Veteran Wellbeing: Insomnia

17 Jul 2020

Story by Georgia Lejeune. This article was originally published in the June 2020 issue of Reveille. It has been adapted for publication here.

A night of tossing and turning, waking frequently and difficulty falling asleep can be disruptive and exhausting enough on its own; however, if irregular sleep is a nightly struggle it may begin to affect your mental health, personal relationships and ability to function effectively during the day.

“Sleep disturbance is one of the most frequently reported complaints among deployed soldiers,” says Associate Professor Andrea Phelps, Deputy Director for Phoenix Australia – Centre for Posttraumatic Mental Health.

“Training and operational requirements disrupt sleep and many personnel learn to not sleep for many hours, to wake up at a moment’s notice and to stay alert and vigilant. Indeed, during deployment, vigilance is important for survival,” Andrea says. “There is also the stress of being away from home and on deployment.”

Although these habits may be useful (and necessary) when on deployment or in training, the effect of sleep deprivation on the mind and body can be serious and in some cases irreversible.

In the short-term, lack of sleep can cause drowsiness which could lead to accidents, memory issues and trouble with concentration.

More serious, long-term effects include a higher risk of developing diabetes (studies indicate a lack of sleep can affect the release of insulin in the body), high blood pressure and heart disease.

“In the longer term,” says Andrea, “sleep disturbance can be a precursor to adjustment difficulties and mental health problems. In particular, sleep disturbance in the early aftermath of trauma has been found to predict the development of PTSD.”

Symptom of Other Stresses

Megan Brown, Community Support Manager for RSL DefenceCare, regularly works with veterans who are experiencing financial stress, family problems, homelessness or anxiety about claims made through the Department of Veterans’ Affairs (DVA).

Although only a small percentage of veterans list insomnia as the initial reason for accessing support from RSL DefenceCare, it’s often linked as a symptom of other stresses – such as poor financial, physical and mental health or sleep apnoea.

“We don’t give enough respect to the importance of sleep,” says Megan. “We think if we don’t get enough sleep then we are just tired as a consequence, but it causes countless physical and mental changes and puts you at a higher risk of dying young.”

Organisations such as RSL DefenceCare can often help alleviate the stress that may be leading to unhealthy sleep patterns (or affecting your ability to sleep).

Megan references instances where RSL DefenceCare has been able to assist with purchasing sleep apnoea machines (when not covered by DVA), paid for boarding of pets so a veteran could attend an inpatient program and housed veterans who have been sleeping rough.

To improve your quality and quantity of sleep, it’s important to assess your current stress levels and pre-sleep habits and make long-term changes if necessary.

“If you are struggling with sleep the kindest thing you can do for yourself and your loved ones is to act on it,” says Megan. “See your GP, talk to someone, start using simple meditation and relaxation measures to improve your sleep and so improve your overall wellbeing.”

Sleep Hygiene

Healthy sleep hygiene relates to the practices and habits that are necessary for a good night’s sleep. Here are some tips for implementing good sleep hygiene into your daily routine:

Avoid caffeine, nicotine and alcohol at least 4–6 hours before bedtime and try to not take naps during the day (or limit them to 30 mins)
Create a sleep ritual by setting yourself a regular bedtime, doing relaxing stretches before bed or reading a book before going to sleep
Sleep when you are sleepy; however, if sleep doesn’t come in 20 mins get out of bed and do something calming or boring until you feel sleepy again
Try not to eat heavy or rich foods before bed as this can trigger indigestion, which can disrupt sleep
Exercise regularly (although not close to bedtime) and get frequent exposure to natural light.

Sleep Resources

Headspace app: the Basics pack gives users a free introduction to meditation and mindfulness. Visit headspace.com/headspace-meditation-app

Calm app: a popular app with many choices including Sleep Stories, sounds and guided and nonguided meditations. Visit calm.com Open Arms’ Sleeping Better program: an educational and skills-based group program helping veterans better understand the sleep process and how to manage their sleep problems. For more information. Visit openarms.gov.au or call 1800 011 046

Beyond Blue’s Beyond Now app: the suicide safety plan app helps users create a plan for when they are feeling suicidal or unsafe. Visit beyondblue.org.au or call 1300 224 636

CBT-i Coach app: developed in partnership with the US Department of Veterans Affairs, the app provides information on cognitive behavioural therapy and tips for creating positive sleep routines, visit www.ptsd.va.gov/appvid/mobile/cbticoach_app_ public.asp