#CHRONIC INSOMNIA CAUSES MANUAL#

Within the military, daytime fatigue due to poor sleep poses a direct threat to military operational readiness, as it is associated with negative health impacts such as impaired decision making and reaction time, decreased cognitive function, increased musculoskeletal injury, and decreased anaerobic and endurance performance. 13 Not surprisingly, insomnia has been associated with higher rates of numerous physical and mental health conditions, as well as poor job performance and increased work-related injuries and accidents. Sleep is vital to systemic physiology including metabolism, appetite regulation, immune and hormone function, as well as cardiovascular systems it is critical to neurobehavior, cognitive performance, memory consolidation, and mood regulation. 10 Additionally, during Operation Iraqi Freedom (OIF), Operation Enduring Freedom (OEF), and Operation New Dawn (OND), diagnosis rates of insomnia increased dramatically in all branches of service. Department of Defense (DOD) medical surveillance data for the period 2000 through 2009 document a 19-fold increase in insomnia diagnoses over the 9-year period (crude incidence rate of insomnia increased from 7.2 to 135.8 cases per 10,000 person years ). 5-9 In addition, studies suggest insomnia is a growing health threat to SMs. 3,4 In a RAND report on sleep in the military, 48.6% of military personnel surveyed had poor sleep quality, and recent studies have reported the prevalence of insomnia as ranging from 4.5% to 22.8% among military personnel. Insomnia is the most common sleep disorder in the U.S., with 20% to 30% of adults reporting at least 1 symptom of insomnia and an estimated 6% to 10% meeting diagnostic criteria for chronic insomnia.

#CHRONIC INSOMNIA CAUSES MANUAL#

Chronic insomnia is defined as insomnia symptoms for at least 3 months duration and occurring at least 3 days per week, by the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), 1 and the International Classification of Sleep Disorders, Third Edition. Insomnia is characterized by a subjective perception of difficulty initiating or maintaining sleep, dissatisfaction with sleep quantity or quality despite adequate opportunity, and subsequent daytime impairment. The evidence-based management pathways outlined in the Department of Veterans Affairs and Department of Defense Clinical Practice Guideline should be promoted to mitigate the negative consequences of chronic insomnia.

Insufficient sleep from chronic insomnia poses a direct threat to operational readiness due to impaired cognitive performance and increased musculoskeletal injury. What is the impact on readiness and force health protection? Among those diagnosed, 53.7% received behavioral therapy, the first line recommended insomnia treatment, and 72.7% received pharmacotherapy. What are the new findings?įrom 2012 through 2021, the crude incidence rate of chronic insomnia among active component service members was 116.1 cases per 10,000 person-years, and the annual rate remained stable throughout the 10-year period. Clinician education about the VA/DOD CPG may improve utilization of these evidence-based management pathways for SMs with chronic insomnia. Co-existing mental health conditions increased the likelihood of receiving therapy for insomnia cases. As case ages increased, the proportion who received therapy decreased. A sub-analysis of SMs with chronic insomnia diagnosed during 2019-2020 found that 53.9% received behavioral therapy and 72.7% received pharmacotherapy. During this period, 148,441 incident cases of chronic insomnia occurred, with an overall rate of 116.1 per 10,000 person-years (p-yrs). This retrospective cohort study estimated the incidence of chronic insomnia in active component military members from 2012 through 2021 and the percentage of SMs receiving VA/DOD CPG-recommended insomnia treatments. The Department of Veterans Affairs and Department of Defense Clinical Practice Guideline (VA/DOD CPG) provides evidence-based management pathways to mitigate the negative consequences of common sleep disorders among service members (SMs). Health Readiness & Combat Support | Public Health | Medical Surveillance Monthly Report ABSTRACT

Chronic insomnia causes