Each May in my small, coastal New England town, people turn out in droves for the Memorial Day parade. It’s flags and firetrucks and soldiers young and not-so-young, and if we’re extra lucky, plenty of sunshine. It’s a wonderful annual event and a small, but genuine and heartfelt, tribute to the veterans who’ve served our country.

Memorial Day 2018

Life for veterans, as we know, is about a lot more than parades and stateside cheering. Many military veterans face significant and ongoing mental and physical health challenges. Among them are problems with sleep. The rates at which vets struggle with sleep might surprise you.

Active-duty military personnel face many challenges to sleep when they’re deployed, including:

  • Changes to time zones that disrupt sleep-wake cycles
  • Irregular and shifting work hours while on duty (shift workers, both military and civilian, are especially vulnerable to sleep disorders, including sleep apnea)
  • Sleeping in noisy, bright, and crowded environments
  • High levels of stress and the need for hyper-vigilance
  • Separation from family, friends, and social networks
  • Exposure to combat

Sleep problems among members of the military often don’t end when active service does. Veterans remain at dramatically higher risks for sleep problems and sleep disorders than the civilian population. Vets are four times as likely to suffer from obstructive sleep apnea. A recent, large, epidemiological study found that sleep apnea is the most common diagnosed sleep disorder among veterans, followed by insomnia. That same study also found rates of sleep disorders among veterans have soared in recent years, increasing by six times between 2000-2010.

Often, sleep problems among veterans exists alongside other health issues: emotional trauma and physical injury, post-traumatic stress disorder, substance use disorders, and depression. Sleep experts tell us, sleep problems can be a cause, a symptom, and a complicating factor in each of these conditions. When sleep and other health issues continually aggravate each other, the result can be a debilitating cycle that’s tough to break.

The National Sleep Foundation offers some key signs of sleep troubles to watch for in veterans:

Changes to mood. Depression and anxiety often go hand in hand with sleep problems. Mood swings, drop in motivation, a loss of interest in activities, irritability and short-temperedness are all changes that may signal not only a psychological issue, but a sleep issue.

Excessive sleepiness. Feeling very tired during the day, and needing to take frequent naps, are signs a person isn’t getting enough high-quality sleep at night. Excessive sleepiness is one of the  symptoms of sleep-disordered breathing and of sleep apnea.

Presence of nightmares. Post-traumatic stress disorder and sleep problems are closely linked. Research indicates that 90 percent or more people with PTSD also suffer sleep disturbances. Nightmares, as well as anxiety about sleep, are common symptoms of PTSD, as is insomnia.

Snoring. Snoring interferes with restful sleep and is a hallmark sign of sleep apnea. The NSF recommends being alert for not only for snoring, but to other signs of sleep disorders, including trouble falling asleep and staying asleep, drowsiness during the day, and any signs of trouble breathing while sleeping.

Knowing what to watch for can help vets, and the people close to them, get the help they need to sleep better. That’s something to cheer for.

Written by Caitlin Reynolds