Sleep is often the first thing to suffer for military personnel. Many service members face chronic sleep disorders that affect their health, daily performance, and overall well-being.

Conditions like obstructive sleep apnea (OSA) and insomnia are surprisingly common. Usually appearing alongside other issues like PTSD, anxiety, and pain. These sleep problems don’t exist in a vacuum. They’re closely connected to both mental and physical health.

What Are the Common Sleep Disorders in Military Personnel?

The unique demands and stressors of their roles put military personnel at high risk of developing sleep disorders. The nature of military service, with its irregular hours, high-stress environments, and physical strain, sets the stage for a range of sleep disturbances.

Common Sleep Disorders in Military Personnel

Insomnia

Insomnia is one of the most prevalent sleep disorders among active duty members. Studies show that around 27-54% of military personnel experience insomnia symptoms. Difficulty falling asleep, staying asleep, or waking up too early are just some of the signs. People experiencing any of these can lead to daytime fatigue, irritability, and impaired cognitive function.

In addition, factors like stress, anxiety, trauma from combat, and irregular sleep patterns contribute significantly to this disorder. Chronic insomnia can impact their readiness and performance. So, it is an important issue within military populations.

Obstructive Sleep Apnea (OSA)

OSA, on the other hand, causes repeated pauses in breathing during sleep. These interruptions can lead to fragmented sleep, daytime sleepiness, and cardiovascular problems.

Compared to the general population, OSA among military members is higher. Factors like increased body mass index (BMI), exposure to dust and smoke during deployments, and high-stress levels may contribute. 

Recent studies indicate that approximately 62% of military personnel meet the diagnostic criteria for OSA. Many also experience comorbid conditions such as insomnia and post-traumatic stress disorder (PTSD). 

Behaviorally Induced Insufficient Sleep Syndrome (BIISS)

Often referred to as sleep deprivation, BIISS is marked by the intentional reduction of sleep duration. Among military personnel, this can stem from extended duty hours, high-intensity training, and overnight shifts. These are all common in military settings.

Studies indicate that approximately 76% of active duty service members receive less than the recommended 7 hours of sleep per night. Getting only 4-6 hours.  A sleep deficit correlates with impaired cognitive performance, diminished reaction times, and a higher likelihood of errors or accidents. 

Circadian Rhythm Disorders

Military life often comes with frequent time zone shifts, overnight duties, and unpredictable schedules. These troubles can throw off your circadian rhythm — the internal “body clock” that regulates sleep-wake cycles.

When this rhythm is disturbed, it can make falling asleep, staying asleep, and waking up refreshed a struggle. Disorders like shift work disorder and jet lag are common, especially for those with regular deployments or non-traditional work hours. Disrupted circadian rhythms may lead to chronic sleep issues, reduced alertness, and increased fatigue.

Nightmares and Parasomnias

Nightmares are notably prevalent in military members exposed to combat or traumatic experiences. Studies suggest that up to 67% of those with posttraumatic stress disorder (PTSD)  experience regular nightmares. These distressing dreams lead to recurrent awakenings and heightened anxiety about sleep, perpetuating sleep disturbances.

Other parasomnias, such as sleepwalking, night terrors, and REM sleep behavior disorder, can also affect this population. For individuals living with PTSD, nightmares and parasomnias severely impair sleep quality and continuity. Contributing to psychological distress, anxiety, and a worsening cycle of sleep disruption and mental health struggles.

How Do Military Duties Contribute to Sleep Problems?

Military life puts unique pressures on sleep, often leading to chronic sleep problems. Here’s how:

Operational Demands and Irregular Schedules

Shift work, overnight watches, and on-call duties disrupt normal sleep patterns. Service members also report poor sleep quality due to these irregular schedules. This ongoing disruption can disturb the body’s circadian rhythm, resulting in chronic sleep deprivation.

Combat Exposure and Mental Health

Combat-related experiences often lead to mental health issues like PTSD, anxiety, and depression. Research shows that 92% of active duty personnel with PTSD struggle with chronic insomnia and nightmares. These conditions not only make it difficult to fall asleep but also prevent deep, restorative sleep.

Constant Stress and Pressure

The high-stress environment of military life increases levels of hypervigilance. Even during non-combat periods. This heightened state can cause the body’s stress response to activate at night and may cause difficulties falling asleep. Continuous stress can increase the risk of sleep disorders.

Environmental Challenges

Deployments often place service members in uncomfortable, noisy, or cramped environments, making restful sleep difficult. Deployed personnel report sleep disturbances due to extreme temperatures, noise, and light pollution.

