Daniel J Taylor1, Kristi E Pruiksma2, Willie J Hale2, Kevin Kelly3, Douglas Maurer3, Alan L Peterson2,4,5, Jim Mintz2,6, Brett T Litz7,8, Douglas E Williamson9,10. 1. Department of Psychology, University of North Texas, Denton, TX. 2. Department of Psychiatry, University of Texas Health Science Center at San Antonio, San Antonio, TX. 3. Carl R. Darnall Army Medical Center, Fort Hood, TX. 4. South Texas Veterans Healthcare System, San Antonio, TX. 5. Department of Psychology, University of Texas at San Antonio, San Antonio, TX. 6. Department of Epidemiology and Biostatistics, University of Texas Health Science Center at San Antonio, San Antonio, TX. 7. Massachusetts Veterans Epidemiology Research and Information Center, VA Boston Healthcare System, Boston, MS. 8. Department of Psychiatry, Boston University School of Medicine, Boston, MA. 9. Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC. 10. Durham VA Medical Center, Durham, NC.
Abstract
STUDY OBJECTIVES: To determine the prevalence, correlates, and predictors of insomnia in US Army personnel prior to deployment. METHODS: Cross-sectional cohort design assessing insomnia and other psychosocial variables in active duty service members (n = 4,101), at Fort Hood, Texas, prior to military deployment. Insomnia was defined as an Insomnia Severity Index ≥ 15. RESULTS: The prevalence of insomnia was 19.9%. Enlisted personnel were five times more likely to report insomnia than officers (odds ratio [OR] = 5.17). Insomnia was higher among American Indian/Alaskan Natives than other groups (ORs = 1.86-2.85). Those in the Insomnia Group were older, had longer military careers, and reported more marriages, children, and military deployments (ds = 0.13-0.34) than the No Insomnia group. The Insomnia Group reported more severe mental health symptoms, more recent stressful life events, greater childhood abuse, and lower levels of trait resilience, social support, and unit cohesion (Cohen ds = 0.27-1.29). After controlling for covariates, the Insomnia Group was more likely to have a history of head injuries and clinically significant posttraumatic stress disorder (PTSD), anxiety, depression, alcohol use problems, back pain, extremity pain, headaches, and fatigue (ORs = 1.40-3.30). A simultaneous logistic regression found that greater PTSD, depression, fatigue, stressful life events, headaches, anxiety, alcohol use problems, extremity pain, history of head injury, childhood physical neglect, back pain, number of times married, and lower leader support/unit cohesion and tangible social support were statistically significant predictors of insomnia status. CONCLUSIONS: Insomnia occurs in about one of five service members prior to a military deployment and is associated with a wide array of psychosocial stressors and mental and physical health problems.
STUDY OBJECTIVES: To determine the prevalence, correlates, and predictors of insomnia in US Army personnel prior to deployment. METHODS: Cross-sectional cohort design assessing insomnia and other psychosocial variables in active duty service members (n = 4,101), at Fort Hood, Texas, prior to military deployment. Insomnia was defined as an Insomnia Severity Index ≥ 15. RESULTS: The prevalence of insomnia was 19.9%. Enlisted personnel were five times more likely to report insomnia than officers (odds ratio [OR] = 5.17). Insomnia was higher among American Indian/Alaskan Natives than other groups (ORs = 1.86-2.85). Those in the Insomnia Group were older, had longer military careers, and reported more marriages, children, and military deployments (ds = 0.13-0.34) than the No Insomnia group. The Insomnia Group reported more severe mental health symptoms, more recent stressful life events, greater childhood abuse, and lower levels of trait resilience, social support, and unit cohesion (Cohen ds = 0.27-1.29). After controlling for covariates, the Insomnia Group was more likely to have a history of head injuries and clinically significant posttraumatic stress disorder (PTSD), anxiety, depression, alcohol use problems, back pain, extremity pain, headaches, and fatigue (ORs = 1.40-3.30). A simultaneous logistic regression found that greater PTSD, depression, fatigue, stressful life events, headaches, anxiety, alcohol use problems, extremity pain, history of head injury, childhood physical neglect, back pain, number of times married, and lower leader support/unit cohesion and tangible social support were statistically significant predictors of insomnia status. CONCLUSIONS:Insomnia occurs in about one of five service members prior to a military deployment and is associated with a wide array of psychosocial stressors and mental and physical health problems.
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