A team of scientists from across the country, including four researchers from the University of South Carolina’s Arnold School of Public Health, has found that sleep disorders among United States Veterans increased by 600 percent over an 11-year period (July of 2000 to June of 2010). The study, which was supported by a grant from the Department of Veterans Affairs (Office of Research and Development, Health Services Research and Development Office (PPO 09-246)), was published in the journal, Sleep.
[Dr. Jim Burch]
The six-fold increase was observed in a sample of just under 9.8 million U.S. Veterans seeking care in Veterans Health Administration facilities. The largest increases were identified among those with post-traumatic stress disorder (PTSD), other mental disorders, or combat experience. Veterans with cardiovascular disease, cancer, or other chronic diseases also experienced higher rates of sleep disorder diagnoses relative to those without those conditions.
Veterans with PTSD had the highest sleep disorder prevalence (16 percent). “It also is remarkable to note that PTSD prevalence increased three-fold over the 11-year study period,” says principal investigator Dr. Jim Burch, who is an associate professor in the Arnold School’s department of epidemiology and biostatistics (EPID/BIOS) and a Health Science Specialist at the WJB Dorn Department of Veterans Affairs Medical Center. “Sleep disorders were three to four times more prevalent among Veterans with PTSD relative to those without PTSD.”
The current study design does not definitively prove that PTSD caused the increase in sleep disorder diagnoses. However, the authors recently completed a follow-up study (not yet published) demonstrated an association between a pre-existing history of PTSD and increased odds of sleep disorder onset.
Not surprisingly, increased prevalence of sleep disorders among Veterans can result in numerous health issues. “Sleep is considered a physiological necessity,” explains Dr. Burch, who notes the trajectory of the sleep disorder diagnoses observed in their study suggests a continuation beyond 2010. “Inadequate sleep has been associated with a wide range of adverse health outcomes, including an increased risk of chronic diseases such as heart disease and cancer, psychiatric disorders, reduced quality of life, and increased mortality.”
These trends and their implications suggest a growing need for adequate sleep disorder management and health care planning for Veterans moving forward. “Our current research is examining a non-pharmacological method for improving sleep (i.e., HRV biofeedback),” Dr. Burch says. “This intervention also will be evaluated for its ability to ameliorate pain, stress, fatigue, and depression among Veterans, which are all strongly associated with poor sleep.”
Over 21 million Veterans live in the U.S., and nearly nine million of them receive healthcare through the Veterans Health Administration, which is the largest integrated health care system in the U.S.