Poor Sleep Quality Contributor to Suicide Ideation, Other Harmful Behaviors

By Antwaun ParrishAugust 22, 2023

(Photo Credit: U.S. Army) VIEW ORIGINAL

Following the release of the Suicide Prevention and Response Independent Review Committee, or SPRIRC, report earlier this year, the Secretary of Defense issued an immediate action directive for commanders to promote mission readiness through healthy sleep.

Why? It’s because research shows that service members who report sleep difficulties are nearly three times more likely to report suicide ideation and other harmful behaviors. While there is not a direct correlation between suicide ideation and suicide attempts or completion, the impact on readiness and Soldier well-being is concerning.

As a result, the Secretary of Defense’s immediate action directive requires commanders to ensure Soldiers’ duty schedule allows for seven to eight hours of sleep per 24-hour period, in accordance with DoD Instruction 1010.10 and SPRIRC report recommendation 5.32. In addition, commanders are to minimize shift change frequency to minimize sleep disruption.

DoDI 1010.10 provides information for leaders and is intended to help prevent and mitigate the effects of sleep deprivation among service members to help them obtain adequate sleep by:

•        Encouraging the use of behavioral strategies to improve sleep quantity and quality, such as the use of mobile applications to help track sleep or shift work when allowed by operational requirements.

•        Promoting a sleep environment that facilitates healthy sleep, which considers complete darkness, good ventilation, ambient temperatures and low noise levels, and if appropriate, encouraging use of eye masks and earplugs to counteract suboptimal sleep settings.

•        Prioritizing time for optimized sleep hygiene and fatigue prevention measures as mission requirements permit. Some ways to prioritize sleep include committing to at least seven hours of uninterrupted sleep, incorporating at least seven hours of sleep per 24-hour period into duty schedules and planning recovery time of at least two consistent nights of sleep if operational requirements take precedence for any period of seven or more calendar days, including consideration for units to be placed “off cycle” for at least three nights following periods of significant sleep deprivation, to ensure recovery to baseline performance.

According to research studies, sleep disruption is common among service members and is more the rule than the exception, which according to the Pentagon’s 2021 Study on Effects of Sleep Deprivation on Readiness of Members of the Armed Forces, “factors into suicide ideation and behaviors… because insomnia degrades stress reactivity, emotion regulation and the decision-making process.”

Sleep deprivation results in an overactive emotional center of the brain, which is called the amygdala. The amygdala—an almond-shaped mass of gray matter inside each cerebral hemisphere—is the part of the brain involved with experiencing emotions.

“Without sleep, the prefrontal cortex, an area of the brain that is involved in the regulation of our thoughts, behaviors and emotions, is no longer able to keep the amygdala in check,” says Maj. Connie Thomas. “This leads to inappropriate emotional responses, most often negatively biased, to events and interactions.” Because of the cognitive impairment from sleep loss, chronically sleeprestricted individuals do not realize how impaired they are and will believe that they only need, say, four hours of sleep. According to Thomas, “That is because the chronically sleep-restricted brain is not good at self-assessing its need for sleep or the impact of sleep loss on functioning. It is also difficult for leaders to implement certain sleep promoting strategies in different environments, including in the field and deployed setting.” Thomas goes on to say that “Outside of mission constraints, Soldiers may not want to prioritize their sleep over other more desirable things (i.e., social or pleasurable activities) or have difficulty obtaining adequate sleep because of family or personal responsibilities.”

Commanders and leaders have access to resources they can use to ensure their Soldiers understand the importance of proper sleep.

•        Field Manual 7-22 is the most cogent, concise and up-to-date summary of fatigue management information specific to the military.

•        Performance Experts at R2 Performance Centers offer trainings that support healthy sleep habits.

•        The Behavioral Biology Branch has created a series of knowledge products that have been shared with commanders and leaders. These products provide information and interventions to ensure Soldiers get proper sleep. These products are available at: https://wrair.health.mil/Sleep-Resources/.