Physical Strain and Injuries

Intense physical activity is part of military duties. However, this can also result in musculoskeletal pain and injuries. There are 40% of military personnel suffer from chronic pain. So pain management is important for improving sleep quality.

Substance Use and Medication

Caffeine, nicotine, and alcohol are commonly used to manage stress or stay awake. However, these substances can significantly reduce sleep quality. Additionally, certain medications for pain, anxiety, or depression have side effects like insomnia, further complicating sleep health.

Limited Access to Sleep Resources

Access to sleep specialists and support is often limited, especially for those deployed. Sleep education programs may be expanding. But still, many service members still face challenges in diagnosing and treating sleep disorders effectively. 

What Does the Latest Research Say About Sleep Disorders and Associated Medical Comorbidities in Active Duty Military Personnel?

A comprehensive study examines the prevalence of sleep disorders and their links to conditions like PTSD, mild traumatic brain injury (mTBI), anxiety, depression, and pain syndromes.

A Closer Look at the Study’s Objectives and Design

The study aimed to examine the prevalence of sleep disorders among active-duty service members who were referred for sleep evaluations. It focused on how demographic factors and comorbid diagnoses might be linked to certain sleep disorders.

Researchers used a retrospective cross-sectional approach. They analyzed data from military personnel who underwent polysomnography, which is a diagnostic sleep study. This data was collected from a military medical treatment facility.

What Are the Most Prevalent Sleep Disorders in Military Personnel?

The study examined 725 active duty members, identifying several primary sleep disorders. Here’s what they found:

  • Mild Obstructive Sleep Apnea (OSA): A condition characterized by repeated episodes of partial or complete obstruction of the airway during sleep. It was the most common sleep disorder identified, affecting 27.2% of the study participants.
  • Insomnia: The second most prevalent disorder, reported in 24.7% of participants. This included trouble falling asleep, staying asleep, or waking up too early and not being able to return to sleep.
  • Moderate-to-Severe OSA: A more severe form of OSA was found in 24.0% of the sample. This condition involves frequent breathing interruptions, which significantly impact sleep quality and overall health.
  • Paradoxical Insomnia: Representing 5.1% of cases, this disorder is characterized by a discrepancy between perceived and actual sleep, where individuals feel they are sleeping much less than they truly are.
  • Behaviorally Induced Insufficient Sleep Syndrome (BIISS): Identified in 8.9% of the study group. It is essentially sleep deprivation due to lifestyle choices, such as prioritizing work, social activities, or other non-sleep activities over rest.
  • Snoring as a Control Group: Though not a sleep disorder by itself, 5.3% of participants were identified as having snoring without other significant sleep issues.

Overall, a staggering 41.8% reported short sleep duration (less than 5 hours per night), a rate much higher than in the general population.

How Do Sleep Disorders Correlate With Comorbid Conditions?

One key aspect of the study was its exploration of the comorbid conditions often seen alongside sleep disorders. 58.1% of the military personnel assessed had one or more comorbid diagnoses, suggesting that sleep disorders rarely occur in isolation. Some of the significant relationships observed were:

  • Moderate-to-Severe OSA: Linked to several factors, including age, sex, anxiety, and BMI.
    • Age: Older age was associated with an increased risk of developing moderate-to-severe OSA.
    • Sex: Males had a much higher risk (adjusted odds ratio [OR] of 19.97) of this condition compared to females.
    • Anxiety: Interestingly, there was an inverse relationship between anxiety and moderate-to-severe OSA, with a slightly protective effect.
    • BMI: A higher BMI significantly increases the risk. An adjusted OR of 1.19 indicates that even slight increases in BMI are associated with OSA.
  • Insomnia: Displayed strong associations with certain psychological and physical health conditions.
    • PTSD: Military personnel with PTSD were more than twice as likely to have insomnia (adjusted OR of 2.12).
    • Pain Syndromes: Individuals experiencing chronic pain were at an elevated risk for insomnia (adjusted OR of 1.48).
    • Sex: Females had a lower risk of insomnia compared to males (adjusted OR of 0.22).
    • BMI: A lower BMI was associated with a higher risk of insomnia, suggesting that the relationship between weight and sleep disorders is not uniform.

Deployment and Sleep Disorders: What’s the Connection?

The study revealed that a substantial 85.2% of participants had been deployed at least once. Deployment can bring about numerous physical and psychological challenges.

