Sleep is vital to rest the body and, most importantly, to reset the brain. The brain works hard to provide mental and physical readiness.

Soldiers require at least seven to nine hours of sleep every 24 hours to maintain peak performance, according to Field Manual (FM) 7-22: Holistic Health and Fitness, which is dated October 2020. However, this sleep must be uninterrupted in order for the brain to function at maximum capacity.

Many soldiers try to catch up on sleep over the weekends, but it is not always feasible to pay off sleep debt during ramped-up operating tempo.

The principles of sleep are sleep duration, sleep timing and sleep continuity. By design, humans are awake during the day and asleep at night. One of the unique challenges as a soldier is being able to apply these three principles through Initial Entry Training, routine Army life and deployments. The longer a soldier sleeps, the better their response time and mental acuity. More sleep also helps reduce attention lapses, errors and physical injury.

Sleep continuity positively contributes to a soldier’s cognitive ability, concentration, critical thinking and problem-solving, making decisions, along with mood and resilience to better handle stress.

Optimal Performance

FM 7-22 highlights the importance of sleep as a component of the Army’s Performance Triad of sleep, activity and nutrition in sustaining optimal soldier performance. “The relationship between sleep duration and cognitive readiness (and thus, military effectiveness) is best thought of as a continuum, with more sleep always producing improved performance,” the field manual says. This is a challenge in the Initial Entry Training environment: ensuring training requirements are met while balancing sleep needs in the young trainee population.

In June, 153 Basic Combat Training (BCT) trainees in the 193rd Infantry Brigade at Fort Jackson, South Carolina, were administered a sleep survey, led by one of the authors of this article, with the following results:

• Total hours of sleep are reduced during BCT. Trainees on average get more sleep before they come to basic training. They reported an average of 1.7 hours more sleep before BCT: 8.2 hours of sleep per night prior to BCT, and 6.5 hours of sleep per night during BCT.
• Insomnia sleep onset is less of a problem than insomnia-type awakening throughout the night during BCT. Only 25% of trainees reported difficulty with sleep onset, while 48% reported awakening throughout the night. A common complaint was sleep interruption for fireguard duty.
• Sleep hygiene is improved at BCT. Trainees do not have access to smartphones, tablets or other electronic devices before bedtime. They also do not eat before bedtime, with dinner being served several hours before, and have no access to snacks in the bays.
• Twenty-eight percent of trainees felt lack of sleep impaired performance of graduation requirements, with 18% reporting perceived field exercise impairment and 16% reporting Army Combat Fitness Test impairment.
• Only 5% of trainees reported taking naps during the day, as permitted by their drill sergeant cadre, and as recommended in FM 7-22. This is likely due to the tight BCT schedule and high operating tempo during daylight hours.
• Sixty-seven percent of trainees reported not feeling fully rested upon awakening. Factors contributing to this response likely include a much earlier start time to the day than most had experienced previously: 4:30 a.m. was the most common wake time.
• Twenty-nine percent of trainees reported experiencing nightmares during BCT. Stress and anxiety over training events likely contributed to this.
• Trainees are not allowed alcohol or nicotine use at BCT, and none reported violating these policies.

Time for a Nap

Closing the gap between average reported hours of trainee sleep (6.7 hours) and ideal total sleep duration could likely be best achieved by pushing for a 30-minute nap at some point in the afternoon on training days when the BCT training calendar can accommodate it. This would follow the recommendation as stated in FM 7-22: “Most Soldiers need 7 to 9 hours of sleep every 24 hours to maximize health and sustain performance.”

Trainees are often waiting for another company or platoon to complete a training exercise and could nap during that time if permitted by drill sergeants. Per FM 7-22: “For those able to take advantage of it, the afternoon dip provides an opportunity for obtaining good quality daytime sleep to help pay down any existing sleep debt. Soldiers can generally take these naps without significantly disrupting the circadian rhythm of alertness—provided that the naps are not so long or so frequent that they begin to impair the ability to initiate sleep at night.”

This would likely be a better option than attempting to change the practice of fireguard, which is required both to maintain close observation and control of the trainee population and also to serve as a proxy for determining deployment readiness where sleep deprivation may be a common stressor.

In addition, the practice of taking naps would serve soldiers well on future field exercises, deployments and operational exercises requiring less than ideal night sleep cycles.

Trainees should be allowed to take naps during the afternoon when it does not interfere with training in order to comply with sleep readiness and promote better judgment, decision-making and situational awareness. This recommendation was presented to battalion and brigade command team leaders at Fort Jackson, who agreed with the idea of maximizing trainee sleep. Specific changes are pending further evaluation.

Furthermore, sleep hygiene and nap recommendations have been integrated into the U.S. Army Training and Doctrine Command Organic Medical Support trainee medical brief administered in the first two weeks of every training cycle. Emphasis is placed on trainee education regarding the importance of maintaining good sleep hygiene, avoiding excess alcohol and nicotine use, practicing good diet and nutrition, and not falling into bad habits at their follow-on duty assignments.

Improving sleep readiness fundamentals will build enhanced mental sharpness and resilience in the field and during deployment in order to support operational goals.

_____________________________________________

When to Seek Help

A soldier who has persistent sleep problems despite generally good sleep habits and an adequate sleep environment might want to seek expert help, according to Field Manual 7-22: Holistic Health and Fitness. Schedule an appointment with a health care provider if you have persistent daytime sleepiness, difficulty staying asleep, difficulty falling asleep, or disturbance from a sleeping partner who snores and/or gasps at night.

_____________________________________________

* * *

Capt. Michael Gagliano is the battalion physician assistant at the U.S. Army Training and Doctrine Command Organic Medical Support, 2nd Battalion, 13th Infantry Regiment, 193rd Infantry Brigade, Fort Jackson, South Carolina. Previously, he served as the field artillery battalion physician assistant with the 2nd Battalion, 20th Field Artillery Regiment, Fort Sill, Oklahoma. He deployed to Korea with the 75th Fires Brigade Field Artillery (Multiple Launch Rocket System). He has a master’s degree in physician assistant studies from the University of Nebraska Medical Center.

Maj. Kelly Guerra is the senior physician assistant at Headquarters, First Army, Rock Island Arsenal, Illinois. Previously, she was the officer in charge, U.S. Army Medical Recruiting Station, Valencia, California. She has deployed to Africa. She has a master’s degree in physician assistant studies from the University of Nebraska Medical Center and holds a certification in aerospace medicine.