The Army's Performance Triad -- sleep, diet and exercise -- aims to keep Soldiers fit to fight by maintaining three fundamentals that position Soldiers for optimal performance.

Fort Knox health experts have voiced concerns that underrating one of the three could be short-circuiting the whole system.

"Sleep is absolutely undervalued [by the typical Soldier] in the Performance Triad, but it is foundational to [diet and exercise]," said Deborah Reed, an internal behavioral health consultant for Ireland Army Health Clinic. "Soldiers think that exercise and food choices are more important, and they don't see that sleep is vital to both. They are all equally important, but they are not viewed as equally important."

Brent Newell, a health educator with the Fort Knox Army Wellness Center, said the importance of rest is overlooked because of America's on-the-move culture.

"The whole 'go-go-go faster' pace is okay, but [people] have to realize there's a trade-off," Newell said. "The more you work your body, the more rest you need to repair it. There is a balance you have to find to [live] healthy."

Newell said maintaining a constantly high operational tempo doesn't allow the body to heal.

"We have to have that natural cycle and sleep is an essential part of that; it's how the body repairs itself," said Newell. "It's all connected. … Our bodies benefit from movement, but our minds benefit from stillness. Both movement and stillness need to be balanced."

Reed said she believes a person's natural sleep cycle is disturbed by the stresses of modern living.
"It perpetuates itself," Reed said. "You get to bed late because you're overstimulated with the coffee and energy drinks you drank to wake you up because you're so tired from lack of sleep."

"As a society, we've forgotten how to relax," she continued "We've got an internet superhighway running through our heads all the time, with a 24-hour news cycle and [electronic] devices to give us entertainment anywhere and anytime we want it."

She warned that Soldiers may have it worse than most because of their hectic and irregular schedules.

"The early hours with [physical training] most mornings, having [charge of quarters] duty, working late, sleeping in the field and deploying to austere environments break up the sleep routine," Reed said. "Sometimes, they can't sleep when they return [from deployment] because they're still hypervigilant because they've been in that fight-or-flight environment so long."

Reed said the differences between soldiering in a garrison environment and a deployed environment has required the Army to put out two schools of thought on the matter, depending on the situation.

According to an article put out by Army Medicine titled "10 Effective Sleep Habits for Adults," healthy sleep habits that promote optimal sleep duration and quality are important for everyone.

They include maintaining a regular routine with fixed wake-up and bedtimes, creating a comfortable sleeping environment complete with temperature control and removal of distractions from the bedroom, and stopping caffeine at least six hours before bed.

Napping is also discouraged unless safety is a concern. In that case, a short 30-60 minute nap will take the edge off of sleepiness.

"Ideally, you want to stay awake long enough that you'll go to sleep quickly and sleep through the night. Naps disrupt that sleep drive," Reed said, "It is not preferred; Soldiers can't keep that up for long, but they have to sleep to function."

Another Army Health pamphlet, "Sleep Tactics for the Professional Soldier Athlete: Sustained Operations," states that combat operations can create an environment where inadequate sleep is the norm and where it is mission critical to make sleep a top priority. However, the pamphlet also recommends napping "as much as possible" to overcome sleep distractors and to ensure a cumulative 7-8 hours of sleep every 24 hours if a continuous night's sleep is unattainable.

Newell said he's seen what a lack of sleep routine can do, and he posits that other methods might be learned to promote rest in an adverse environment.

"Being a veteran myself, I've witnessed both sides, and there's a lack of education about simple breathing and stillness techniques that can promote sleep and recovery," Newell said. "Sleep can be wildly interfered with due to overuse of the body or the mind, or both. These stressors are the biggest hindrances to sleep, but a stressed or overactive mind may be calmed with restorative practices like meditation breathing or yoga that can promote rest."

Getting sufficient sleep is important enough that Reed said Soldiers should explore various sleep aids and techniques.

"Whatever works for you -- people might find comfort in reducing the fight-or-flight response through weighted blankets, ear foam, sound machines or temperature changes. Anything that comforts you and de-stresses you may help you rest," Reed said. "Shut off your devices early so that you can power down, and stick to techniques that tell your body that you're ready to sleep."