b'U.S. Army soldiers slept in a hasty fighting position on a cold morning in the mountains near Sar Howza, Paktika province, Afghanistan, in September 2009. Photo by Staff Sgt. Andrew Smithu From Page 13evidence-based management pathway to help navi- Ascaseagesincreased,theproportionofser-gate the treatment of chronic insomnia. The recentvicememberswhoreceivedtherapydecreased. USU-led study found, however, that implementationCo-existing mental health conditions increased the of these recommendations has been limited, accord- likelihood of receiving therapy for insomnia cases, ing to the researchers. according to the study. Chronic insomnia is a persistent problem amongInsomnia is associated with higher rates of numer-ourservicemembers,theArmedForcesHealthous physical and mental health conditions, poor job Surveillance Division researchers wrote in an email.performance and increased work-related injuries and There is a gap between what the Clinical Practiceaccidents. This sleep disorder also poses a threat to Guideline recommends for management of chronicmilitary operational readiness and can have devas-insomnia and what is being done in clinical practicetating effects, such as two separate fatal collisions of throughout the Military Health System. While behav- U.S. Navy ships in 2017 where fatigue was cited as a ioral therapy is recommended as first line treatment,contributing factor, the study authors advised. especially for those with co-occurring mental healthTheevidence-basedmanagementpathwaysout-conditions, we found that 54% of individuals withlined in the VA and DoD Clinical Practice Guideline chronic insomnia received behavioral therapy, whileshould be promoted to mitigate the negative con-73% received pharmacotherapy. We were also sur- sequences of chronic insomnia and to enhance the prised to find that medications recommended againsthealthandwell-beingofourservicemembers, useforchronicinsomniaintheClinicalPracticetheArmedForcesHealthSurveillanceDivision Guideline are still prescribed for this purpose. researchers recommended.Incidence of chronic insomnia increased with age,The researchers added that the MHS needs to pro-withrateshighestamongtheoldestservicemem- mote awareness of the Clinical Practice Guideline bers. Incidence also differed by sex and racial/ethnicfor the Management of Chronic Insomnia Disorder group, being 51% higher among females than malesand Obstructive Sleep Apnea to enhance the imple-and 69% to 89% higher for non-Hispanic Black ser- mentation recommendations among clinicians car-vicememberscomparedtothoseofnon-Hispanicing for servicemembers. white,Hispanicorother/unknownrace/ethnicity.1Hsu NM, Stahlman SL, Fan MT, Wells NY. Incidence and Manage-Servicemembers with a history of prior deploymentment of Chronic Insomnia, Active Component, U.S. Armed Forces, had an incidence rate 108% higher than those with- 2012 to 2021. MSMR. 2023 Jan 20;30(1):2-10. PMID: 36881546.out prior deployment. 15'