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Rawcliffe AJ, Tyson H, Hinde K, Jacka K, Holland R, Chapman S, Roberts AJ. Sleep duration and perceptions of sleep quality in British Army recruits during basic training - an observational analysis. Front Neurol 2024; 15:1321032. [PMID: 38426172 PMCID: PMC10903264 DOI: 10.3389/fneur.2024.1321032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Accepted: 01/25/2024] [Indexed: 03/02/2024] Open
Abstract
Introduction Sleep is critical to the health, wellbeing and performance of military personnel during basic training. This two-part study evaluated sleep-wake patterns and sleep disturbances in junior soldiers (JS) and infantry recruits in Autumn 2021 (study 1), and non-infantry recruits in spring 2022 (study 2). Methods During studies 1 and 2, validated wearable technology combined with a sleep diary was used to quantify sleep-wake indices, sleep disturbances and perceptions of sleep quality. Sleep diary data was analysed descriptively. A series of repeated-measures ANOVAs examined differences in objective sleep-wake indices. Correlation analysis determined associations between time in bed (TIB) and total sleep time (TST). Results Significant (p < 0.05) differences in most sleep-wake indices were observed between weeks of basic training for all cohorts. Strong positive correlations between TIB and TST were observed for each cohort across basic training (r = 0.681 - 0.970, p < 0.001), with longer TST associated with greater TIB. The mean±SD sleep duration (hours and mins [hm]) for JS (06:22 ± 00:27hm), non-infantry (05:41 ± 00:47hm) and infantry (05:46 ± 00:34hm) recruits across basic training was consistently below national recommendations. The mean±SD bed and wake times for JS (bedtime: 23:01 ± 00:32hm; awake: 05:34 ± 00:10hm), non-infantry (bedtime: 23:38 ± 01:09hm; awake: 04:47 ± 00:58hm), and infantry (bedtime: 23:13 ± 00:29hm; awake: 05:38 ± 00:26hm) recruits varied across weeks of basic training, with over 80% reporting "fairly bad" or "very bad" sleep quality and frequent periods of "dozing off" during daytime activity. The most commonly reported sleep disturbing factors identified during basic training involved: late-night military admin (e.g., ironing, boot cleaning, kit set up etc), early morning wake times, extraneous noise, light and hot room temperatures within the primary sleeping environment, bed/mattress discomfort, muscle soreness and feelings of stress and anxiety. Discussion/Conclusion Our findings contribute to the existing evidence that long-term sleep loss is pervasive during initial military training programmes. The average sleep durations indicate chronic and unrecoverable sleep loss which would be expected to significantly impair physical and cognitive military performance, and increase the risk of injury, illness and attrition rates during basic training. Changes in the design and scheduling of basic training programmes to enable, at the least, minimum sleep recommendations to be met, and to improve sleep hygiene in the primary sleeping environment are warranted.
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Affiliation(s)
- Alex J. Rawcliffe
- Army Recruit Health and Performance Research, Medical Branch, HQ Army Recruiting and Initial Training Command, Ministry of Defence, Upavon, United Kingdom
- Faculty of Science and Engineering, Anglia Ruskin University, Cambridge, United Kingdom
| | - Hayley Tyson
- Army Recruit Health and Performance Research, Medical Branch, HQ Army Recruiting and Initial Training Command, Ministry of Defence, Upavon, United Kingdom
| | - Katrina Hinde
- Human Sciences Group, Defence Science and Technology Laboratory, Salisbury, United Kingdom
| | - Kimberley Jacka
- Army Recruit Health and Performance Research, Medical Branch, HQ Army Recruiting and Initial Training Command, Ministry of Defence, Upavon, United Kingdom
| | - Rachel Holland
- Army Recruit Health and Performance Research, Medical Branch, HQ Army Recruiting and Initial Training Command, Ministry of Defence, Upavon, United Kingdom
| | - Shaun Chapman
- Army Recruit Health and Performance Research, Medical Branch, HQ Army Recruiting and Initial Training Command, Ministry of Defence, Upavon, United Kingdom
- Cambridge Centre for Sport and Exercise Sciences, School of Psychology and Sport Science, Anglia Ruskin University, Cambridge, United Kingdom
| | - Andrew J. Roberts
- Army Recruit Health and Performance Research, Medical Branch, HQ Army Recruiting and Initial Training Command, Ministry of Defence, Upavon, United Kingdom
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LaGoy AD, Kubala AG, Seech TR, Jameson JT, Markwald RR, Russell DW. Steps toward developing a comprehensive fatigue monitoring and mitigation solution: perspectives from a cohort of United States Naval Surface Force officers. SLEEP ADVANCES : A JOURNAL OF THE SLEEP RESEARCH SOCIETY 2024; 5:zpae008. [PMID: 38425454 PMCID: PMC10904103 DOI: 10.1093/sleepadvances/zpae008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Revised: 01/12/2024] [Indexed: 03/02/2024]
Abstract
Study Objectives This study analyzed fatigue and its management in US Naval Surface Force warships, focusing on understanding current practices and barriers, and examining the influence of organizational and individual factors on managing chronic fatigue. Furthermore, this study explored the impact of organizational and individual factors on fatigue management. Methods As part of a larger study, 154 naval officers (mean ± standard deviation; 31.5 ± 7.0 years; 8.8 ± 6.8 years of service; 125 male, and 29 female) completed a fatigue survey. The survey addressed (1) self-reported fatigue, (2) fatigue observed in others, (3) fatigue monitoring strategies, (4) fatigue mitigation strategies, and (5) barriers to fatigue mitigation. Logistic and ordinal regressions were performed to examine the effect of individual (i.e. sleep quality and years in military service) and organizational (i.e. ship-class) factors on fatigue outcomes. Results Fatigue was frequently experienced and observed by 23% and 54% of officers, respectively. Of note, officers often monitored fatigue reactively (i.e. 65% observed others nodding off and 55% observed behavioral impairments). Still, officers did not frequently implement fatigue mitigation strategies, citing few operationally feasible mitigation strategies (62.3%), being too busy (61.7%), and not having clear thresholds for action (48.7%). Fatigue management varies across organizational factors, which must be considered when further developing fatigue management strategies. Conclusions Fatigue remains a critical concern aboard surface force ships and it may be better addressed through development of objective sleep and fatigue monitoring tools that could inform leadership decision-making.
