Staff Perspective: Lessons Learned from Examining Sleep Functioning of At-Home Partners Over the Course of Military Deployment
Miller et al. (2017) conducted a study on the sleep functioning of at-home partners from the Readiness and Resilience in National Guard Soldiers (RINGS-2) project. The RINGS-2 project is a prospective longitudinal study of National Guard soldiers deployed to Iraq/Kuwait in 2011-2012. This is an important study because despite existing literature indicating deployments having negative effects on the health of military spouses, there has been limited research focused specifically on sleep functioning changes across the deployment cycle. Learning more about sleep related difficulties across the deployment cycle for at-home partners can help to better identify potential risk factors and generate ideas for prevention and intervention efforts.
The authors collected data from spouses or cohabiting partners (N = 686) at four time intervals: 1) 2-5 months prior to the service member’s deployment, 2) 4 months into the deployment, 3) 8 months into the deployment, and 4) 2-3 months after the service member returned from deployment. For this study, participants completed multiple measures to assess not only sleep related complaints (i.e., two items from the PHQ-8 and one item from the PCL-C), but a multitude of others factors that could interfere with their sleep functioning: negative emotionality (i.e., 20 item scale from the Personality Psychopathology Five Scales (PSY-5) of the MMPI-2RF), a depression screener (i.e., PHQ-8), a brief alcohol screening measure (i.e., AUDIT), relationship satisfaction (i.e., 7 item measure, Dyadic Adjustment Scale-7), a brief survey of family stressors (i.e., 14 items, Deployment Risk and Resiliency Inventory-2), and a brief assessment of negative communication (i.e., 5 items, Communication Danger Signs Scale). The purpose of their analysis was to see whether distinct patterns or trajectories of sleep disturbances existed in this population, and what would predict group membership to a particular trajectory.
The results from the study found 4 distinct groups across the deployment cycle. About 62% of the sample were classified as resilient sleepers. This particular group reported low levels of sleep complaints prior, during, and after the service member’s deployment. In addition, the resilient group was characterized by low or non-problematic alcohol use, fewer family stressors, more positive communication and relationship satisfaction, and low negative emotionality. However, Miller et al (2017) also found that 29% of their sample reported a worsening of sleep complaints over the course of deployment. These individuals were classified into two groups, chronic poor sleepers and deployment onset of sleep problems. The chronic poor sleepers were identified by higher levels of pre-deployment depression and family stressors, as well as an increase in depressive symptoms during the deployment. The deployment onset of sleep problems were characterized by higher rates of pre-deployment family stressors, and increase in depression and alcohol use during deployment. It was noted overall, pre-deployment family stressors and an increase in depressive symptoms during deployment were significantly related to sleep problems for at-home partners regardless of the group. Finally, 9% of the authors sample were identified as a group that improved their sleep functioning over the course of deployment. These individuals where characterized by high pre-deployment sleep related complaints, negative emotionality, depression and family stressors. However, the authors also found that this group had lower levels of negative communication that could have possible served as a protective factor during the course of deployment.
The study conducted by Miller et al (2017) is an important step forward to understanding sleep functioning of at-home partners across the deployment cycle. We know that there are several things that can affect a person’s sleep and that a person’s sleep functioning can have an important effect on multiple health domains (i.e., cognitive, psychological, physical, etc.). The authors provide an important contribution to the literature by providing an understanding of the different trajectories of sleep functioning for at-home partners, and what specific characteristics are associated with more problematic sleep complaints across the deployment cycle. Future research can benefit from using objective measures of sleep functioning and including more demographic information in the analyses (e.g., gender, race, relationship status, living with children, how many deployments have they experienced, etc.) to help identify importance characteristics associated with particular sleep functioning trajectories.
Recommendations
- The results of this study suggest that agencies or programs seeking to help at-home partners dealing with military deployments should inquire about or assess sleep functioning.
- At-home partners that screen positive for sleep related problems, mental health problems (e.g., depression, problematic alcohol use), relationship and communication problems pre-deployment should be referred to appropriate resources to prevent symptoms from getting worse over the deployment cycle.
- Agencies or programs working with family members dealing with military deployments should be aware that increased depressive symptoms and alcohol use are risk factors for poor sleep functioning.
- The Insomnia Severity Index is a brief 7 item that is available at for free https://www.myhealth.va.gov/mhv-portal-web/insomnia-severity-index It is a validated measure, extensively used in research that can help screen for sleep related problems.
