Sleep during and following military deployment: A scoping review

Sleep loss, ubiquitous in the military and especially severe during combat deployments, constitutes a threat to the health and effectiveness of service members (SMs). Mitigating these negative effects depends upon the ability to accurately measure them; however, the utility of current subjective sleep and daytime sleepiness measures, which have been validated in civilian populations, is unclear for SMs. Specifically, established clinical thresholds for poor sleep quality and pathological sleepiness may not accurately reflect the sleep health of previously deployed SMs. The present scoping review was conducted to determine if prior military deployment results in pervasive sleep disturbance as defined by standard subjective measures. The findings suggest that it does, but because objective performance was not included in the reviewed studies, the extent to which these findings actually reflect meaningful impairment is unknown. Future studies using objective measures are needed to determine whether combat deployment results in immediately consequential and long-term deficits in sleep and daytime functioning. Such research will clarify whether currently available subjective measures are appropriate for previously deployed SMs or if new, population-specific measures should be developed, particularly as future large-scale combat operations (LSCO) are expected to involve increasingly severe sleep loss.