The use of the Odds Ratio Product (ORP) and self-reported data to detect comorbid insomnia and sleep apnea.

Study Objectives: To evaluate the utility of the Odds Ratio Product (ORP) in differentiating comorbid insomnia and sleep apnea (COMISA) from obstructive sleep apnea (OSA) and chronic insomnia (CIN).

Methods: We retrospectively analyzed 9750 patients in four groups: 1) 1152 controls; 2) 2395 with CIN; 3) 2297 with OSA; and 4) 3906 with COMISA. CIN was defined as difficulty initiating/maintaining sleep with daytime fatigue/sleepiness occurring "often"/"always".

Survey of Resources in Behavioral Sleep Medicine Across the Department of Defense, Defense Health Agency.

Introduction: Insomnia affects approximately 40% of active duty service members and adversely affects health, readiness, and safety. The VA/DoD Clinical Practice Guideline for the management of insomnia recommends cognitive-behavioral treatment of insomnia (CBTI) or its abbreviated version (brief behavioral treatment of insomnia [BBTI]) as the first-line insomnia treatment. The goal of this study was to assess CBTI/BBTI resources at MTFs, perceived facilitators and barriers for CBTI/BBTI, and gaps in these treatments across the Defense Health Agency.

Digital CBTI hubs as a treatment augmentation strategy in military clinics: study protocol for a pragmatic randomized clinical trial.

Background: Chronic insomnia is the most prevalent sleep disorder among military service members, and it compromises readiness, performance, and physical and mental health. Cognitive behavioral treatment for insomnia (CBTI) is the standard of care for the treatment of insomnia recommended by the VA/DoD Clinical Practice Guideline, the American Academy of Sleep Medicine, and the American College of Physicians. CBTI is highly effective but has limited scalability.

Sex differences in US military personnel with insomnia, obstructive sleep apnea, or comorbid insomnia and obstructive sleep apnea.

Study Objectives: The aim of this study was to evaluate sex-related differences in symptoms of sleep disorders, sleep-related impairment, psychiatric symptoms, traumatic brain injury, and polysomnographic variables in treatment-seeking military personnel diagnosed with insomnia, obstructive sleep apnea (OSA), or comorbid insomnia and OSA (COMISA).

Methods: Participants were 372 military personnel (46.2% women, 53.

Associations of smartphone usage patterns with sleep and mental health symptoms in a clinical cohort receiving virtual behavioral medicine care: a retrospective study.

Study Objectives: We sought to develop behavioral sleep measures from passively sensed human-smartphone interactions and retrospectively evaluate their associations with sleep disturbance, anxiety, and depressive symptoms in a large cohort of real-world patients receiving virtual behavioral medicine care.

Methods: Behavioral sleep measures from smartphone data were developed: daily longest period of smartphone inactivity (inferred sleep period [ISP]); 30-day expected period of inactivity (expected sleep period [ESP]); regularity of the daily ISP compared to the ESP (overlap percentage); and smartphone usage during inferred sleep (disruptions, wakefulness during sleep period). These measures were compared to symptoms of sleep disturbance, anxiety, and depression using linear mixed-effects modeling.

A First Look at Childhood Abuse in Women with Obstructive Sleep Apnea.

Women who experienced childhood sexual abuse have higher rates of obesity, a risk factor for obstructive sleep apnea (OSA). We assessed if prior childhood sexual abuse was more common in women with OSA vs. control, with possible mediation by obesity.

Probable trauma associated sleep disorder in post-9/11 US Veterans.

Study Objectives: The purpose of this study was to (1) estimate trauma associated sleep disorder (TASD) prevalence among post-9/11 era veterans and to describe differences in service and comorbid mental health clinical characteristics among individuals with and without probable TASD, and (2) estimate TASD prevalence and characteristics of reported traumatic experiences stratified by sex.

Methods: We used cross-sectional data from the post-deployment mental health study of post-9/11 veterans, which enrolled and collected baseline data from 2005 to 2018. We classified veterans as having probable TASD using self-reported measures: traumatic experiences from the traumatic life events questionnaire (TLEQ) and items from the Pittsburgh sleep quality index with Addendum for posttraumatic stress disorder (PTSD) mapped to TASD diagnostic criteria and ascertained mental health diagnoses (PTSD, major depressive disorder [MDD]) via Structured Clinical Interview for .

Nightmare disorder in active-duty US military personnel.

Study Objectives: Military personnel experience high rates of traumatic experiences. Despite this, few studies have examined the presence of nightmare disorder in military personnel. The primary aim of this study was to examine diagnoses of nightmare disorder across the 4 largest branches of the active-duty US military.

Cognitive Behavioral Therapy for Insomnia Among Active Duty Military Personnel Diagnosed With Obstructive Sleep Apnea.

Introduction: Insomnia and obstructive sleep apnea are common conditions among military service members, with high rates of comorbidity. Although cognitive behavioral therapy for insomnia (CBT-I) has been established as an effective treatment for insomnia, it is unclear whether or not CBT-I is effective among service members with comorbid insomnia and obstructive sleep apnea.

