Abstract

Introduction:Insomnia is a highly prevalent sleep disorder in the US. Among the military population, 41% of active duty service members reported less than 5 hours sleep per night, and there was nearly a 20-fold increase in incidence of insomnia among service members between 2000 and 2009. Given that most soldiers with insomnia seek initial treatment in the primary care setting, an understanding of soldiers' treatment expectations and preferences may contribute to treatment success. This study examines soldiers' perspectives on behavioral insomnia treatment in the primary care setting. Methods:This was a cross-sectional survey study conducted at two outpatient clinic waiting areas in a military treatment facility. The survey assessed soldiers' experience of insomnia, treatment expectations and preferences, and willingness to practice behavioral techniques. Participation was voluntary and responses were anonymous. Results:Two hundred active duty service members (177 males; mean age = 29 years) completed the survey. More than 40% of the respondents reported trouble falling or staying asleep on most days during a typical week; the average sleep time reported was 5.7 hours (SD = 1.4) during a 24-hour period over the previous 30 days. More than 80% of the respondents indicated interest in learning behavioral skills to sleep better, in being taught good sleep habits, or in getting assistance with developing and sticking to a behavioral treatment plan. Willingness to practice behavioral techniques was moderately strong. Fifty-nine percent of the respondents indicated preference for behavioral treatment only or behavioral first and then medications. Discussion:Cognitive-behavioral treatment for insomnia is an alternative to short-term sedative-hypnotic treatment. Soldiers' interest and willingness to practice behavioral sleep techniques are strong. Primary care providers should move beyond providing sleep hygiene by adding education on ways to strengthen the bed and sleep association and to establish a consistent and regular sleep-wake schedule.

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