Petrofsky Lyddia A, Heffernan Corinne M, Gregg Brian T, Smith-Forbes Enrique V, Sturdivant Rodney X
U.S. Army Medical Center of Excellence, San Antonio, TX 78234, USA.
U.S. Army-Baylor University, San Antonio, TX 78234, USA.
Mil Med. 2024 May 18;189(5-6):1023-1031. doi: 10.1093/milmed/usad040.
Sleep deprivation is rampant within the military population, and insufficient sleep can lead to physical and mental health problems impacting soldier's readiness and deployability. Past research has shown the importance of leadership's role in subordinates' sleep health. Understanding the values, beliefs, and quality of military leader sleep is essential to the development of effective interventions to optimize occupational performance and overall sleep health. Therefore, the purpose of this study was to examine the military leaders' values, beliefs, and sleep quality and the impact on occupational performance. The authors aimed to (1) identify military leaders' sleep quality and beliefs; (2) explore the relationship between military leaders' sleep quality, beliefs and attitudes about sleep, and impact on occupational performance; and (3) examine the value leaders place on sleep for themselves and subordinates in relation to occupational performance.
This observational, mixed-methods study design recruited a convenience sample of 109 Army active duty medical service members currently serving in a leadership role. Participants completed an electronic survey to include general demographic information and three self-report measures: the Pittsburgh Quality of Sleep Index, the Dysfunctional Beliefs about Sleep, and the Functional Outcomes of Sleep Questionnaire. Eleven participants completed the semi-structured qualitative interview focusing on sleep values and the impacts on performance. Univariate and multivariate regressions were performed for statistical analysis of the quantitative survey data, whereas thematic analysis was used to analyze the qualitative interview data. This study was approved by the U.S. Army Medical Center of Excellence Institutional Review Board.
Multivariate regression analysis demonstrated small-to-medium effect sizes (R2 = 0.355-0.559) for relationships between sleep quality, sleep beliefs, functional performance, and demographic variables. More specifically, military grade, position, use of alcohol, time in service, and gender were all found to contribute significantly to scores on the Pittsburgh Sleep Quality Index, the Dysfunctional Beliefs About Sleep Scale-16, and the Functional Outcomes of Sleep Questionnaire-10 (P < .05). Qualitative data resulted in three primary themes: (1) Poor sleep degrades performance, (2) sleep is a top priority, and (3) leaders have a responsibility for subordinates' sleep health.
This sample of military leaders was found to perceive themselves as poor-quality sleepers despite demonstrating more functional attitudes and beliefs about sleep and reporting normal-to-mild impairments in daily functioning as a result of daytime sleepiness. Furthermore, findings suggest that leaders' sleep quality and beliefs stand to be further improved, whereas their sleep values need to be consistently demonstrated to subordinates. With a clearer understanding of military leaders' values, beliefs, and sleep quality, future research could focus on implementing and developing holistically based and individualized sleep interventions intended to optimize performance and sleep health.
睡眠剥夺在军人中很普遍，睡眠不足会导致身心健康问题，影响士兵的战备状态和部署能力。过去的研究表明，领导在下属睡眠健康方面的作用至关重要。了解军事领导人的睡眠价值观、信念和质量对于制定有效的干预措施以优化职业表现和整体睡眠健康至关重要。因此，本研究的目的是考察军事领导人的价值观、信念和睡眠质量及其对职业表现的影响。作者旨在：（1）确定军事领导人的睡眠质量和信念；（2）探讨军事领导人的睡眠质量、对睡眠的信念和态度之间的关系及其对职业表现的影响；（3）考察领导人在职业表现方面对自己和下属睡眠的重视程度。
本观察性混合方法研究设计选取了109名担任领导职务的美国陆军现役医疗服务人员作为便利样本。参与者完成了一项电子调查，内容包括一般人口统计学信息和三项自我报告测量：匹兹堡睡眠质量指数、对睡眠的功能失调信念以及睡眠问卷的功能结果。11名参与者完成了关于睡眠价值观及其对表现影响的半结构化定性访谈。对定量调查数据进行单变量和多变量回归分析以进行统计分析，而主题分析用于分析定性访谈数据。本研究得到了美国陆军卓越医疗中心机构审查委员会的批准。
多变量回归分析表明，睡眠质量、睡眠信念、功能表现和人口统计学变量之间的关系具有小到中等的效应量（R2 = 0.355 - 0.559）。更具体地说，军阶、职位、饮酒情况、服役时间和性别均被发现对匹兹堡睡眠质量指数、睡眠功能失调信念量表 - 16以及睡眠问卷功能结果 - 10的得分有显著贡献（P < 0.05）。定性数据产生了三个主要主题：（1）睡眠不佳会降低表现；（2）睡眠是首要任务；（3）领导人对下属的睡眠健康负有责任。
尽管该样本中的军事领导人对睡眠表现出更具功能性的态度和信念，并且报告因日间嗜睡导致日常功能有正常到轻度的损害，但他们仍认为自己睡眠质量差。此外，研究结果表明领导人的睡眠质量和信念有待进一步改善，而他们的睡眠价值观需要持续向下属展示。通过更清楚地了解军事领导人 的价值观、信念和睡眠质量，未来的研究可以专注于实施和开发基于整体和个性化的睡眠干预措施，以优化表现和睡眠健康。
