title: Perceived insufficient rest or sleep among veterans: Behavioral Risk Factor Surveillance System 2009.
abstract: OBJECTIVE
  Sleep problems are of particular concern among the active duty military population as factors such as inconsistent work hours and deployment may compromise adequate sleep and adversely impact performance. However, few prior studies have investigated whether the prevalence of sleep problems differ between Veterans and demographically similar non-Veterans. The purpose of this study is to investigate whether self-reported insufficient rest or sleep varies in relation to Veteran status and to identify high-risk groups of Veterans.
  
  
  METHODS
  This study used data from the 2009 Behavioral Risk Factor Surveillance System (analyzed in 2011), a state based national telephone survey of non-institutionalized US adults. Insufficient rest was assessed in 411,313 adults aged 21 and older, of whom 55,361 were Veterans. Sleep duration was assessed in 6 states (n = 4,936 Veterans and 30,983 non-Veterans). Model-based direct rate adjustment was used to estimate the prevalence of insufficient rest or sleep while controlling for confounding. Multivariable logistic regression was used to estimate odds ratios of insufficient sleep or rest in subgroups of Veterans.
  
  
  RESULTS
  After multivariable adjustment, insufficient rest or sleep (22.7% vs. 21.1%, p < 0.001) and short sleep duration (< 7 h/night, 34.9% vs. 31.3%, p = 0.026) were more common among Veterans than non-Veterans. When the Veteran group was further divided among newly transitioned (≤ 12 months) and longer-term Veterans (> 12 months), the overall test for a difference was not statistically significant between groups, mainly because there was little difference in sleep between the two groups of Veterans. High-risk Veteran subgroups included those who were 21-44 years of age (vs. 65-74), women, non-whites, current smokers, obese, unable to work, and those in poor health.
  
  
  CONCLUSIONS
  This study suggests that Veterans have a high burden of sleep problems and identifies subgroups that should be targeted to receive interventions and enhanced education regarding insufficient sleep.
authors.affiliation: Department of Preventive Medicine, Madigan Healthcare System, Tacoma, WA, USA. paul.faestel@us.army.mil
authors.forename: Paul M
authors.initials: PM
authors.lastname: Faestel
authors.forename: Christopher T
authors.initials: CT
authors.lastname: Littell
authors.forename: Michael V
authors.initials: MV
authors.lastname: Vitiello
authors.forename: Christopher W
authors.initials: CW
authors.lastname: Forsberg
authors.forename: Alyson J
authors.initials: AJ
authors.lastname: Littman
mesh_terms: D000328:Adult; D000368:Aged; D016022:Case-Control Studies; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011159:Population Surveillance; D015995:Prevalence; D012307:Risk Factors; D012893:Sleep Wake Disorders / Q000453:epidemiology* / Q000517:prevention & control; D014481:United States / Q000453:epidemiology; D014728:Veterans / Q000706:statistics & numerical data
keywords: Behavior Risk Factor Surveillance System; Insufficient sleep; Veterans health