (F = 7.32, standardized beta = -0.33, corresponding to a moderate effect size; p < 0.001), such that those sleeping five hours or less per night reported significantly poorer physical health compared with those sleeping seven hours or more per night. Additionally, poorer sleep quality was associated with poorer health, such that a one standard deviation increase in the PSQI was associated with a 0.23 decrease in mean physical health (p < 0.001). Sleep-related daytime impairment was also significantly associated with poorer physical health (F = 22.86, p < 0.001), such that servicemembers reporting more frequent impairment had significantly poorer physical health than those who reported no impairment, with effect sizes in the moderate to large range for increasing frequency of daytime impairment. Similarly, greater frequency of fatigue was associated with poorer physical health (F = 20.35, p < 0.001), which corresponded to a large effect size based on the standardized beta coefficients reported in Table 3.8. Finally, having a spouse report loud snoring or long pauses for servicemember was associated with lower mean physical health (standardized difference = -0.30; p < 0.001). Across all these sleep measures, the associations were generally of moderate to large magnitude, based on the standardized coefficients, shown in Table 3.8. The largest effect sizes were observed for fatigue and sleep-related daytime impairment; in each case, effect sizes were greater than 0.6, which corresponds to a large effect.

 
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