Develop a Clinical Practice Guideline for Sleep Disorders

Medical publications related to sleep primarily mention sleep as a symptom of other conditions, mainly mental disorders. This structure does not account for a large and growing body of research summarized in Chapter Two that sleep may be a precipitating factor for mental disorders and that treatment of sleep problems may actually also improve symptoms of mental disorders, such as PTSD. New medical policies are needed, such as a clinical practice guideline that specifically addresses sleep and discusses preventing, identifying, and treating sleep disorders. These medical policies for military populations should build on existing American Academy of Sleep Medicine (AASM) practice guidelines provided for the general population. Medical policies should also address the use of stimulants and sleep medications with consistent guidance.

Key informants expressed fear of negative career consequences if they self-identified as having a mental disorder. Thus, new medical policies that focus on sleep may be a way to combat stigma associated with treatment-seeking, which may be lower for sleep than for mental disorders, which may, in turn, have downstream benefits for other co-occurring conditions. Indeed, research with both civilians and veterans suggests that targeting sleep disorders, such as insomnia or nightmares, may also have effects on reducing mental health problems that servicemembers may be more resistant to seek help for, such as PTSD and depression (Manber, Edinger, et al., 2008; Nappi, Drummond, and Hall, 2010; Ulmer, Edinger, and Calhoun, 2011). The role of sleep may not only be a prodromal symptom that can herald the onset of other mental health disorders; it may also be a possible entry point to enhance treatment-seeking for populations in need, who may otherwise be resistant to treatment.

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