Multidimensional qualities of sleep health following serious physical combat injuries: A Latent Class Analysis: The...

This paper aims to report on multidimensional qualities of sleep health using Latent Class Analysis (LCA) in the ADVANCE study: a cohort of UK Armed Forces personnel who sustained serious physical combat injuries whilst on deployment to Afghanistan (n = 522; including amputation injuries (n = 139) and non-amputation injuries (n = 383)) compared to a demographically similar group of personnel who sustained no such injuries (uninjured group) (n = 514). LCA indicated two classes: no-mild sleep problems and moderate-severe sleep problems. The injured group had greater risk of being represented in the moderate-severe sleep problem class compared to the uninjured group (Relative Risk (RR) 1.18 (95 % Confidence Interval (CI) 1.07, 1.42). This was also true for the non-amputation injury subgroup (RR 1.24 (95 %CI 1.10, 1.55)), but not the amputation injury subgroup (RR 1.10 (95 %CI 0.59, 1.34)). The amputation injury subgroup were more likely to report long-sleep duration (>8 h) (RR 2.85 (95 %CI 1.54, 5.13)) and the non-amputation injury subgroup short-sleep duration (<6 h) (RR 1.29 (95 %CI 1.09, 1.74)) compared to the uninjured group. UK Armed Forces personnel who sustained non-amputation injuries exhibit greater risk of endorsing symptoms of poor sleep health and short sleep duration compared to demographically similar personnel who sustained no such injuries, whereas those with amputation injuries have greater risk of long-sleep duration only. Regardless of injury, this cohort represents a group who present with between double and triple the rates of short-sleep duration observed in the UK general population, which may affect long-term health outcomes.