Assessing Insomnia in Active-Duty Service Members in a Military Primary Care Clinic

Insomnia is a significant problem in the U.S. military, affecting the health, resiliency, and readiness of service members (Seelig et al., 2016). Although insomnia is a common sleep disorder among active-duty personnel (Mysliwiec et al., 2013), it often goes unrecognized and untreated because sleep disturbances are not routinely assessed during military primary care visits (U.S. Navy Medicine, 2014).

To introduce an evidence-based assessment for insomnia-the Insomnia Severity Index (ISI)-into a military primary care setting to increase the number of service members assessed for insomnia.

The ISI was integrated into the patient intake process at a military primary care clinic serving active-duty service members exclusively. Data were collected from 180 patients before implementation and 164 patients after implementation to compare the number of sleep assessments conducted. An independent samples t-test and Fisher's exact test were used to examine whether the ISI intervention led to an increase in insomnia assessment.

A significant increase was found in patients who were evaluated for insomnia from pre-implementation (13.9%, n = 25/180) to post-implementation (90.3%, n = 148/164), p < .0001.

A sleep screening process can be effectively implemented at a military primary care facility to increase the number of active-duty service members assessed for insomnia.

Sleep assessment is critically needed to identify service members with sleep disorders that may negatively impact their physical and mental health. An evidence-based screening tool is an important preventive measure that can be integrated into primary care visits to ensure routine evaluation of sleep.