The Role of Sleep in Mental Illness in Veterans and Active Service Members

Active duty service members as well as retired veterans are at greater risk for insomnia and/or sleep-disordered breathing (SDB) than the general population. Difficulties such as these may facilitate the development of or exacerbate psychiatric symptoms, as well as difficulties with cognition, and are a hallmark feature of mental health problems in this population. Cognitive behavioral therapy for insomnia (CBT-I) is an effective psychotherapeutic intervention for insomnia, while continuous positive airway pressure (CPAP) is effective in treating sleep-disordered breathing. While CBT-I is successful in ameliorating psychiatric symptoms in addition to sleep, less is known about its efficacy in individuals with psychosis, particularly in the veteran population. Regular screening is important among veterans with psychiatric disorders, but is not regularly assessed in clinics. Similarly, older adults are particularly susceptible to SDB, and early identification of the presence of sleep-disordered breathing may improve cognitive functioning and prevent rapid cognitive decline. The Veterans Health Administration is diligently working to improve access to sleep services, which will ultimately enhance the quality of life for many veterans.

现役军人以及退伍军人比普通人群患失眠和/或睡眠呼吸障碍（SDB）的风险更高。诸如此类的问题可能会促使精神症状的产生或加重，以及导致认知困难，并且是这一人群心理健康问题的一个标志性特征。失眠的认知行为疗法（CBT - I）是一种治疗失眠的有效心理治疗干预措施，而持续气道正压通气（CPAP）在治疗睡眠呼吸障碍方面是有效的。虽然CBT - I除了改善睡眠外，在缓解精神症状方面也很成功，但对于其在精神病患者，特别是退伍军人中的疗效知之甚少。在患有精神障碍的退伍军人中进行定期筛查很重要，但诊所中并没有经常进行评估。同样，老年人特别容易患睡眠呼吸障碍，早期识别睡眠呼吸障碍的存在可能会改善认知功能并防止认知能力快速下降。退伍军人健康管理局正在努力改善获得睡眠服务的途径，这最终将提高许多退伍军人的生活质量。