Fund/Conduct Longitudinal Research on Sleep and Downstream Effects on Operational Readiness and Resilience

Our literature review (Chapter Two) and primary data collection (Chapter Three) on the correlates and consequences of sleep problems indicated that there is (1) a lack of longitudinal research on precipitating factors that precludes identifying prevention targets and (2) an inability to clarify whether sleep problems exist prior to deployment because within-person studies have not tracked sleep across the deployment cycle. Based on cross-sectional findings reported in Chapter Three that sleep quality and sleep-related daytime impairments, as well as sleep duration, are important correlates of servicemember mental and physical health and perceived readiness, longitudinal studies should incorporate broader assessments of sleep (rather than focusing on sleep duration, solely) and their linkages with resilience. Future studies that contribute to prevention efforts should track sleep across the deployment cycle and should also augment current survey approaches with the use of objective measures as well as validated measures of sleep, rather than relying on single- or few-item assessments that cannot capture the multidimensional nature of sleep. Longitudinal studies with military samples are needed to understand how preserving healthy sleep patterns (e.g., by banking sleep or establishing healthy patterns pre-deployment) can effectively help reduce sleep problems after deployment and strengthen resilience to sleep and mental health problems. Indeed, the civilian longitudinal literature reveals that sleep problems can lead to further mental health problems; research establishing how healthy sleep can protect against development of mental health problems in military populations is an area ripe for future work.

Finally, more research is needed to determine how perpetuating factors (e.g., use of caffeine to combat daytime fatigue), adopted either during deployment or after deployment, contribute to long-term sleep problems in the post-deployment period, as these may be targets for subsequent intervention efforts.

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