Comparison of sleep problems and posttraumatic stress disorder associated psychiatric states in military active-duty Army and Navy Personnel in Taiwan

Background: For decades, sleep problems have been proven to link to mental disorders and are independent risk factors for suicidality. But further details in the connections between them in the military are still understudied. In this study, we intended to fill this gap of linkage through by collecting self-reported responses from active-duty soldiers in Taiwan. Methods: In this study, we compared total sleep hours per day, sleep problems, prevalence of relevant psychological factors, and subclinical symptoms of posttraumatic stress disorder (PTSD) among Taiwanese soldiers using responses to Pittsburgh Sleep Quality Index (PSQI) item 5 from 808 Taiwanese soldiers. To examine their associations with each sleep problem, we used logistic regression models through redefining all sleep problems as dichotomous as outcome variables. Results: Compared with the navy, subjects in the army slept significantly fewer hours per day (p < 0.001), experienced significantly more difficulties with daily activities (p < 0.001), and displayed significantly less enthusiasm (p = 0.001). The female soldiers showed significantly more sleep problems than male soldiers, namely, waking up significantly more in the middle of night (p < 0.01), feeling significantly colder (p < 0.05) or significantly hotter (p = 0.001), having significantly more pain (p < 0.05), and having significantly more other reasons (p < 0.01). Samples from the male soldiers reported significantly more problems with enthusiasm in the past month (p < 0.01). After adjusting for interaction between other variables, the greater magnitude of “thwarted belongingness” is significantly more associated with sleep problems caused by pain or other reasons (all p < 0.05). “Perceived burdensomeness” was significantly more negatively related to sleep problems caused by waking up in the middle of the night and coughing or snoring loudly (all p < 0.05). All four subclinical symptoms of PTSD, namely, numbness, re-experience, avoidance, and arousal, affect soldiers' sleep differently. Conclusion: According to this study, Taiwanese Army and Navy soldiers suffer from different psychiatric conditions and sleep disorders depending on their gender. Aside from anxiety and depression, subclinical symptoms of PTSD were also associated with sleep problems, thwarted belongingness, and perceived burdensomeness in the military. The effects of treating sleep problems on suicide prevention in the military, especially among those with subclinical symptoms of PTSD, still require more focused research.