Sleep in the Military: Promoting Healthy Sleep among U.S. Servicemembers

By Wendy M. Troxel; Regina A. Shih et al. | Go to book overview

CHAPTER SIX
Barriers to Achieving Healthy Sleep Among Servicemembers

Even the best evidence-based practices, programs, and policies to prevent and treat sleep problems among servicemembers may not mitigate barriers to achieving healthy sleep. In the military context, such barriers can be cultural, operational, or individual (knowledge-related); they can also include medical and treatment system barriers. Understanding these barriers—and their interactions with one another—is critical to implementing policy changes to address key sleep-related challenges that servicemembers face.

One of the most robust ways to systematically assess the gaps between policies and their actual implementation and adherence is by soliciting the perspectives of representatives across DoD. In our case, we conducted key informant interviews with clinical practitioners, researchers, and line leaders in both the military health system and the military departments knowledgeable about the clinical and operational implications of military sleep policies. This qualitative method allowed us to capture indepth views of how DoD and Service-level sleep policies have been implemented and barriers to achieving healthy sleep in the military context. Quantitative analyses might include a comprehensive survey of a sample of servicemembers that is representative of the entire military. In lieu of conducting that kind of time-intensive, burdensome, and cost-prohibitive survey, qualitative data analyses are a robust way to obtain preliminary data to motivate future research directions.

We begin with an overview of our approach to identifying the barriers to healthy sleep. We then review each type of barrier identified and explore the implications of these findings.


Approach

Participants

The findings in this chapter are derived from interviews with 40 key informants in DoD and input from our expert working group meeting. Our final interview sample included 30 personnel working in military medical settings across DoD (including medical professionals and sleep experts, as well as health policymakers at multiple

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