Trends and factors associated with insomnia and sleep apnea in all United States military service members from 2005 to 2014

Sleep disorders are a critical issue for the military, as they impact operational readiness, personnel health, wellbeing and health-care costs. The incidence of insomnia and obstructive sleep apnea (OSA) are increasing in the United States civilian population, and rates in military personnel exceed those of civilians. Using a comprehensive database, rates of medical encounters for insomnia and OSA were investigated and their associations with various demographic factors examined in the total US military population [1,381,406 +/- 25,123, mean +/- standard deviation (SD) personnel per year] from 2005 to 2014. Encounters for insomnia increased from 16 of 1000 in 2005 to 75 of 1000 in 2014 (372%). Encounters for OSA increased from 44 of 1000 in 2005 to 273 of 1000 in 2014 (517%). Those experiencing the greatest increases in insomnia included women, individuals >= 40 years of age, blacks, senior enlisted personnel and Army personnel compared to other military services. Those experiencing the greatest rates of OSA included men, individuals >= 40 years of age, blacks, senior officers and Army personnel. Rates of insomnia and OSA increased linearly over time (R-2 = 0.95-0.99; P < 0.01) for every subpopulation except those aged <20 years. In response to this epidemic-like increase in sleep disorders, their prevention, identification and aggressive treatment should become a health-care priority of the US military.