- For more information about the Readiness and Resilience initiative sponsored by the Army you can go to http://www.army.mil/readyandresilient/
Timothy Rogers, Ph.D., is a Deployment Behavioral Health Psychologist at Joint Base San Antonio-Lackland Texas
Reference:
Miller, K. E., Koffel, E., Kramer, M.D., Erbes, C. R., Arbisi, P. A., & Polusny, M. A. (2017). At-home partner sleep functioning over the course of military deployment. Journal of Family Psychololgy. Advance online publication. http://dx.doi.org/10.1037/fam0000262
Miller et al. (2017) conducted a study on the sleep functioning of at-home partners from the Readiness and Resilience in National Guard Soldiers (RINGS-2) project. The RINGS-2 project is a prospective longitudinal study of National Guard soldiers deployed to Iraq/Kuwait in 2011-2012. This is an important study because despite existing literature indicating deployments having negative effects on the health of military spouses, there has been limited research focused specifically on sleep functioning changes across the deployment cycle. Learning more about sleep related difficulties across the deployment cycle for at-home partners can help to better identify potential risk factors and generate ideas for prevention and intervention efforts.
The authors collected data from spouses or cohabiting partners (N = 686) at four time intervals: 1) 2-5 months prior to the service member’s deployment, 2) 4 months into the deployment, 3) 8 months into the deployment, and 4) 2-3 months after the service member returned from deployment. For this study, participants completed multiple measures to assess not only sleep related complaints (i.e., two items from the PHQ-8 and one item from the PCL-C), but a multitude of others factors that could interfere with their sleep functioning: negative emotionality (i.e., 20 item scale from the Personality Psychopathology Five Scales (PSY-5) of the MMPI-2RF), a depression screener (i.e., PHQ-8), a brief alcohol screening measure (i.e., AUDIT), relationship satisfaction (i.e., 7 item measure, Dyadic Adjustment Scale-7), a brief survey of family stressors (i.e., 14 items, Deployment Risk and Resiliency Inventory-2), and a brief assessment of negative communication (i.e., 5 items, Communication Danger Signs Scale). The purpose of their analysis was to see whether distinct patterns or trajectories of sleep disturbances existed in this population, and what would predict group membership to a particular trajectory.
The results from the study found 4 distinct groups across the deployment cycle. About 62% of the sample were classified as resilient sleepers. This particular group reported low levels of sleep complaints prior, during, and after the service member’s deployment. In addition, the resilient group was characterized by low or non-problematic alcohol use, fewer family stressors, more positive communication and relationship satisfaction, and low negative emotionality. However, Miller et al (2017) also found that 29% of their sample reported a worsening of sleep complaints over the course of deployment. These individuals were classified into two groups, chronic poor sleepers and deployment onset of sleep problems. The chronic poor sleepers were identified by higher levels of pre-deployment depression and family stressors, as well as an increase in depressive symptoms during the deployment. The deployment onset of sleep problems were characterized by higher rates of pre-deployment family stressors, and increase in depression and alcohol use during deployment. It was noted overall, pre-deployment family stressors and an increase in depressive symptoms during deployment were significantly related to sleep problems for at-home partners regardless of the group. Finally, 9% of the authors sample were identified as a group that improved their sleep functioning over the course of deployment. These individuals where characterized by high pre-deployment sleep related complaints, negative emotionality, depression and family stressors. However, the authors also found that this group had lower levels of negative communication that could have possible served as a protective factor during the course of deployment.
The study conducted by Miller et al (2017) is an important step forward to understanding sleep functioning of at-home partners across the deployment cycle. We know that there are several things that can affect a person’s sleep and that a person’s sleep functioning can have an important effect on multiple health domains (i.e., cognitive, psychological, physical, etc.). The authors provide an important contribution to the literature by providing an understanding of the different trajectories of sleep functioning for at-home partners, and what specific characteristics are associated with more problematic sleep complaints across the deployment cycle. Future research can benefit from using objective measures of sleep functioning and including more demographic information in the analyses (e.g., gender, race, relationship status, living with children, how many deployments have they experienced, etc.) to help identify importance characteristics associated with particular sleep functioning trajectories.
Recommendations
- The results of this study suggest that agencies or programs seeking to help at-home partners dealing with military deployments should inquire about or assess sleep functioning.
- At-home partners that screen positive for sleep related problems, mental health problems (e.g., depression, problematic alcohol use), relationship and communication problems pre-deployment should be referred to appropriate resources to prevent symptoms from getting worse over the deployment cycle.
- Agencies or programs working with family members dealing with military deployments should be aware that increased depressive symptoms and alcohol use are risk factors for poor sleep functioning.
- The Insomnia Severity Index is a brief 7 item that is available at for free https://www.myhealth.va.gov/mhv-portal-web/insomnia-severity-index It is a validated measure, extensively used in research that can help screen for sleep related problems.
- For more information about the Readiness and Resilience initiative sponsored by the Army you can go to http://www.army.mil/readyandresilient/
Timothy Rogers, Ph.D., is a Deployment Behavioral Health Psychologist at Joint Base San Antonio-Lackland Texas
Reference:
Miller, K. E., Koffel, E., Kramer, M.D., Erbes, C. R., Arbisi, P. A., & Polusny, M. A. (2017). At-home partner sleep functioning over the course of military deployment. Journal of Family Psychololgy. Advance online publication. http://dx.doi.org/10.1037/fam0000262