America has a sleeping problem—and for many of our service members and family members this problem can be even more pronounced. According to the Centers for Disease Control and Prevention, a third of U.S. adults report they usually get less than the recommended amount of sleep, which is seven to nine hours for adults aged eighteen to sixty-four.

A study conducted by the RAND Corporation and published in the Sleep Health Journal revealed that military spouses from across all branches of service report high rates of short sleep duration and poor sleep quality. This study highlighted the need to place emphasis on healthy sleep habits amongst service members and family members. Lack of adequate sleep can contribute to poor health outcomes and poor quality of life. Sleep is required for the brain to perform optimally and allows you to be better able to cope with stress. Sleep affects almost every type of tissue and system in the body from the brain, heart, and lungs to metabolism, immune function, and mood.

The CDC says not getting enough sleep is linked with increased risk for many chronic diseases and conditions—such as Type 2 diabetes, heart disease, obesity, and depression. It has also been a contributing factor in motor vehicle crashes and machinery-related injuries, causing substantial injury and disability each year.

A good night of rest allows you to:
·  Feel well rested and energetic the next day.
·  Learn and make memories, solve problems, and make decisions.
·  Cope with stress and regulate emotions.
·  Recover faster from injury or illness.
·  Remove waste from the brain.

DEVELOP GOOD SLEEP HYGIENE

Dr. Sara Alger, a sleep research scientist at the Walter Reed Army Institute of Research Behavioral Biology Branch's Sleep Research Center in Silver Spring, Maryland, said some studies comparing lack of sleep with Blood Alcohol Concentration (BAC) find that when a person has twenty-four hours of continuous wakefulness or if they only get four hours of sleep over five to six nights, they’re operating at a performance-level equivalent of a .09 blood alcohol level. The legal limit of intoxication in the U.S. is .08 BAC, so attempting to go about daily activities under this level of sleep loss looks similar to going about your day drunk, which can lead to increased risk for accidents, injuries, and other fatigue-related consequences.

Dr. Alger is currently the primary investigator in a multi-study project to determine strategies using the intentional combination of nocturnal sleep and daytime napping to overcome fatigue and maximize cognitive and physical performance. Dr. Alger says she hopes to address some of the stigma behind the concept of napping with this project. This is something she has been passionate about for some time.

In a 2019 Letter to the Editor of Sleep, an academic journal published by the Sleep Research Society, Dr. Alger and her colleagues argued there is a wealth of evidence that even brief daytime naps of ten to twenty minutes decrease subjective sleepiness, increase objective alertness, and improve cognitive performance. Longer naps facilitate creative problem solving and logical reasoning, boost the capacity for future learning, and consolidate memories.

Curating healthy sleep habits begins with understanding sleep basics. Your circadian rhythm is the approximately twenty-four-hour biological clock that is controlled by your brain. Everybody is different. Some clocks are a hair over twenty-four hours and others are a little under. This makes the difference between a morning lark and a night owl.

The sleep/wake cycle can also influence eating habits, digestion, body temperature, hormone release, and other bodily functions. Disruptions to your circadian rhythm can make you feel out of sorts and can make it harder to pay attention. Your circadian rhythm works best when you have regular sleep habits.

Dr. Alger explains that sleep hygiene is a variety of practices and habits that help you have a good night’s rest, so you can be fully alert during the day. Here are some healthy habits to establish:

• Develop a decompression routine thirty to sixty minutes before going to sleep—this could include making sure your space is clean, packing your gym bag and lunch, laying out your clothes, reading, or listening to relaxing music.

• Use the bathroom right before going to bed.

• The bedroom should be a dark, cool, and quiet space.

• Get exercise during the day but avoid vigorous-intensity exercise close to bedtime.

Keeping a consistent sleep and wake cycle is important to feeling well rested. Dr. Alger says it is important to get out of bed if you are not asleep in thirty minutes. After multiple nights of being unable to sleep in your bed, the brain develops a link between the bed and being awake, rather than being asleep. If you are struggling to fall asleep, try the following:

• Get out of bed if you are awake for more than thirty minutes, and then return when you are sleepy again.

• During this time, you should try to engage in a relaxing activity until you are ready for sleep.

• This process can be repeated until you fall asleep.

What to avoid before bedtime:

• Using electronics an hour before going to bed.

• Watching TV or doing work in bed.

• Caffeine six hours before bedtime.

• Sleeping outside of your bed.

• Working out less than three hours before bedtime.

• Naps after 3 p.m.

• Eating or consuming alcohol too close to bedtime.

  This sleep log from the National Sleep Foundation can be helpful for identifying ways to improve your sleep quality and duration.

Overseas moves and travel to and from overseas assignments can be challenging for military families. Jet lag can lead to daytime sleepiness and trouble falling or staying asleep at night, and it can take several days to adjust to a new time zone or work schedule. Dr. Alger offers a few tips and tricks to ease jet lag:

• If you are moving or deploying across time zones, begin adapting to the new time zone a few days before leaving. Adjust your sleep schedule by thirty to sixty minutes per day as your body clock adjusts to a new time zone.

• If you are only traveling for a few days, stick with your regular sleep schedule but try to be well rested before leaving by going to bed earlier the week prior to departure.

• Make sure to stay hydrated during travel and avoid alcohol. Focus on fiber-rich foods and fresh fruits and vegetables to help lower inflammation brought on by the stress of travel.

RESOURCES YOU CAN USE TO GET HELP

The military and military families may have a sleeping problem, but there are a host of resources for service members and family members who are trying to improve their sleep hygiene. Here are some of the best:
·  WRAIR Sleep Resources
·  Performance Triad: Effective Sleep Strategies
·  Health.mil: Sleep
·  CDC: Sleep and Sleep Disorders

Another excellent resource on your installation to get help with recognizing poor sleep habits and how to improve them are your Army/Armed Forces Wellness Centers. The AWC/AFWCs have health coaches and sleep education services for active-duty service members and their families, retirees, and DOD civilians. These services include general information about healthy sleep habits, the impact of sleep on health and wellbeing, tools, tips, and positive action steps to improve sleep.  

One important service that AWCs/AFWCs offer is an assessment called Individual Stress Management or ISMT. Studies have shown that increased stress levels can lead to the inability to fall asleep and negatively impact quality of sleep. Lack of sleep can also lead to increased appetite, weight gain, low energy, and problems remembering things, and even impact your ability to make quick and accurate decisions. The AWC/AFWCs ISMT service uses a biofeedback device to measure how effectively you can control your stress responses. With regular AWC/AFWC visits, you can measure changes over time and help master your ability to manage stress. There are currently 35 AWC/AFWCs across duty stations throughout the United States and overseas. Find the one closest to you and to make your appointment.

ABOUT NICOLE

Nicole Leth is the Lead Health Educator at Fort Belvoir’s Armed Forces Wellness Center. Nicole holds a Bachelor of Science Degree in Pre-Professional Biology from the University of Tennessee and a Master's Degree in Public Health with an emphasis on Nutrition from the University of Massachusetts Amherst. Nicole is CHES certified (Certified Health Education Specialist) and is a Certified Personal Trainer (CPT) with the National Strength and Conditioning Association (NSCA). In between earning her Bachelor and Master’s degrees, Nicole worked as an EMT and a Paramedic in Hawaii, Texas and New York. It was through this work in EMS that Nicole became passionate about public health and nutrition. Nicole has worked as a Health Educator in a private physician practice, done advocacy work for various public health coalitions and has taught undergraduate public health and nutrition courses for the Department of Kinesiology and Health Sciences at Columbus State University.