These may include exposure to combat, injuries, disrupted sleep patterns, and high-stress environments. Such experiences are likely linked to a rise in sleep disorders. Additionally, they contribute to comorbid conditions like PTSD, mTBI, and pain syndromes.

What Are the Implications for Sleep Health in Military Personnel?

These findings highlight the importance of a multidisciplinary approach to diagnosing and treating sleep disorders in military populations. Sleep issues often come hand-in-hand with other health concerns, both physical and psychological. Addressing only sleep problems may fall short of providing full relief. That’s why a team-based strategy is necessary. Combining the expertise of sleep specialists, mental health professionals, and primary care providers can lead to more comprehensive care.

Additionally, the high prevalence of short sleep duration in this population is a critical concern. Chronic sleep deprivation can worsen health issues, impair daily functioning, and reduce overall quality of life. Military health programs should prioritize sleep education and interventions to prevent and manage these disorders.

The Need for Further Research

We still need more research to truly understand the sleep health challenges military personnel face. Looking into the long-term effects of sleep disorders on both physical and mental health is so important. And finding out which treatments are most effective could make a real difference in the well-being of those who serve.

How Does The Insomnia and Sleep Institute of Arizona Support Military Personnel with Sleep Disorders?

The Insomnia and Sleep Institute of Arizona knows that military life comes with unique sleep challenges. The constant deployments, unpredictable hours, and pressures of service can make restful sleep feel like a distant goal. That’s why we’re here. We help military members get back to the quality sleep they need.

Our team of sleep specialists understands these challenges deeply, and we’re ready to provide personalized, hands-on care. We treat a range of sleep disorders like obstructive sleep apnea (OSA) and insomnia, using advanced diagnostic tools like sleep studies to find the best approach for each person. It doesn’t matter if it is CPAP therapy or implants to help you breathe easier through the night or Cognitive Behavioral Therapy for Insomnia (CBT-I) to calm your mind. Our solutions are designed to fit your life and your needs.

We focus on making our care flexible and practical. Because we know how tough military life can be, we ensure that our treatments are easy to integrate into your routine. With better sleep, we aim to support your overall health and well-being, helping you feel more rested, alert, and ready for whatever comes next. Contact us.

References

 

Mysliwiec, V., McGraw, L., Pierce, R., Smith, P., Trapp, B., & Roth, B. J. (2013). Sleep Disorders and Associated Medical Comorbidities in Active Duty Military Personnel. Sleep, 36(2), 167–174. https://doi.org/10.5665/sleep.2364

‌Sherry, T. B., Roth, C. P., Mallika Bhandarkar, & Hepner, K. A. (2021, July). Chronic Pain Among Service Members: Using Administrative Data to Strengthen Research and Quality Improvement. Rand.org; RAND Corporation. https://www.rand.org/pubs/research_reports/RRA1160-1.html

‌VA.gov | Veterans Affairs. (2016). Va.gov. https://www.ptsd.va.gov/professional/treat/cooccurring/sleep_problems_vets.asp

‌Good, C. H., Brager, A. J., Capaldi, V. F., & Mysliwiec, V. (2019). Sleep in the United States Military. Neuropsychopharmacology, 45(1), 176–191. https://doi.org/10.1038/s41386-019-0431-7

‌Sleep and Performance. (2019). Army University Press. https://www.armyupress.army.mil/Journals/Military-Review/English-Edition-Archives/November-December-2023/Sleep-Performance/

Mysliwiec, V., Gill, J., Lee, H., Baxter, T., Pierce, R., Barr, T. L., Krakow, B., & Roth, B. J. (2013). Sleep Disorders in US Military Personnel. CHEST Journal, 144(2), 549–557. https://doi.org/10.1378/chest.13-0088

Prevalence, risk correlates, and health comorbidities of insomnia in US military veterans: results from the 2019–2020 National Health and Resilience in Veterans Study | Journal of Clinical Sleep Medicine. (2019). Journal of Clinical Sleep Medicine. https://jcsm.aasm.org/doi/full/10.5664/jcsm.9182

Weber, F. C., & Wetter, T. C. (2021). The Many Faces of Sleep Disorders in Post-Traumatic Stress Disorder: An Update on Clinical Features and Treatment. Neuropsychobiology, 81(2), 85–97. https://doi.org/10.1159/000517329

Disclaimer: The information in this article, including study findings, is not intended to diagnose, treat, or provide specific medical advice. For medical advice and treatment, please contact a healthcare provider.