Publication year
2017
Citation Title
Trends and factors associated with insomnia and sleep apnea in all United States military service members from 2005 to 2014.
Journal Name
Journal of Sleep Research
Journal Volume
26
Issue Number
5
Page Numbers
665-670
Summary
The number of insomnia and obstructive sleep apnea cases is increasing in the U.S. civilian population, and is increasing at an even faster rate among military personnel. Researchers investigated trends and demographics among military personnel from 2005 and 2014 who had medical codes for insomnia or obstructive sleep apnea in their medical charts. Findings showed increased prevalence of insomnia and obstructive sleep apnea among Army personnel, senior enlisted personnel, and officers.
Key Findings
The number of insomnia encounters increased by 372% and the number of obstructive sleep apnea encounters increased by 517% among enlisted military personnel between 2005 and 2014.
The Army had the highest number of insomnia and obstructive sleep apnea encounters compared to other military branches.
Senior enlisted personnel and officers and Black Service members had the highest rates of insomnia and obstructive sleep apnea compared to other military positions.
Implications for Program Leaders
Provide education to Service members on the importance of sleep and how to cope with sleep disorders
Engage Service members who suffer from sleep disorders in a support group to help learn strategies to cope and deal with the stress caused by sleep disorders
Tailor efforts to senior enlisted personnel and officers to reduce risks of sleep disorders
Implications for Policy Makers
Encourage the training of medical professionals to better identify insomnia and obstructive sleep apnea among Service members
Recommend education for medical service providers about the secondary effects of sleeping disorders
Continue to support programs that address the challenges of Service members who have sleep disorders
Methods
Collected data from the Defense Medical Epidemiological Database (DMED), which contains information on all in- and out-patient medical occurrences for all Active duty military personnel.
Researchers documented the number of times medical codes for insomnia and obstructive sleep apnea were present in the database.
Population data were graphed for each year according to the number of encounters for insomnia and obstructive sleep apnea.
Participants
All Active duty personnel who had in- and out-patient medical encounters between 2005 and 2014 were included in the sample.
During the 10 year study period, the military population ranged from 1,338,965 to 1,417,434 military personnel.
Service members represented the following branches: Army, Navy, Air Force and Marine Corps.
Limitations
The database prevented researchers from being able to investigate predictive factors which could lead to sleep disorders.
Researchers could not account for increasing emphasis on diagnosis and treatment of sleep disorders among Service members, which could have confounded the findings.
Researchers did not provide information about data quality including reports of the amount of missing data, which could have impacted the results.
Avenues for Future Research
Utilize a more comprehensive database that allows for investigation of predictive factors of sleep disorders, such as deployment history, combat exposure, or PTSD
Investigate the impact of an increase in emphasis of diagnosis and treatment for sleep disorders among health care providers for Service members
Include information about data quality that includes rates of missing data
Focus
Multiple Branches
Target Population
Population Focus
Military Component
Abstract
Sleep disorders are a critical issue for the military, as they impactoperational readiness, personnel health, wellbeing and health-carecosts. The incidence of insomnia and obstructive sleep apnea (OSA)are increasing in the United States civilian population, and rates inmilitary personnel exceed those of civilians. Using a comprehensivedatabase, rates of medical encounters for insomnia and OSA wereinvestigated and their associations with various demographic factorsexamined in the total US military population [1,381,40625,123,meanstandard deviation (SD) personnel per year] from 2005 to2014. Encounters for insomnia increased from 16 of 1000 in 2005 to 75of 1000 in 2014 (372%). Encounters for OSA increased from 44 of 1000in 2005 to 273 of 1000 in 2014 (517%). Those experiencing the greatestincreases in insomnia included women, individuals≥40 years of age,blacks, senior enlisted personnel and Army personnel compared to othermilitary services. Those experiencing the greatest rates of OSA includedmen, individuals≥40 years of age, blacks, senior officers and Armypersonnel. Rates of insomnia and OSA increased linearly over time(R2=0.95–0.99;P<0.01) for every subpopulation except those aged<20 years. In response to this epidemic-like increase in sleep disorders,their prevention, identification and aggressive treatment should becomea health-care priority of the US military.
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