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Sleep disorders significantly increase among US veterans in last decade

From 2000 to 2010, sleep disorders increased nearly 6-fold among veterans receiving care at Veterans Health Administration facilities in the United States.

“Military personnel are particularly vulnerable to sleep disturbances due to the irregularity of their sleep/wake schedules, austere living conditions (eg, extremes in temperature, noise, physical exertion), the stress of combat, elevated rates of physical and psychological injury, and issues associated with postdeployment psychosocial reintegration. Some of these conditions can have residual effects well after the period of service is over,” Melannie Alexander, PhD, of the University of South Carolina, Columbia, and colleagues wrote.

To assess diagnosed sleep disorders among veterans seeking care in U.S. Veterans Health Administration facilities, researchers analyzed electronic medical records from the national Veterans Administration Informatics and Computing Infrastructure database for 2000 through 2010 (n = 9,786,778).

Sleep apnea and insomnia were the most common diagnoses among participants with any sleep disorder, occurring among 47% and 26%, respectively. These were followed by hypersomnias (10%), movement disorders (4%), parasomnias (3%) and circadian rhythm sleep disorders (0.1%).

The majority of participants with sleep disorders were prescribed at least one sleep medication (91%).

Sleep disorder prevalence increased approximately 6-fold during the study period, according to researchers.

Sleep apnea and insomnia prevalence increased more than 7-fold. Age-adjusted sleep apnea increased from 0.4% in 2000 to 3% in 2010, while age-adjusted insomnia prevalence increased from 0.2% to 1.5%.

PTSD prevalence tripled during the study period and accounted for the highest prevalence of sleep disorders among analyzed comorbid conditions (16%).

“Veterans with PTSD had a very high sleep disorder prevalence of 16%, the highest among the various health conditions or other population characteristics that we examined. Because of the way this study was designed, this does not prove that PTSD caused the increase in sleep disorder diagnoses,” study researcher James Burch, PhD, of the University of South Carolina, said in a press release. “However, we recently completed a follow-up study, soon to be submitted for publication, that examined this issue in detail. In that study, a pre-existing history of PTSD was associated with an increased odds of sleep disorder onset.” – by Amanda Oldt

Disclosure: Alexander reports receiving support from the University of South Carolina Behavioral-Biomedical Interface Program, funded in part by training grant 5T32GM081740-04 from the National Institute of General Medical Sciences. Please see the full study for a list of all authors’ relevant financial disclosures.