Hacking sleep: Study finds National Guard soldiers self-treat sleep issues

Late-night patrols, extreme conditions, memories of violence, the danger of shelling — there are plenty of triggers to keep soldiers up at night and they don’t leave their sleep troubles in the field when deployment ends. Sleep problems among military personnel have been well-documented, according to San Francisco State University Professor of Anthropology Martha Lincoln, but what hasn’t been studied is how soldiers develop their own self-prescribed hacks to fall asleep. Which is why Lincoln and co-authors Roland Moore and Genevieve Ames published a study in the journal Sleep Health exploring how National Guard soldiers address their sleep issues once they return home.

The study is part of a larger research project on post-traumatic stress disorder (PTSD) and substance abuse among National Guard soldiers who saw combat. The project is funded by the National Institute on Alcohol Abuse and Alcoholism (NIAAA), a research institute of the National Institutes of Health. The grant was awarded to the Pacific Institute for Research and Evaluation where Lincoln was a research scientist prior to her appointment at SF State. Lincoln’s research focuses on the ways soldiers engineer their own sleep-aid regimens, which can involve anything from drinking alcohol to taking over-the-counter sleep aids like Tylenol PM or melatonin. 

“Some members of the military worry they could face negative repercussions if they see counselors or therapists and get prescription medications to treat sleeplessness,” Lincoln said. “Soldiers often feel that will raise red flags in their personnel file, so they’ll do other things to remedy their sleep problems.”

What surprised Lincoln were the elaborate workarounds soldiers used to solve their sleep problems. “Respondents would say, ‘I’ll go to the gym and work out until I’m physically exhausted and maybe I’ll come home and play video games, or maybe I’ll have a drink or several drinks. And maybe I’ll take over-the-counter cold medications,’” she said. “There’s a strong culture of physical fitness in the military, and people would use that to soothe their nerves as well as wear themselves out.”

In Lincoln’s view, these attempted remedies, while resourceful, are an unfortunate reflection of the constraints of military life.

“There’s a culture of masculine effectiveness in the armed forces that discourages acknowledging or dwelling on mental, emotional or behavioral health disorders,” she said. “Soldiers would tell us, ‘I’m a pilot. I can’t take Ambien.’ Or, ‘I can’t take Zoloft because I can’t have a note about that in my file.’”

Some of those interviewed even expressed concern that if they sought mental health services it could cast doubt on their fitness for service, affecting their eligibility for promotion and chances for job retention.   

To conduct their study, Lincoln and the other researchers interviewed 101 National Guard combat veterans in New Mexico and Hawaii, locations chosen for their diverse demographics. These soldiers had indicated in a prior screening that they had symptoms of PTSD or substance abuse problems. After listening to the soldiers discuss their sleep problems and other issues, Lincoln and co-investigators concluded the interviews by encouraging respondents to seek mental health services and offering them health resources.

“It was obvious to me that in many of the interviews, the people who were telling me their problems would not be comfortable using those resources,” she said. Given this, Lincoln says she hopes that medical providers who serve military populations understand that soldiers are treating their sleep disorders in unsupervised and sometimes unhealthy ways.

The project is funded by the National Institute on Alcohol Abuse and Alcoholism (NIAAA), a research institute of the National Institutes of Health. NIH Grant #1R01AA020308