Sleep for Optimal Health and Readiness

Sleep is critical to functioning across multiple dimensions.[ Reference 1 ] When one is well rested, it is easier to pay attention, remember details, make sound decisions, maintain a positive mood, conduct oneself appropriately, and get along well with others.[ Reference 2 ]

Domains of health and readiness affected by sleep include:

    • Physical health
    • Operational readiness
    • Productivity
    • Cognitive performance
    • Workplace safety
    • Driving
    • Mood
    • Stress
    • Interpersonal relationships

Most service members report getting less than the recommended seven hours of sleep per night.[ Reference 3 ] Sleep disorders, such as insomnia (difficulty falling and/or staying asleep) and sleep apnea (periodic suspension of breathing during sleep) are prevalent in this population. [ Reference 4 ] Inadequate sleep can adversely affect operationally relevant capabilities and increase the risk for accidents.[ Reference 5 ]

Chronic restriction of sleep to six or fewer hours per night is associated with levels of daytime cognitive dysfunction (e.g., reduced vigilant attention and slowed working memory) that are comparable to impairment observed after several nights of total sleep
deprivation.[ Reference 6 ]

The biological need to sleep can overwhelm a chronically sleep-deprived individual’s efforts to maintain wakefulness and result in micro sleeps, which are episodes of up to 30 seconds of sleep that can occur even when one engaged in activities, including driving.[ Reference 1 ] Research suggests that driving while drowsy is as dangerous as driving while intoxicated.[ Reference 1 ] In addition, chronically inadequate sleep is associated with physiological changes that can lead to obesity, hypertension, diabetes, and other medical conditions.[ Reference 7 ]

Ways to Promote Healthy Sleep  

Sleep is closely related to stress, including combat and operational stress. Getting too little sleep can be a source of stress, and feeling stressed can interfere with sleep. Mental health providers can promote healthy sleep among service members by helping them address feelings, beliefs, and behaviors that can interfere with sleep.[ Reference 8 ], [ Reference 9 ] ,[ Reference 10 ]

  • Manage symptoms that can interfere with sleep (e.g., stress, anxiety, or pain)

    • Utilize mindfulness and relaxation techniques.
    • Create a pre-bedtime wind-down/relaxation routine and reduce caffeine intake.
    • Limit the use of pain relievers that contain caffeine and discuss alternatives to prescribed medications with adverse effects on sleep.
  • Challenge sleep-limiting beliefs

    • Time for sleep is not a "luxury;" it is biological necessity.
    • Sleep deprivation is not a "badge of honor;" it is a potential hazard.
    • Prioritizing sleep is not "selfish;" it is okay to put self-care above other activities.
  • Encourage healthy, sleep-promoting behaviors

    • Put away blue light-emitting devices (e.g., laptops, smartphones) before bedtime; blue light suppresses the release of the sleep-facilitating hormone melatonin.
    • Maintain a consistent sleep-wake schedule, including on weekends and holidays; this helps regulate the body's internal clock.
    • Avoid stress-based eating to keep a healthy body weight; overweight/obesity increases the risk for sleep apnea.

Service members often have little control over their sleep schedules and environments during deployments and training exercises, which can make it difficult to maintain good sleep habits.  Using sleep masks and earplugs may be useful in some environments.[ Reference 11 ]  “Sleep banking” before periods of sleep restriction and strategic naps may also help service members maintain alertness and performance when operational demands limit opportunities for sleep.[ Reference 12 ]  Military leaders can support healthy sleep among service members by facilitating sleep-promoting behaviors (e.g., keeping consistent sleep schedules). 

Resources

The following resources can support service members, leaders, and providers in addressing sleep issues.