Physical sleeping environment is related to insomnia risk and measures of readiness in US army special operations soldiers

Janna Mantua; B M Ritland; J A Naylor; G Simonelli; C A Mickelson; J J Choynowski; A F Bessey; W J Sowden; T M Burke; A B McKeon

doi:10.1136/bmjmilitary-2021-001801

Physical sleeping environment is related to insomnia risk and measures of readiness in US army special operations soldiers

BMJ Mil Health. 2023 Aug;169(4):316-320. doi: 10.1136/bmjmilitary-2021-001801. Epub 2021 Jul 22.

Authors

Janna Mantua¹, B M Ritland², J A Naylor³, G Simonelli^{4

5}, C A Mickelson⁶, J J Choynowski⁶, A F Bessey^{4

7}, W J Sowden⁸, T M Burke⁶, A B McKeon⁶

Affiliations

¹ Operational Research Team, Walter Reed Army Institute of Research, Silver Spring, Maryland, USA Janna.r.mantua.civ@mail.mil.
² Human Performance Division, United States Army Research Institute of Environmental Medicine, Natick, Massachusetts, USA.
³ 75th Ranger Regiment, Ft. Benning, Georgia, USA.
⁴ Department of Psychology, Walter Reed Army Institute of Research, Silver Spring, Maryland, USA.
⁵ Department of Psychology, Hôpital du Sacré-Coeur de Montréal, Montreal, Quebec, Canada.
⁶ Operational Research Team, Walter Reed Army Institute of Research, Silver Spring, Maryland, USA.
⁷ Department of Psychology, Clemson University, Clemson, South Carolina, USA.
⁸ Department of Behavioral Health, Tripler Army Medical Center, Tripler Army Medical Center, Hawaii, USA.

PMID: 34301851
DOI: 10.1136/bmjmilitary-2021-001801

Abstract

Background: US military service members have characteristically poor sleep, even when 'in garrison' or at one's home base. The physical sleeping environment, which is often poor in military-provided housing or barracks, may contribute to poor sleep quality in soldiers. The current study aimed to assess whether the sleeping environment in garrison is related to sleep quality, insomnia risk and military readiness.

Methods: Seventy-four US army special operations soldiers participated in a cross-sectional study. Soldiers were queried on their sleeping surface comfort and the frequency of being awakened at night by excess light, abnormal temperatures and noise. Subjective sleep quality and insomnia symptoms were also queried, via the Pittsburgh Sleep Quality Index and Insomnia Severity Index, respectively. Lastly, measures of soldier readiness, including morale, motivation, fatigue, mood and bodily pain, were assessed.

Results: Soldiers reporting temperature-related and light-related awakenings had poorer sleep quality higher fatigue and higher bodily pain than soldiers without those disturbances. Lower ratings of sleeping surface comfort were associated with poorer sleep quality and lower motivation, lower morale, higher fatigue and higher bodily pain. Each 1-point increase in sleeping surface comfort decreased the risk for a positive insomnia screen by 38.3%, and the presence of temperature-related awakenings increased risk for a positive insomnia screen by 78.4%. Those living on base had a poorer sleeping environment than those living off base.

Conclusion: Optimising the sleep environment-particularly in on-base, military-provided housing-may improve soldier sleep quality, and readiness metrics. Providers treating insomnia in soldiers should rule out environment-related sleep disturbances prior to beginning more resource-intensive treatment.

Keywords: depression & mood disorders; pain management; sleep medicine.

MeSH terms

Cross-Sectional Studies
Fatigue
Humans
Military Personnel*
Pain
Sleep
Sleep Initiation and Maintenance Disorders* / epidemiology
Sleep Initiation and Maintenance Disorders* / etiology