Materials And Methods: This retrospective, observational study examined insomnia outcomes among a group of service member patients (N = 73) with comorbid insomnia and obstructive sleep apnea.

Clinical and polysomnographic features of trauma associated sleep disorder.

Study Objectives: Trauma associated sleep disorder is a proposed parasomnia that develops after trauma with clinical features of trauma related nightmares, disruptive nocturnal behaviors, and autonomic disturbances. The purpose of this case series is to better characterize the clinical and video-polysomnographic features of patients meeting clinical criteria for this proposed parasomnia.

Methods: Semistructured clinical interview and detailed video-polysomnography review of 40 patients.

Performance comparison of peripheral arterial tonometry-based testing and polysomnography to diagnose obstructive sleep apnea in military personnel.

Study Objectives: Obstructive sleep apnea (OSA) is increasingly common among military personnel, but diagnostic capabilities are challenged by limited capability for polysomnography (PSG). We sought to evaluate the diagnostic properties of peripheral arterial tonometry (PAT)-based home sleep apnea testing (HSAT) to accurately identify and classify OSA among active-duty military personnel.

Methods: This study was a retrospective review of all patients suspected of having OSA who completed an initial PAT-based HSAT followed by confirmatory PSG within 120 days.

Guiding principles for determining work shift duration and addressing the effects of work shift duration on performance, safety, and health: guidance from the American Academy of Sleep Medicine and the Sleep Research Society.

Risks associated with fatigue that accumulates during work shifts have historically been managed through working time arrangements that specify fixed maximum durations of work shifts and minimum durations of time off. By themselves, such arrangements are not sufficient to curb risks to performance, safety, and health caused by misalignment between work schedules and the biological regulation of waking alertness and sleep. Science-based approaches for determining shift duration and mitigating associated risks, while addressing operational needs, require: (1) a recognition of the factors contributing to fatigue and fatigue-related risks; (2) an understanding of evidence-based countermeasures that may reduce fatigue and/or fatigue-related risks; and (3) an informed approach to selecting workplace-specific strategies for managing work hours.

STRONG STAR and the Consortium to Alleviate PTSD: Shaping the future of combat PTSD and related conditions in military and veteran populations.

The STRONG STAR Consortium (South Texas Research Organizational Network Guiding Studies on Trauma and Resilience) and the Consortium to Alleviate PTSD are interdisciplinary and multi-institutional research consortia focused on the detection, diagnosis, prevention, and treatment of combat-related posttraumatic stress disorder (PTSD) and comorbid conditions in military personnel and veterans. This manuscript outlines the consortia's state-of-the-science collaborative research model and how this can be used as a roadmap for future trauma-related research. STRONG STAR was initially funded for 5 years in 2008 by the U.

OSA and cardiorespiratory fitness: a review.

Unlabelled: The effects of untreated obstructive sleep apnea (OSA) on cardiopulmonary function remain unclear. Cardiorespiratory fitness (CRF), commonly reflected by VO max measured during cardiopulmonary exercise testing, has gained popularity in evaluating numerous cardiopulmonary conditions and may provide a novel means of identifying OSA patients with the most clinically significant disease. This emerging testing modality provides simultaneous assessment of respiratory and cardiovascular function with results helping uncover evidence of evolving pathology in either organ system.

Guiding principles for determining work shift duration and addressing the effects of work shift duration on performance, safety, and health: guidance from the American Academy of Sleep Medicine and the Sleep Research Society.

Risks associated with fatigue that accumulates during work shifts have historically been managed through working time arrangements that specify fixed maximum durations of work shifts and minimum durations of time off. By themselves, such arrangements are not sufficient to curb risks to performance, safety, and health caused by misalignment between work schedules and the biological regulation of waking alertness and sleep. Science-based approaches for determining shift duration and mitigating associated risks, while addressing operational needs, require: (1) a recognition of the factors contributing to fatigue and fatigue-related risks; (2) an understanding of evidence-based countermeasures that may reduce fatigue and/or fatigue-related risks; and (3) an informed approach to selecting workplace-specific strategies for managing work hours.

Insomnia symptom severity and cognitive performance: Moderating role of APOE genotype.

Introduction: We evaluated whether insomnia symptom severity was associated with cognitive function, and whether this relationship was modified by biomarkers associated with Alzheimer's disease risk.

Methods: We examined insomnia symptoms and neuropsychological performance 3.4 years later in 511 dementia-free Framingham Heart Study participants (62.

Behavioral and Occupational Health in Military Firefighters: An Understudied Population.

To our knowledge, no studies on health conditions in U.S. military firefighters exist.

The Military Service Sleep Assessment: an instrument to assess factors precipitating sleep disturbances in U.S. military personnel.

Study Objectives: Military personnel frequently experience sleep difficulties, but little is known regarding which military or life events most impact their sleep. The Military Service Sleep Assessment (MSSA) was developed to assess the impact of initial military training, first duty assignment, permanent change of station, deployments, redeployments, and stressful life events on sleep. This study presents an initial psychometric evaluation of the MSSA and descriptive data in a cohort of service members.