Department of Preventive Medicine, Madigan Healthcare System, Tacoma, WA, USA.
J Clin Sleep Med. 2013 Jun 15;9(6):577-84. doi: 10.5664/jcsm.2754.
Sleep problems are of particular concern among the active duty military population as factors such as inconsistent work hours and deployment may compromise adequate sleep and adversely impact performance. However, few prior studies have investigated whether the prevalence of sleep problems differ between Veterans and demographically similar non-Veterans. The purpose of this study is to investigate whether self-reported insufficient rest or sleep varies in relation to Veteran status and to identify high-risk groups of Veterans.
This study used data from the 2009 Behavioral Risk Factor Surveillance System (analyzed in 2011), a state based national telephone survey of non-institutionalized US adults. Insufficient rest was assessed in 411,313 adults aged 21 and older, of whom 55,361 were Veterans. Sleep duration was assessed in 6 states (n = 4,936 Veterans and 30,983 non-Veterans). Model-based direct rate adjustment was used to estimate the prevalence of insufficient rest or sleep while controlling for confounding. Multivariable logistic regression was used to estimate odds ratios of insufficient sleep or rest in subgroups of Veterans.
After multivariable adjustment, insufficient rest or sleep (22.7% vs. 21.1%, p < 0.001) and short sleep duration (< 7 h/night, 34.9% vs. 31.3%, p = 0.026) were more common among Veterans than non-Veterans. When the Veteran group was further divided among newly transitioned (≤ 12 months) and longer-term Veterans (> 12 months), the overall test for a difference was not statistically significant between groups, mainly because there was little difference in sleep between the two groups of Veterans. High-risk Veteran subgroups included those who were 21-44 years of age (vs. 65-74), women, non-whites, current smokers, obese, unable to work, and those in poor health.
This study suggests that Veterans have a high burden of sleep problems and identifies subgroups that should be targeted to receive interventions and enhanced education regarding insufficient sleep.
睡眠问题在现役军人中尤为令人关注,因为工作时间不规律和部署等因素可能会影响充足的睡眠,并对表现产生不利影响。然而,先前很少有研究调查睡眠问题的发生率在退伍军人和人口统计学上相似的非退伍军人之间是否存在差异。本研究旨在调查自我报告的休息或睡眠不足是否与退伍军人身份有关,并确定退伍军人的高风险群体。
本研究使用了 2009 年行为风险因素监测系统(2011 年分析)的数据,这是一项基于州的美国非机构化成年人全国电话调查。在 21 岁及以上的 411313 名成年人中评估休息不足,其中 55361 名为退伍军人。在 6 个州评估了睡眠持续时间(退伍军人 4936 人,非退伍军人 30983 人)。使用基于模型的直接率调整来估计控制混杂因素后休息或睡眠不足的患病率。使用多变量逻辑回归估计退伍军人亚组中睡眠不足或休息不足的优势比。
经过多变量调整后,休息或睡眠不足(22.7%比 21.1%,p<0.001)和睡眠持续时间较短(<7 小时/晚,34.9%比 31.3%,p=0.026)在退伍军人中比非退伍军人更为常见。当将退伍军人组进一步分为新过渡(≤12 个月)和长期(>12 个月)退伍军人时,两组退伍军人之间的总体差异检验没有统计学意义,主要是因为两组退伍军人之间的睡眠差异不大。高危退伍军人亚组包括 21-44 岁(与 65-74 岁相比)、女性、非白种人、当前吸烟者、肥胖、无法工作和健康状况不佳的人群。
本研究表明退伍军人的睡眠问题负担很重,并确定了应针对这些群体进行干预和加强有关睡眠不足的教育的亚组。