Considering we spend over half of our lives sleeping, it’s shocking how much we underestimate the impact lack of sleep can have on our health and wellbeing. Not being able to fall asleep, sustaining quality sleep, getting enough sleep, dealing with broken sleep and waking when you should definitely still be asleep – are all daily challenges for many. 

The health impacts

Severe lack of sleep, defined as sleeping 4 or fewer hours each night over a prolonged time period does more than impact day-to-day alertness, mood and productivity. Severe poor sleep can impair daily functioning for many, and over time, maybe a contributing factor in the development of chronic health issues including mental health disorders, cardiac and gastrointestinal conditions and of course, diagnosable sleep disorders such as insomnia. 

The list of things that can affect our ability to get optimal sleep in the short and long term is endless. It can be as simple as dietary stimulants such as caffeine, alcohol, nicotine or sugary foods, or lifestyle factors like the impact of shift work, environmental stimuli, daylight savings, time zone shifts, jet lag, device use, ageing or coping with major life transitions. There could also be physiological factors like sleep apnoea, chronic pain, or medications affecting the body’s ability to get quality, restful sleep (there is a meaningful difference between sleep quantity and quality).

For others, it’s part of a package deal wrapped up in other health conditions – anxiety, depression, diabetes, chronic fatigue syndrome, dementia, fibromyalgia, pregnancy, menopause, schizophrenia, sleepwalking and – for veterans in particular, post-traumatic stress disorder (PTSD).   

 Given all these potential factors affecting our sleep, it is not uncommon to experience short, temporary periods of poor sleep (days or weeks) across our lives. However, for some people their sleep difficulties may persist and develop into chronic sleep conditions that require professional support or treatment.

Sleep disorders amongst veterans with PTSD

For over 15 years, Gallipoli Medical Research Foundation (GMRF) has been dedicated to investigating the health and wellbeing needs of veterans. A key research project investigated the physical and psychological impact of PTSD on veterans. The broader research indicates up to 90% of veterans with PTSD experience poor sleep, and this can worsen symptoms of PTSD. GMRF’s research found that veterans with PTSD are 2.1 times more likely to have sleep apnea and 3 times more likely to experience nightmares compared to those without PTSD. Both issues contribute heavily to lack of quality sleep in veterans with PTSD. 

This important PTSD research, now published in the Medical Journal of Australia, found that “ … compared to veterans without PTSD, veterans with PTSD had high rates of sleep disorders, such as insomnia, obstructive sleep apnoea (OSA) and nightmares”.

Subsequent to that research, GMRF launched the Veteran Sleep Therapy Study in 2019, sponsored by the Department of Veterans’ Affairs. This study explores suitability and effectiveness of specific treatments for veterans suffering from poor sleep, nightmares and PTSD. Its outcomes will create better pathways for veterans seeking treatment for PTSD and its associated sleep symptoms.  

How to take charge of your own sleep health

Regardless of an individual’s health status, there are a few fundamental behaviour choices that can be made, to establish better sleep practices and improve sleep health.

• Understand your own body rhythm

Support your body clock by going to bed and setting your wake-up alarm for around the same times every day. Establish morning routines around movement and activity and evening routines around resting and winding down. Once you’re up, try to expose yourself to sunlight in daylight hours, get some exercise and try not to nap during the day to play catch up, as this will impact your ability to sleep later that evening.

• Make lifestyle changes where you can

Avoiding sleep-impacting substances like caffeine, nicotine and alcohol in the six hours before bed, and making good dietary choices after sunset can be surprisingly effective for some people. It can also be extremely effective to decide your bedroom is a sanctuary for sleep and relaxation and nothing else. You may need a different mattress, or to buy some bed linen that is gentle on the skin and maintains your ideal body temperature. Lighting that helps you transition into darkness can also be useful. ‘Sanctuary’ also means no TVs and no devices in bed (e.g., some might prefer a traditional alarm clock rather than your phone). Or you could try placing your phone on the other side of the room, out of arm’s reach.

• Health and wellbeing support

Having the right support in place can help you to recognise issues early and ensure you can act quickly if your sleep issues worsen. This could be in the form of close friends, family or a strong social support network, or outsourced to your GP and a psychologist/psychiatrist/therapist. Qualified health professionals may advise the strategies previously mentioned, in addition to customised advice and possibly medication. They may also recommend treatment specific for sleep: e.g., referral for a sleep study assessment for sleep apnoea (OSA); or the gold-standard insomnia treatment Cognitive Behavioural Therapy for Insomnia), or for other health conditions you are dealing with that may be contributing to or resulting from your sleep issues.

The Sleep Health Foundation is a great resource for those experiencing poor sleep. Open Arms also provides resources tailored to the veteran community and can provide more immediate practical assistance. Carry on Victoria has a range of supports available to veterans, their families and the general community looking for further information or treatment options.

If you are a veteran, know a veteran or are a family member of a veteran who is going through difficulties, you can contact the Australian Government’s Department of Veterans’ Affairs for assistance or contact us at Carry On Victoria and we can point you in the right direction.