Study: Sleep disorders normal for post-combat troops

TOKYO — Sleeping disorders reported by troops returning from the war zone may be a normal result of time in combat rather than a symptom of post-traumatic stress disorder or traumatic brain injury, according to a study to be published this summer in the peer-reviewed journal Military Medicine.

“Sleep Disruption Among Returning Combat Veterans from Iraq and Afghanistan,” presented during last month’s American Psychiatric Association annual meeting, examines the sleep patterns of 69 servicemembers who returned from Iraq and Afghanistan between 2006 and 2008.

“What we found was that sleep problems are ubiquitous to combat,” Army Capt. Vincent Capaldi, the study’s lead author and a resident physician in psychiatry and internal medicine at Walter Reed Army Medical Center, told Stars and Stripes last month. “There is a higher incidence of people complaining about sleep problems after they return from combat, but there doesn’t appear to be a connection between PTSD and TBI and obstructive sleep apnea in combat veterans.”

The Army declined to provide a copy of the study prior to publication.

However, Capaldi said research data was collected at Walter Reed during an overnight sleep study that checked multiple parameters, such as brain function, eye movement and heart rhythm, as well as by surveying test subjects’ medical records to screen for PTSD and TBI.

The study did not look at the impact of repeated deployments or the amount of time a soldier spent in combat, he said.

According to an Army news release, 8 percent of soldiers in Afghanistan were taking mental health-related medications to treat sleep problems in 2008, while soldiers in Iraq averaged 5.6 hours of sleep per night, significantly less than the 6.4 hours individuals indicated they required to feel rested.

Previous studies have shown that troops returning from war are likely to sleep poorly in the months after they come home.


Sgt. Mike Ennis, 31, of Stafford, Va., who returned to his family in Germany last month after a year serving with the 2nd Stryker Cavalry Regiment in Afghanistan, said he expected trouble sleeping when he got home.

“The first couple of days back I was up every couple of hours,” Ennis told Stars and Stripes. “It’s a lot quieter here than sleeping with a bunch of guys (in Afghanistan).”

Anecdotal reports suggest people tend to get acclimated to the sounds in their usual environment, Capaldi said.

Five days after he got home, Ennis said he was sleeping four or five hours each night compared to six to seven hours a night before he deployed.

Lt. Col. Vincent Mysliwiec, chief of sleep medicine at Madigan Army Medical Center, said in emailed comments that previous research has already shown many deployed servicemembers suffer from insomnia.

“Soldiers in a combat environment have increased stress and have to be hyper-vigilant, both of which, along with the inherent noise and environmental disturbances result in poor sleep quality and frequent awakenings while deployed,” he said.

It is unclear how long it takes for soldiers to return to a normal sleep pattern upon returning from deployment, he said.

The latest sleep study shows the importance of regular, good sleep practices in soldiers upon redeployment and providing evaluations for those whose sleep difficulties persist, whether they have PTSD, TBI or solely sleep complaints, he said.

“A key takeaway (from the study) is that routine screening for sleep problems may be beneficial for all combat veterans, since many who suffer from sleep disturbance post-deployment are otherwise healthy,” Capaldi said.



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