A Review of Environmental Barriers to Obtaining Adequate Sleep in the Military Operational Context.

ABSTRACT

INTRODUCTION: Sleep loss is ubiquitous in military settings, and it can be deleterious to cognitive, physiological, and operational functioning. This is especially true in the military operational context (e.g., training, garrison, combat) where continuous operations prevent adequate time for rest and recuperation. Furthermore, even when servicemembers do have opportunities for sleep, environmental disruptors in the military operational context make it difficult to obtain restorative sleep. Such environmental disruptors are potentially preventable or reversible, yet there is little public awareness of how to minimize or eliminate these sleep disruptors. Therefore, the goal of this review was to outline prominent environmental sleep disruptors, describe how they occur in the military operational context, and also discuss feasible strategies to mitigate these disruptors. MATERIALS AND METHODS: We discuss four factors - light, noise, temperature, and air pollution - that have previously been identified as prominent sleep disruptors in non-military settings. Additionally, we extracted publicly-available yearly temperature and pollution data, from the National Oceanic and Atmospheric Association and the Environmental Protection Agency, respectively, for major prominent military installations in the continental US in order to identify the sites at which servicemembers are at the greatest risk for environmental sleep disruptions. RESULTS: Based on previous literature, we concluded light and noise are the most easily mitigatable sleep-disrupting environmental factors. Air pollution and temperature, on the other hand, are more difficult to mitigate. We also propose that harsh/uncomfortable sleeping surface is a fifth critical, previously unexplored sleep disruptor in the military operational context. Furthermore, we identified several problematic military sites for air pollution for temperature. Specifically, each branch has major installations located in regions with extreme heat (especially the Army), and each branch has at least one major installation in a high air pollution region. These findings show that even when in training or garrison in the US, military servicemembers are at risk for having sleep disruption due to environmental factors. CONCLUSIONS: Environmental disruptors, such as light, noise, temperature, and air pollution, can negatively impact sleep in the military operational context. Simple, feasible steps can be taken to reduce sleep disruptions that are caused by light and noise. Yet there is a need for research and development on tools to mitigate air pollution, extreme temperatures, and inhospitable sleeping surfaces. Leadership at the discussed military bases and training facilities should focus on improving the sleep environment for individuals under their command. Such interventions could ultimately improve warfighter health, wellness, and operational performance, leading to greater warfighter readiness and lethality.