People in the military take pride in the old slogan, "We do more before 9 AM than most people do all day," but UT Health San Antonio Director of Sleep Medicine Vincent Mysliwiec, MD, FAASM, stresses that sleep is important, too.
"During the day we're always active. We're thinking, we're learning new things, we're physically challenged," he explained. "During the period when we're sleeping, that's where our mind consolidates our memories into new knowledge, and retaining that knowledge, as well as providing the hormones that restore our body and then provide the ability for our body to function well the next day."
Good physical function is a priority in the military, but servicemembers often sleep fewer than six hours a night. Mysliwiec, who is also a retired colonel in the U.S. Medical Corps, said that's the nature of the military.
"They do shift work. They have a stressful profession. Their profession is rigorous," Mysliwiec said. "They have 24-hour duty at times which then they may have to work the next day as well."
That's a concern, because short sleep duration has been linked to an increased risk of a variety of health challenges, inlcuding Alzhiemer's disease and other dementias.
Disordered sleep has spiked in the military since 2005, according to Mysliwiec's research. He found a 45-fold increase in insomnia diagnoses among U.S. service members between 2005 to 2019. There was a 30-fold increase in obstructive sleep apnea diagnoses.
The most common sleep disorder in the military, however, is COMISA; comorbid insomnia and sleep apnea. That's true of both men and women.
"When you looked at the male and female service members, there was no significant difference," Mysliwiec said. "Somewhat unexpected finding there."
Military personel with COMISA also had the highest rates of PTSD, anxiety, depression, and nightmares. Mysliwiec said sleep diroders in the military can be complex, so clinicians should be thorough when a patient reports insomnia or chronic fatigue.
"You can't just look at for sleep apnea, you can't just look for insomnia. You also have to consider nightmares or disruptive nocturnal behaviors," he said. "It really needs a comprehensive evaluation."
Proper diagnosis and treatment is not only important for military readiness, but also for a service members short and longterm health and overall quality of life.
Science & Medicine is a collaboration between TPR and The University of Texas Health Science Center at San Antonio, about how scientific discovery in San Antonio advances the way medicine is practiced everywhere.
