Gaffey Allison E, Mattocks Kristin M, Yaggi Henry K, Marteeny Valerie, Walker Lorrie, Brandt Cynthia A, Haskell Sally G, Bastian Lori A, Burg Matthew M
VA Connecticut Healthcare System, West Haven, CT.
Department of Internal Medicine (Cardiovascular Medicine), Yale School of Medicine, New Haven, CT.
Med Care. 2025 Jul 1;63(7):472-478. doi: 10.1097/MLR.0000000000002152. Epub 2025 Apr 30.
Unique characteristics and service exposures of the post-9/11 cohort of U.S. Veterans can influence their sleep health and associated comorbidities. The objectives of this study were to learn about men and women post-9/11 Veterans' and "front line" VA providers' knowledge about sleep and experiences with Veterans Health Administration (VA) sleep management.
One sample included post-9/11 Veterans who received VA care (n=23; 60% women; Mage: 45 y). To complement those views, primary care and mental health providers were recruited from VA medical centers (n=27). Semistructured qualitative interviews were conducted using Microsoft Teams. Questions pertained to sleep knowledge, care practices, and perceived barriers to sleep-related VA care. Interview data were synthesized with content analysis and inductive coding to characterize major themes.
Four main themes emerged: (1) Sleep is viewed as foundational but Veterans and providers often have limited related knowledge and more routine education is needed. (2) Men and women have distinct sleep management needs. Relative to men, women are more likely to advocate for sleep assessment and for behavioral versus pharmacological treatment. (3) Sleep management practices vary considerably between clinics and providers. (4) Veterans and their providers each experience unique barriers to sleep management.
Post-9/11 Veterans and providers view sleep as critical. Yet, VA sleep management needs to be more uniform. Providers are motivated to assess sleep but require standardized education and low-burden opportunities to incorporate sleep into their practice, perhaps with mental health screening. Ultimately, more specialized care is required to meet the responsibility of Veterans' sleep health.
9·11事件后美国退伍军人的独特特征和服务经历会影响他们的睡眠健康及相关合并症。本研究的目的是了解9·11事件后的退伍军人以及“一线”退伍军人事务部（VA）提供者对睡眠的了解，以及他们在退伍军人健康管理局（VA）睡眠管理方面的经历。
一个样本包括接受VA护理的9·11事件后退伍军人（n = 23；60%为女性；平均年龄：45岁）。为补充这些观点，从VA医疗中心招募了初级保健和心理健康提供者（n = 27）。使用Microsoft Teams进行半结构化定性访谈。问题涉及睡眠知识、护理实践以及与VA睡眠相关护理的感知障碍。访谈数据通过内容分析和归纳编码进行综合，以确定主要主题。
出现了四个主要主题：（1）睡眠被视为基础，但退伍军人和提供者的相关知识往往有限，需要更多常规教育。（2）男性和女性有不同的睡眠管理需求。相对于男性，女性更有可能主张进行睡眠评估以及采用行为治疗而非药物治疗。（3）不同诊所和提供者之间的睡眠管理实践差异很大。（4）退伍军人及其提供者在睡眠管理方面各自面临独特的障碍。
9·11事件后的退伍军人和提供者认为睡眠至关重要。然而，VA的睡眠管理需要更加统一。提供者有动力评估睡眠，但需要标准化教育和低负担机会将睡眠纳入他们的实践，或许可以通过心理健康筛查。最终，需要更专业的护理来履行对退伍军人睡眠健康的责任。
