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Sleep Better: Understanding the Sleep Disorders Affecting Veterans

Sleep is just as important to your health as diet and exercise. Good, restorative sleep improves your brain performance, mood and overall health, but when you don’t get enough it raises your risk for health issues such as heart disease, stroke, obesity and dementia.

If left untreated, a sleep disorder can negatively impact your health and quality of life. Seeking treatment is an important step in helping you solve what’s keeping you from good, restorative sleep.

Many factors can interrupt sleep from time to time – a stressful situation at work, an illness, or a frustrating family situation – but when difficulty sleeping becomes something more consistent, you may need additional support. Many Veterans, especially those who suffer from post-traumatic stress disorder (PTSD), often report problems with sleep, including nightmares, insomnia and obstructive sleep apnea. It’s important to know what these disorders are, what symptoms to look out for and how best to treat them to get the sleep you need.

Common Sleep Disorders  

If you’re a Veteran struggling with sleep, you’re not alone. According to the Department of Veterans Affairs (VA), up to 50% of Veterans enrolled in VA health care have insomnia or another sleep disorder. Insomnia, obstructive sleep apnea and nightmares are all more likely to develop in Veterans than in the general population for a variety of reasons. During service, military members are often put in stressful situations, need to stay awake for long periods of time, work irregular hours and are constantly alert to the dangers of combat. For these reasons, your mind and body may need to relearn how to sleep well again. Here are the most common sleep issues reported by Veterans:

Woman shows fatigue Insomnia – This is a common sleep disorder that can make it hard to fall asleep, hard to stay asleep, or cause you to wake up too early and not be able to get back to sleep. With insomnia, you may feel tired after a full night’s sleep, feel irritable or anxious, or have difficulty paying attention and focusing. Many adults get insomnia at some point in their lives – often during traumatic or stressful times – but it may only last a few weeks. Others suffer from chronic or long-term insomnia that may be associated with other medical conditions like PTSD.

Obstructive sleep apnea – This is a common sleep-related breathing disorder which causes you to repeatedly stop and start breathing while you sleep. Noticeable signs include consistent snoring, excessive daytime sleepiness, abrupt awakenings accompanied by gasping or choking, and observed episodes of stopped breathing during sleep.

Nightmares – Nightmares are considered a sleep disorder when disturbing dreams routinely cause you distress or keep you from getting enough sleep night after night.

10 Tips for Sleeping Better

Depending on how serious your troubles with sleep are, sometimes a few changes to your sleep routine can be helpful. Here are some suggestions:

  1. Make and stick to a sleep schedule. Aim for 7-8 hours of sleep each night and try to go to bed and wake up around the same time every day, even on the weekends. This can help your body get into a rhythm for sleeping and waking.
  2. Create a good sleep environment. Make your room cool and dark. Get rid of distractions like TV or cell phone notifications. Use a fan or earplugs if it helps and try room-darkening shades if necessary.
  3. Get outside. Getting into the natural light during the day is helpful for your internal clock to understand day and night.
  4. Avoid caffeine late in the day. Caffeine can take several hours to wear off, so you could be keeping yourself awake long after your late afternoon coffee fix.
  5. Try to avoid napping. If you do need a take one, make sure it’s short (20 minutes or so) and try not to make it late in the day. This can interfere with your normal sleep schedule.Woman jogging on a trail
  6. Get active. Exercise and movement can help tire your body out and make it easier to fall asleep at night.
  7. Avoid alcohol and large meals before bedtime. Both can prevent deep, restorative sleep.
  8. Limit your electronic use before bed, cutting yourself off at least 30 minutes before bed. The blue light can keep your brain wired and suppress your body’s ability to produce melatonin (a hormone that promotes sleep). Instead try reading a book, listening to music or finding another activity that relaxes you.
  9. Don’t lie in bed awake for too long. If you can’t fall asleep within 20 minutes or so, get up and do a relaxing activity until you feel sleepy again.
  10. See if deep breathing and meditation can help. Breathing techniques, a meditation podcast, or journaling can all help you set aside your worries and release the stress of the day and prepare you for sleep.

If these tips don’t help, it’s probably time to talk to your health care provider. Your provider can help you determine what’s going on and what treatment may be most effective at getting you back on track.

Resources That Can Help

For more information on understanding sleep, why it matters, and how much sleep you actually need, the National Institutes of Health offers Brain Basics: Understanding Sleep, an article full of information and helpful graphs. In addition, the Centers for Disease Control and Prevention (CDC) has a lot of tips for better sleep, including an example of a sleep diary, a tool recommended to help you keep track of your sleep problems before seeing your health care provider.

For Veterans suffering from insomnia, VA offers Cognitive Behavioral Therapy for Insomnia (CBT-i). CBT-i is a series of strategies focused on stimulus control, sleep restriction, cognitive restructuring and sleep hygiene. CBT-i can be done through individual therapy or in a group and usually requires four to eight sessions. When there’s not a certified CBT-i provider close by, Veterans can access a CBT-i training course through the Path to Better Sleep Program. This program includes four parts and can be done online.

  • Sleep Check-up – This is a five-minute questionnaire with customized questions that help screen for the sleep disorders you may be experiencing. It includes videos of Veterans sharing their experiences, as well as downloadable factsheets that you can share with your health care provider.
  • Sleep 101 – This part of the program helps you understand the importance of good sleep and helps you identify behaviors that interfere with your sleep.
  • SleepEZ – This portion of the program includes a sleep diary, a personalized sleep schedule and relaxation exercises.
  • BreatheEZ – This part of the program provides detailed information on sleep apnea, testing methods, treatment options and more.

In addition to CBT-i, there are several medications available for insomnia. However, in general, they carry significant side effects and are recommended for short-term use only. While certain medications initially promote sleep, after a few weeks of use tolerance and physical dependence develop. Because of withdrawal issues, built-up tolerance, side effects and more, Veterans should work with their providers closely before using any medications for sleep concerns.

For Veterans dealing with obstructive sleep apnea, you can learn about treatment options offered by VA, including continuous positive airway pressure, lifestyle modification assistance, sleep positioning devices and more.

If left untreated, a sleep disorder can negatively impact your health and quality of life. Seeking treatment is an important step in helping you solve what’s keeping you from good, restorative sleep.

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