Abstract

Abstract Introduction Military service is associated with a number of occupational stressors, including non-conducive sleeping environments, shift schedules, and extended deployments overseas. Service members who undergo combat deployments are at increased risk for mental health and sleep difficulties. Bidirectional associations between sleep and mental health difficulties are routinely observed, but the directional association of these difficulties from one deployment to the next has not been addressed. The purpose of this study was to examine whether residual sleep problems or mental health difficulties after a 12-month period of reset operations following an initial deployment were associated with changes in sleep and mental health following a subsequent deployment. Methods Data from 74 U.S. Soldiers were case-matched across three time points. Participants were assessed 6 months (T1) and 12 months (T2) following an initial deployment. Participants were then assessed 3 months (T3) following a subsequent deployment. Symptoms of PTSD, anxiety, depression, and sleep difficulties were assessed at all three time points. Results Cross-lagged hierarchical regression models revealed that residual sleep difficulties across the time points uniquely predicted later changes in PTSD and anxiety symptoms, but not depressive symptoms, following a subsequent deployment. Conversely, residual mental health difficulties were not unique predictors of later changes in sleep difficulties. Conclusion These findings suggest that higher levels of residual sleep difficulties 12 months following a prior deployment are associated with larger increases in mental health problems following a subsequent deployment. Moreover, and importantly, the converse association was not supported. Residual mental health difficulties prior to deployment were not associated with changes in sleep difficulties. These data provide a viable target for intervention during reset operations to mitigate mental health difficulties associated with combat deployments. They might also help inform return-to-duty decisions. Support N/A.

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