Table 1.

Recommendations to Promote Sleep Health

Prevent Sleep Problems 1. Increase servicemember and line leader education about healthy sleep behaviors to increase self-awareness and knowledge about the factors that inhibit or promote adequate, restful sleep. 2. Fund or conduct research to perform longitudinal studies on sleep and effects on operational readiness and resilience. Increase Identification and Diagnosis of Sleep Problems 3. Educate families on signs and symptoms of sleep disturbances as a way to bolster sleep detection efforts. 4. Improve screening for sleep disturbances in primary care settings, including the routine use of validated screening tools to identify those at high risk for the broad range of sleep disorders. Clinically Manage Sleep Disorders and Promote Sleep Health 5. Develop provider education programs on preventing, identifying, and treating sleep disorders, with a focus on giving providers the latest findings in the field of sleep science to effectively advise patients on sleep issues and a focus on prevention as well as treatment. 6. Develop a clinical practice guideline for sleep disorders that specifically addresses sleep and discusses prevention, identification, and treatment of sleep disorders. 7. Increase the use of mobile technology for assessing and clinically managing sleep disorders, in particular to monitor sleep and alertness and to identify and manage sleep disorders before they become chronic or debilitating. 8. Continue to research evidenced-based practices for aadvancing healthy sleep in military populations (e.g., mindfulness, teletherapy) and establish guidelines for treating servicemembers and veterans. 9. Enhance dissemination of evidence-based sleep treatments (e.g., CBT-I, IRT) by training providers in primary care settings as well as behavioral health clinics. 10. Improve continuity of care of sleep disorder treatments, such as through the use of electronic medical records that link records across the deployment cycle. Improve Sleep in Training and Operational Contexts 11. Make appropriate revisions to existing training and operational policies to minimize inconsistencies and align with current clinical guidelines about optimal sleep duration that recommend that the amount of sleep required among civilians is eight hours. 12. Educate line leaders on creating sleep plans that align with current research on circadian rhythms, consider the physical sleeping environment, and factor in shift schedules of roommates or tentmates when assigning duty. 13. Create standardized operational and training policies across DoD to increase sleep duration and quality and reduce fatigue-related impairment. 14. Link sleep-related surveillance data on mishaps to evaluate the role of sleep and fatigue. 15. Prioritize sleep in reintegration policies to offer servicemembers a period of recuperation during which they might be able to begin to return to normal sleep habits and potentially prevent the onset of chronic sleep problems that develop well after the initial reintegration period. 16. Disseminate positive messaging about sleep as an operational imperative (a vital sign, such as blood pressure) to increase awareness and reduce cultural barriers.