Sleep and high-risk behavior in military service members: a mega-analysis of four diverse U.S. Army units
Abstract
Experimental sleep restriction and deprivation lead to risky decision-making. Further, in naturalistic settings, short sleep duration and poor sleep quality have been linked to real-world high-risk behaviors (HRB), such as reckless driving or substance use. Military populations, in general, tend to sleep less and have poorer sleep quality than nonmilitary populations due to a number of occupational, cultural, and psychosocial factors (e.g. continuous operations, stress, and trauma). Consequently, it is possible that insufficient sleep in this population is linked to HRB. To investigate this question, we combined data from four diverse United States Army samples and conducted a mega-analysis by aggregating raw, individual-level data (n = 2,296, age 24.7 ± 5.3). A negative binomial regression and a logistic regression were used to determine whether subjective sleep quality (Pittsburgh Sleep Quality Index [PSQI], Insomnia Severity Index [ISI], and duration [h]) predicted instances of military-specific HRB and the commission of any HRB (yes/no), respectively. Poor sleep quality slightly elevated the risk for committing HRBs (PSQI Exp(B): 1.12 and ISI Exp(B): 1.07), and longer duration reduced the risk for HRBs to a greater extent (Exp(B): 0.78), even when controlling for a number of relevant demographic factors. Longer sleep duration also predicted a decreased risk for commission of any HRB behaviors (Exp(B): 0.71). These findings demonstrate that sleep quality and duration (the latter factor, in particular) could be targets for reducing excessive HRB in military populations. These findings could therefore lead to unit-wide or military-wide policy changes regarding sleep and HRB.
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Sufficient and restorative sleep may decrease poor or risky decision making in the context of military duty.
“Mantua et al. (70) investigated the associations between sleep patterns and high-risk behavior among 2,296 deployed military personnel (mean age 24.7 years) and concluded that sufficient and restorative sleep may decrease poor or risky decision making in the context of military duty.”
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- Authors
- Mantua, J., Bessey, A. F., Mickelson, C. A., Choynowski, J. J., Noble, J. J., Burke, T. M., McKeon, A. B., & Sowden, W. J.
- Affiliations
- Walter Reed Army Institute of Research (US)
- Clemson University (US)
- 75th Ranger Regiment Headquarters, Ft. Benning, GA
- Tripler Army Medical Center (US)
- Corresponding author
- Mantua, Janna
- Venue
- SLEEP
- Publisher
- Oxford University Press (OUP)
- Published
- 2020-10-30
- Volume
- 44
- Issue
- 4
- ISSN
- 0161-8105 (ISSN-L)
- 1550-9109
- OpenAlex
- W3097833516
- Cited by
- 33
- References
- 46
- Citations by year
- 2026: 4 · 2025: 5 · 2024: 3 · 2023: 7 · 2022: 9 · 2021: 5
- FWCI
- 5.07
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- SLEEP (publishedVersion, public-domain)
- PubMed (publishedVersion)
- Funders
- Department of Defense Military Operational Medicine Research Program
- Topics
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and Work-Related Fatigue
- Life Sciences › Neuroscience › Cognitive Neuroscience › Sleep and Wakefulness Research
- Keywords
- sleep quality, sleep duration, high-risk behaviors, military personnel, United States Army, risky decision making, sleep deprivation, insomnia, Pittsburgh Sleep Quality Index, Insomnia Severity Index, sleep policy
- MeSH terms
- Adult, Humans, Sleep Initiation and Maintenance Disorders, Military Personnel, Risk-Taking, Sleep, Sleep Deprivation, United States, Young Adult
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