A little known pundit named Griff Niblack once quipped, "Sleep is the chain that ties health and our bodies together."
Sleep disturbances are common to stress and are linked to an array of physical and mental health problems.
Given the operations tempo placed on U.S. military forces since 2001, there is growing concern about the prevalence and consequence of sleep problems.
Many servicemembers have difficulty with sleep, which can result in problems with resiliency and readiness.
This is a concept the Army is waking up to as it affects force readiness.
The Office of the Army Surgeon General released its inaugural Health of the Force (HOF) report Dec. 10. It provides an eye opener to the health of active-duty soldiers on 30 bases nationwide. The full report can be found at www.armytimes.com/healthreport.
The report will be used as a baseline to track the health of the Army, wrote Lt. Gen. Patricia Horoho, the newly retired Army surgeon general and former commander of Madigan Army Medical Center, in the HOF's forward.
The report used three key metrics, called the Performance Triad, to evaluate the personal readiness of individual soldiers to perform their duties. This triangular approach to readiness improvement consists of sleep, physical activity and nutrition - factors that increase or decrease the risk of injury, obesity, fatigue and other challenges.
The report is not flattering: No installation met the recommended 85 out of 100 score on the three performance triad metrics.
"We must ensure the Army remains ready as the world's premier combat force," wrote Gen. Mark Milley, Army Chief of Staff. "Readiness for ground combat is - and will remain - the U.S. Army's number one priority."
Readiness rests on soldiers resting well.
The weakest link in the trilogy of fitness was found in the sleep category, which averaged 69 out of 100 points. Joint Base Lewis-McChord soldiers scored a 65.7.
"Last year, we saw five percent of the JBLM population," explained Dr. (Lt. Col.) Herbert Kwon, director of the Madigan sleep lab.
According to the HOF report, 10.6 percent of servicemembers at JBLM experience sleep disorders.
He also said that while the study of sleep is not new, it has taken on a more defined role during the last five years.
"There are five categories to the study, but the major one is the behavioral aspect," he said. "The majority of sleep problems both in the general population and the Army are found there."
The Army's HOF report confirms this: Thirty-three of 100 soldiers get five hours or less of sleep per night; almost 62 percent get less than seven hours of nightly rest; and almost 50 percent have clinically significant sleep problems.
Along with these findings, the report stated that 33 percent reported fatigue three to four days a week, while 17 percent reported sleep-related problems that impaired their daily military functions.
These numbers keep some folks up at night.
An exhaustive study conducted by the RAND Corporation confirms many of the Army's findings. The report can be found at www.rand.org.
This study underscores that sleep problems - whatever their cause - can lead to increased risks of depression, post-traumatic stress disorder, and poor physical health outcomes such as an increased peril for obesity, diabetes and cardiovascular disease.
Kwon acknowledged that sleep disorders can be facilitated by obesity, and that obesity can lead to poor sleep habits.
According to the HOF report, 10.6 percent of servicemembers at JBLM experience sleep disorders, and 13.1 percent rank as obese.
"There may be a positive correlation between obesity and sleep deprivation," he said.
The report also emphasizes that getting optimal sleep starts with learning and practicing good sleep habits.
The most commonly reported barriers to sleep included an inability to sleep (31 percent), job responsibilities (31 percent), home and family responsibilities (30 percent), and a need to unwind before going to sleep (25 percent).
"There is a patient population being created here unless there are changes," continued Kwon.
Much of the battle against fatigue-driven sleep disorders begins with CBTI, or Cognitive Behavioral Therapy for Insomnia.
"It's the first line of treatment, since most of the sleep problems we've encountered rest on behaviors," explained Dr. Marquisha Lee, one of two board-certified behavioral health consultants at Madigan. "Sleep is a natural process, and behaviors can have an impact on it; changing those behaviors becomes vital."
Both Kwon and Lee emphasized that sleep must be a priority.
"What you put into sleep, you get out of it," concluded Kwon.
Now that the Army is awake to this problem, it needs to get more sleep to improve force readiness.
Credits: U.S. News & World Report, www.army.mil, and www.armytimes.com.
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