Physical Scientist, US Army Research Laboratory, Aberdeen Proving Ground, MD, 21005, USA.
Sleep Research Center, Center for Military Psychiatry and Neuroscience, Walter Reed Army Institute of Research, Silver Spring, MD, 20910, USA.
Neuropsychopharmacology. 2020 Jan;45(1):176-191. doi: 10.1038/s41386-019-0431-7. Epub 2019 Jun 11.
The military lifestyle often includes continuous operations whether in training or deployed environments. These stressful environments present unique challenges for service members attempting to achieve consolidated, restorative sleep. The significant mental and physical derangements caused by degraded metabolic, cardiovascular, skeletomuscular, and cognitive health often result from insufficient sleep and/or circadian misalignment. Insufficient sleep and resulting fatigue compromises personal safety, mission success, and even national security. In the long-term, chronic insufficient sleep and circadian rhythm disorders have been associated with other sleep disorders (e.g., insomnia, obstructive sleep apnea, and parasomnias). Other physiologic and psychologic diagnoses such as post-traumatic stress disorder, cardiovascular disease, and dementia have also been associated with chronic, insufficient sleep. Increased co-morbidity and mortality are compounded by traumatic brain injury resulting from blunt trauma, blast exposure, and highly physically demanding tasks under load. We present the current state of science in human and animal models specific to service members during- and post-military career. We focus on mission requirements of night shift work, sustained operations, and rapid re-entrainment to time zones. We then propose targeted pharmacological and non-pharmacological countermeasures to optimize performance that are mission- and symptom-specific. We recognize a critical gap in research involving service members, but provide tailored interventions for military health care providers based on the large body of research in health care and public service workers.
军人的生活方式常常包括连续不断的行动，无论是在训练中还是在部署环境中。这些充满压力的环境给试图获得连贯、恢复性睡眠的军人带来了独特的挑战。由于代谢、心血管、骨骼肌肉和认知健康的严重恶化而导致的精神和身体紊乱，往往是由于睡眠不足和/或昼夜节律失调引起的。睡眠不足和由此产生的疲劳会危及个人安全、任务成功，甚至国家安全。从长远来看，慢性睡眠不足和昼夜节律紊乱与其他睡眠障碍（如失眠、阻塞性睡眠呼吸暂停和睡眠障碍）有关。其他生理和心理诊断，如创伤后应激障碍、心血管疾病和痴呆症，也与慢性睡眠不足有关。由于钝器创伤、爆炸暴露以及在负荷下高度体力要求的任务导致的创伤性脑损伤，使合并症和死亡率增加。我们展示了针对军人在军事生涯期间和之后的人类和动物模型中的科学现状。我们专注于夜班工作、持续行动和快速重新适应时区的任务要求。然后，我们提出了有针对性的药物和非药物对策，以优化与任务和症状相关的表现。我们认识到涉及军人的研究存在一个关键差距，但根据医疗保健和公共服务工作者的大量研究，为军人医疗保健提供者提供了量身定制的干预措施。
