Insomnia among military personnel returning from recent operations is incredibly prevalent: more than half of combat veterans engaged in campaigns since September 2001 return home to combat sleeplessness every night. Insomnia alone is bad enough, but for veterans it can also be a risk factor for post-traumatic stress disorder (PTSD) and other psychiatric disorders. That is why Dr. Adam Branoweth of the Department of Veterans Affairs Pittsburg Healthcare System and Dr. Anne Germain of University of Pittsburg School of Medicine undertook a review of scientific literature to evaluate the risks and to discuss cognitive-behavioral treatment options available to veterans.

Although some who deploy on military operations already have trouble with insomnia, it is common for insomnia to develop during the service period or even post-deployment. As many as 54 percent of military personnel have insomnia compared with only 22 percent of civilian adults. Factors like combat exposure, mild traumatic brain injury, irregular sleeping schedules, and the adjustment of returning home can contribute to triggering insomnia.

Insomnia carries dangers both while deployed and back at home. When soldiers are affected by insomnia in the field, they are at greater risk of developing PTSD or depression, or even committing suicide later on. Additionally, experiencing insomnia while at war can increase the risk of physical injuries. The researchers stress that all of these factors strongly indicate a need for more research into the relationship between psychological, socio-environmental, physiological, and neurological factors that contribute to chronic insomnia in the military.

The researchers posit that one important way to mitigate the risks of insomnia is to identify biomarkers that are correlated to a vulnerability to insomnia. This would facilitate early detection, which could lead to prevention or the mitigation of the impact of co-occurring disorders.

Some studies have shown that cognitive-behavioral therapy and imagery rehearsal therapy have had positive effects on veterans suffering from insomnia and nightmares, respectively. These are flexible treatments that can be administered in person, over the phone, or online. Recently, the Veterans Health Administration initiated a program to train clinicians in the treatment of insomnia. At present there are more veterans who need care than there are clinicians able to deliver it. The impact of this program has yet to be seen.

The authors conclude, “Training providers to be knowledgeable about insomnia and behavioral treatment options is a vital component to the treatment of chronic insomnia and managing its impact on other disorders.”

This research is published in the journal Current Psychiatry Reports.

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