Final Words

Given the recent drawdown from combat operations in Iraq and Afghanistan, increasing attention has focused on factors that promote or hinder servicemembers' ability to reintegrate and rebuild their lives post-deployment. This study indicates that insufficient sleep duration, poor sleep quality, and sleep-related daytime impairment are pervasive problems in the military, even more so than they are in society as a whole. These findings are critical for DoD to consider in light of the solid scientific evidence that shows that sufficient, high-quality sleep is critical for mission readiness and that the lack thereof increases risk for adverse mental and physical health consequences, including depression, PTSD, obesity, diabetes, cardiovascular disease, accidents, and injuries.

Table 7.2. Recommendations to Promote Sleep Health

Recommendations to Promote Sleep Health

Historically, sleep problems have been viewed merely as a symptom, secondary to other co-occurring mental health conditions. However, sleep problems are both a symptom of virtually every mental health diagnosis of most concern to DoD, including depression, PTSD, and TBI, and can also presage the development of psychological disorders and suicidality. Left untreated, sleep problems are among the most intractable symptoms in the context of other co-occurring mental health conditions and can predict poorer treatment outcomes and increased risk of relapse in depression. Yet evidence-based practices to treat and prevent sleep problems among servicemembers are limited in their demonstrated efficacy and accessibility. Unfortunately, sleep is traditionally viewed as a luxury by military populations—which can undermine efforts related to the prevention, identification, and treatment of sleep problems.

This report presents 16 overarching policy recommendations to improve the prevention, identification, and treatment of sleep problems in servicemembers. Individual servicemembers, unit leaders, the military health system, training and operational commands, and DoD at large are encouraged to undertake these policy recommendations collectively. Implementing these recommendations must go hand in hand with better messaging about the biological and operational necessity of sleep to overcome knowledge-related, cultural, medical, and operational barriers to ensuring that service-members achieve healthy sleep. Such an integrated approach will be critical to targeting one of the most important factors contributing to the resilience and operational readiness of the U.S. military.