Long Term Sleep Concerns of Military Personnel and Veterans

Sleep problems affect many people, but are considerably more common among military veterans. While different studies attempt to curb these issues and determine their root causes, some likely causes of sleep disorders in veterans are linked to:

• High stress during training
• High stress during deployment
• Intensive schedules during training and deployment
• Injuries sustained during training and deployment
• Returning to civilian life after acclimating to military life;
• Post-traumatic stress disorder (PTSD) and other psychological ailments following training and/or deployment
• Symptoms of other injuries sustained during training and deployment

Common Sleep Issues Among Veterans and Military Personnel

Veterans experience a wide variety of sleeping problems/disorders, but most commonly they are afflicted with Insomnia, Nightmares, and Sleep Apnea.

Insomnia

A higher percentage of veterans suffer from insomnia than do the civilian population. In fact, studies show that 57.2% of military veterans suffer from insomnia, compared to only about 30% of the general adult population.

According to the National Library of Medicine (NIH), “Chronic Insomnia Disorder is a common behavioral sleep disorder clinically defined as dissatisfaction with sleep quantity or quality marked by complaints of difficulty falling or staying asleep, waking up earlier than desired, or sleep that is non-restorative and the cause of significant daytime impairment.” Notably, Insomnia is not related to other medical problems and exists even where the individual has an adequate opportunity and environment to sleep. The NIH also explains that for veterans, Insomnia can be a function of stress response. Insomnia and poor sleep can be a function of “inadequate coping and/or poor regulation of stress across physiological, cognitive, and/or emotional processes. The National Veteran Sleep Disorder study found that insomnia diagnoses increased 19-fold from 2000 to 2010, showing a surge in sleep disorders among veterans during the early 2000s.

Nightmares

Chronic nightmares are prevalent among military veterans, especially those who suffer from PTSD. According to the National Center For PTSD, sleep problems such as insomnia and nightmares are arguably “hallmarks” of PTSD, rather than just being symptoms. Significant nightmares were reported by 52% of combat veterans with PTSD; and 71% of civilians with PTSD reported chronic nightmares. Compared to civilians with PTSD, “the nightmares of veterans were more likely to be a replay of their trauma(s).” Nightmares are difficult to treat. There are few options in terms of pharmacotherapy, but the former recommended drug (prazosin) is no longer recommended for trauma-related nightmares due to insufficient evidence over multiple studies. There is a psychotherapeutic approach to treating nightmares called Imagery Rehearsal Therapy (IRT), also referred to as “nightmare re-scripting.”

Sleep Apnea

Even further, more than half (52.1%) of military veterans screened positive for sleep apnea in a similar study. Notably, this number was derived from veterans who did not report self-diagnosed sleep apnea prior to the study. When reviewing the medical records of these veterans, only 20.5% of them had been formally diagnosed with sleep apnea.

Not only are sleep disorders like sleep apnea more prevalent among veterans and military personnel, but evidence suggests that the prevalence of these disorders increased significantly in the early 2000s. The National Veteran Sleep Disorder study found that sleep disorders increased 6-fold from years 2000 to 2010 in veterans. Like the other disorders mentioned above, sleep apnea is a chronic sleep disorder that can be onset and/or bolstered by PTSD and/or traumatic brain injuries.

Managing Sleep Disorders

Managing sleep disorders in daily life can pose distinct and significant problems. The primary side effect of these disorders in daily living is sleepiness. Studies on the impacts of chronic sleepiness show that:

• Sleepiness from sleep deprivation leads to lower levels of alertness and concentration
• Sleepiness causes more difficulty with focus and paying attention
• Sleepiness can make you more easily confused due to lack of focus/attention
• Sleepiness hampers the ability to perform tasks requiring logical reasoning or complex thought
• Sleepiness impairs judgment; it can be difficult to make the correct decisions and choose the right behavioral responses
• Sleepiness impairs memory because nerve connections that create memories are strengthened during sleep
• Sleepiness makes learning difficult because it leads to lack of focus and the inability to form solid short-term memories
• Sleepiness causes slowed reaction times

All of these effects can make it difficult for military servicemembers and veterans to perform jobs. This is especially true for military personnel or veterans who regularly operate heavy machinery or vessels like ships. Jobs that employ high levels of military veterans are often affected by sleepiness, and include:

• Maritime or sea-faring workers. This type of job requires high alertness and specialized skill, which is why protections are provided for these maritime workers through The Jones Act. Further, these types of workers are at risk of fatigue because they work long hours. Sleep can be interrupted by emergency situations, and sleep can be difficult when bunking on a ship or vessel at odd hours.
• Truck Drivers. Truck drivers are at especially high risk of fatigue. Research shows that driving while drowsy can be as dangerous as driving drunk. Truck drivers are also shift workers who work long or irregular hours.
• Oilfield Workers. Oilfield workers, like the other two professions listed above, work long and irregular shift hours. They are also meant to be working dangerous machinery and should have high levels of focus.

What Are The Best Ways to Manage Sleep Disorders?

Veterans can take several steps to manage and/or correct disordered sleeping before it begins affecting their safety or job performance. The best steps offered by specialists include:

1. Prioritizing a Consistent Sleep Schedule. Again, this can be difficult for veterans who make careers in civilian life in certain professions, like those listed above. Studies from Harvard University recommend that people with insomnia should get up at the same time every day, no matter how little they have slept. Also, they should avoid daytime napping. Lastly, they should maintain the same bedtime every night for a week, then move it outward to get 15 minutes longer each week until they achieve refreshing, satisfying sleep.
2. Avoid Excessive Drinking. Drinking has been shown to prohibit deep sleep. While some people believe it may help them fall asleep, the sleep they are achieving is far lower quality than without alcohol.
3. Exercise Regularly During the Day. Studies from Johns Hopkins University show that 30 minutes of moderate aerobic exercise may help significantly with sleep quality at night.
4. Address the Underlying Cause. Sleeping disorders are often caused or exacerbated by underlying issues such as traumatic brain and spinal injuries, and may worsen when left untreated.

Injured veterans with sleep issues can obtain proper compensation and treatment if they are injured on the job. Working with an experienced attorney at Morrow & Sheppard LLP will help any injured veterans get the attention and compensation they need. It is crucially important to hold the responsible parties accountable when injuries occur. Our firm is here to serve you. Contact us for a free consultation.