How veterans can put their sleep problems to bed

The average American spends 7.7 hours a night sleeping, or about a third of their lives — if they're lucky.

Adequate sleep is vital, and does everything from regulating the immune system to staving off heart attacks and obesity, to helping you think clearly and creatively and process emotions.

Yet sleep problems are rampant, especially among veterans; up to 40 percent report having trouble sleeping, according to a report on Orange County veterans by the University of Southern California's Center for Innovation and Research on Veterans & Military Families. And it can become more problematic over time, says Dr. Robert S. Rosenberg, a sleep medicine physician and author of "The Doctor's Guide to Sleep Solutions for Stress and Anxiety."

Here are common reasons vets are susceptible, plus tips that can help.

Sleep Apnea
Obstructive sleep apnea (OSA) occurs when, during sleep, the airway relaxes so much that it either partly blocks airflow or totally blocks it. The result: shallow breathing that doesn't deliver enough oxygen or you temporarily stop breathing. The brain eventually realizes what's happening and "wakes up" to fix the problem, but this jars a person out of deep sleep multiple times a night, so they never truly get a restorative night's rest.

OSA, as it turns out, is a growing issue among veterans. While only 5 percent of Americans suffer from sleep apnea, up to 20 percent of veterans do, according to the National Sleep Foundation. And vets with post-traumatic stress disorder (PTSD) or traumatic brain injury have higher incidences, Dr. Rosenberg says.

If you snore excessively, constantly feel sleepy during the day or a partner notices you gasping during sleep, see a doctor. "There are so many great treatments, many of which don't involve drugs," Dr. Rosenberg says. A CPAP machine, for example, gently pushes air into your windpipe, keeping it open.

PTSD, depression and anxiety
"Anxiety and mood disorders are almost universally accompanied by insomnia or the inability to remain asleep," Dr. Rosenberg says. It's a Catch-22, however. "In people with anxiety disorders, the lack of sleep makes it more difficult to treat them," he says. "And studies show that sleep deprived people have trouble decoding emotions." Poor sleep also compounds mood disorder symptoms.

Therapy does help, and the sooner you seek it, the better, Dr. Rosenberg says. So take action if troubling symptoms affect your daily life and normal functioning, including sleep. With anxiety, you may frequently feel worried, uneasy or panicky, even over little things; depression often presents as unshakable sadness, hopelessness or irritability, or you're listless; PTSD can cause recurrent nightmares, flashbacks and a number of other symptoms.

Several organizations in Orange County assist vets in finding counselors and doctors, including Goodwill of Orange County’s Tierney Center for Veteran Services in Tustin. "We easily identify those symptoms and connect vets with one of our partners," says Kathy Copeland, Ph.D., the organization's Vice President of Human Services.

Financial, legal, job-related and other stress
Even if you aren't suffering from a clinical disorder, regular, old-fashioned stress can do a number on your ability to fall and stay asleep. And veterans face plenty of it, especially when transitioning to civilian life. The majority of vets don't have a job lined up when discharged, according to the USC report, and finding one proves more difficult than expected or they're underemployed. Many also don't have stable housing, finances or any experience budgeting, while others are dealing with legal issues.

Trying to overcome those things or simply worrying about them can eat up precious hours and cause a vet to toss and turn.

Unfortunately, the sleep-stress connection can be a chicken-and-egg scenario — and perpetuate a vicious circle, Dr. Copeland says. It can be hard to pinpoint which came first, the stress or sleep issues: Stress disrupts sleep while "not getting enough rest exacerbates all the other difficulties you're experiencing," she says.

Help for vets
You don't have to fix everything yourself; reach out to a local organization like the Tierney Center. There, for example, you're paired with a "navigator" who assesses your situation and helps guide you to and through the right organizations for your needs. The center also provides employment and career services and financial-wellness classes. And members can use the center's fitness center free for three months, Dr. Copeland says. (Exercise is one of the best ways to reduce stress, and has been shown to improve sleep.)

Other, sleep-improving tips may also help, Dr. Rosenberg says:

  • Constructive worrying: "Write down your thoughts and feelings at 5 or 6 p.m., then put them in a desk drawer," Dr. Rosenberg says. This helps keep them out of the bedroom, so to speak.
    A digital detox: Ninety minutes before bed, avoid devices that emit blue light like iPhones, computers and the TV; the light can trick your brain into thinking its daytime, reducing production of sleep-inducing melatonin.
    A calming bedtime routine: "Something as simple as taking a bath or reading a book can be very beneficial," Dr. Rosenberg says.
    Mindfulness meditation: "It has proved to be an excellent tool for veterans, and in general improves people's sleep," he says. While you can search online for specific instructions, simply sitting quietly and focusing on your breath is a good way to start.

Paige Worthy for Goodwill of Orange County

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