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Sleep Disorders in US Military Personnel
Open accessAbstract
Background Sleep disturbances are among the most common symptoms of military personnel who return from deployment. The objective of our study was to determine the presence of sleep disorders in US military personnel referred for evaluation of sleep disturbances after deployment and examine associations between sleep disorders and service-related diagnoses of depression, mild traumatic brain injury, pain, and posttraumatic stress disorder (PTSD).Methods This was a cross-sectional study of military personnel with sleep disturbances who returned from combat within 18 months of deployment. Sleep disorders were assessed by clinical evaluation and polysomnogram with validated instruments to diagnose service-related illnesses.Results Of 110 military personnel included in our analysis, 97.3% were men (mean age, 33.6 ± 8.0 years; mean BMI, 30.0 ± 4.3 kg/m2), and 70.9% returned from combat within 12 months. Nearly one-half (47.3%) met diagnostic criteria for two or more service-related diagnoses. Sleep disorders were diagnosed in 88.2% of subjects; 11.8% had a normal sleep evaluation and served as control subjects. Overall, 62.7% met diagnostic criteria for obstructive sleep apnea (OSA) and 63.6% for insomnia. The exclusive diagnoses of insomnia and OSA were present in 25.5% and 24.5% of subjects, respectively; 38.2% had comorbid insomnia and OSA. Military personnel with comorbid insomnia and OSA were significantly more likely to meet criteria for depression (P < .01) and PTSD (P < .01) compared with control subjects and those with OSA only.Conclusions Comorbid insomnia and OSA is a frequent diagnosis in military personnel referred for evaluation of sleep disturbances after deployment. This diagnosis, which is difficult to treat, may explain the refractory nature of many service-related diagnoses.
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“The available literature addressing the prevalence of insomnia in patients with OSA (Table VII.I.1)588,943–956 suffers from several significant shortcomings.”
From International Consensus Statement on Obstructive Sleep Apnea (2023) · cites this paper as [949]
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“The reported rates of an insomnia disorder diagnosis in patients with OSA ranged from 6.4% to 74%.”
From International Consensus Statement on Obstructive Sleep Apnea (2023) · cites this paper as [949]
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“Notably, the majority of studies found rates that were clustered in the range of 29%–50%.”
From International Consensus Statement on Obstructive Sleep Apnea (2023) · cites this paper as [949]
Experimental — accuracy not yet measuredThe check wasn’t confident either way, so it gives no verdict — never disputed.
In the citing paper
“For insomnia symptoms, the prevalence varied from 7% to 68% with most estimates being in the range of 36%–58%.”
From International Consensus Statement on Obstructive Sleep Apnea (2023) · cites this paper as [949]
Experimental — accuracy not yet measuredThe check wasn’t confident either way, so it gives no verdict — never disputed.
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“Notably, the studies with the lowest prevalence rates tended to be the general population studies.”
From International Consensus Statement on Obstructive Sleep Apnea (2023) · cites this paper as [949]
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Metadata
- Authors
- Mysliwiec, V., Gill, J., Lee, H., Baxter, T., Pierce, R., Barr, T. L., Krakow, B., & Roth, B. J.
- Affiliations
- Madigan Army Medical Center (US)
- National Institutes of Health (US)
- West Virginia University (US)
- Sleep and Human Health Institute (US)
- Corresponding author
- Mysliwiec, Vincent
- Venue
- Chest
- Publisher
- Elsevier BV
- Published
- 2013-08
- Volume
- 144
- Issue
- 2
- Pages
- 549-557
- ISSN
- 0012-3692 (ISSN-L)
- PMC
- PMC4694100
- OpenAlex
- W2154732472
- Semantic Scholar
- d8142b73fe6df032fd8df8f7725fa830ee9efb62
- Cited by
- 184
- References
- 61
- Citations by year
- 2026: 9 · 2025: 13 · 2024: 6 · 2023: 16 · 2022: 12 · 2021: 20 · 2020: 16 · 2019: 17 · 2018: 20 · 2017: 14 · 2016: 10 · 2015: 15 · 2014: 12 · 2013: 3
- FWCI
- 18.06
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- CHEST Journal (acceptedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Center for Neuroscience and Regenerative Medicine (Grant 60855)
- Topics
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
- Health Sciences › Medicine › Physiology (medical) › Obstructive Sleep Apnea Research
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and Work-Related Fatigue
- Keywords
- sleep disorders, military personnel, combat deployment, obstructive sleep apnea, insomnia, comorbidities, depression, post-traumatic stress disorder, mild traumatic brain injury, chronic pain, polysomnography
- MeSH terms
- Adult, Brain Injuries, Cross-Sectional Studies, Depression, Female, Humans, Sleep Initiation and Maintenance Disorders, Male, Pain Measurement, Stress Disorders, Post-Traumatic, United States, Polysomnography, Sleep Apnea, Obstructive
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