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Affiliation(s)
- Alice D LaGoy
- Sleep, Tactical Efficiency, and Endurance Laboratory, Warfighter Performance Department, Naval Health Research Center, San Diego, CA, USA
- Military and Veterans Health Solutions, Leidos, Inc., San Diego, CA, USA
| | - Andrew G Kubala
- Sleep, Tactical Efficiency, and Endurance Laboratory, Warfighter Performance Department, Naval Health Research Center, San Diego, CA, USA
- Military and Veterans Health Solutions, Leidos, Inc., San Diego, CA, USA
| | - Todd R Seech
- Commander, Naval Surface Force, U.S. Pacific Fleet, Coronado, CA, USA
| | - Jason T Jameson
- Sleep, Tactical Efficiency, and Endurance Laboratory, Warfighter Performance Department, Naval Health Research Center, San Diego, CA, USA
- Military and Veterans Health Solutions, Leidos, Inc., San Diego, CA, USA
| | - Rachel R Markwald
- Sleep, Tactical Efficiency, and Endurance Laboratory, Warfighter Performance Department, Naval Health Research Center, San Diego, CA, USA
| | - Dale W Russell
- Commander, Naval Surface Force, U.S. Pacific Fleet, Coronado, CA, USA
- Department of Psychiatry, Uniformed Services University of the Health Sciences, Bethesda, MD, USA
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Laroche MA, Chassé É, Théoret D, Lalonde F, Comtois AS. Assessment of Training Load, Sleep, Injuries, and Operational Physical Performance During Basic Military Qualification. Mil Med 2023; 188:e2018-e2025. [PMID: 36355828 DOI: 10.1093/milmed/usac334] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Revised: 09/08/2022] [Accepted: 10/15/2022] [Indexed: 02/17/2024] Open
Abstract
INTRODUCTION Optimizing training load (TL) and sleep is essential to maximize physical performance and prevent musculoskeletal injuries (MSKIs) for Canadian forces recruits during the 10-week basic military qualification (BMQ) course. The purpose of this study was to assess the TL, sleep duration, the occurrence of MSKIs during the BMQ, and the operation fitness performance during the BMQ. MATERIALS AND METHODS Forty Canadian recruits, eight females and 32 males, (age 24 ± 5 years; height 176.4 ± 10.4 cm), were monitored with an accelerometer (GENEActiv) on their wrist between weeks 1 and 9 to evaluate the TL and sleep duration. During weeks 2 and 10, the recruits completed an operational fitness evaluation. Injury surveillance was performed over 10 weeks. RESULTS TL intensity was significantly different (P = 0.0001) from week to week. The weekly average total time of moderate and vigorous physical activity was 189.7 ± 48.1 min and 44.7 ± 15.2 min, respectively. The average sleep duration was 5.4 ± 0.4 h per night and decreased to 4.2 h ± 0.4 during field exercises. A significant difference in sleep duration was observed between recruits with and without a MSKI. The recruits accumulated a total of 95 days under medical restrictions with an average of 3.8 consecutive days. The VO2peak estimated from the Fitness for Operational Requirements of Canadian Armed Forces Employment job-based simulation test significantly improved from weeks 2 to 10 (pre, 47.1 ± 6.3; post: 50.2 ± 5.8; P = 0.001). CONCLUSIONS TL is of high magnitude and varies from week to week. The reported mean sleep duration per week may perhaps negatively impact the occurrence of MSKI. No significant improvement was detected in operational fitness by the end of the BMQ.
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Affiliation(s)
- Marie-Andrée Laroche
- Personnel Support Program, Canadian Forces Leadership and Recruit School, Richelain, QC J0J 1R0, Canada
- Department of Exercise Sciences, Faculty of Sciences, Université du Québec à Montréal, Montréal, QC H2X 3Y7, Canada
| | - Étienne Chassé
- Human Performance Research and Development, Canadian Forces Morale and Welfare Services, Ottawa, ON K1J 1J7, Canada
| | - Daniel Théoret
- Human Performance Research and Development, Canadian Forces Morale and Welfare Services, Ottawa, ON K1J 1J7, Canada
| | - François Lalonde
- Department of Exercise Sciences, Faculty of Sciences, Université du Québec à Montréal, Montréal, QC H2X 3Y7, Canada
| | - Alain-Steve Comtois
- Department of Exercise Sciences, Faculty of Sciences, Université du Québec à Montréal, Montréal, QC H2X 3Y7, Canada
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Bulmer S, Corrigan SL, Drain JR, Tait JL, Aisbett B, Roberts S, Gastin PB, Main LC. Characterising Psycho-Physiological Responses and Relationships during a Military Field Training Exercise. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:14767. [PMID: 36429484 PMCID: PMC9690080 DOI: 10.3390/ijerph192214767] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Revised: 10/28/2022] [Accepted: 11/01/2022] [Indexed: 06/16/2023]
Abstract
UNLABELLED Over a 15-day period, that included an eight-day field trial, the aims of this study were to (1) quantify the physical workload, sleep and subjective well-being of soldiers in training; (2a) Explore relationships between workload and well-being, and (2b) sleep and well-being; (3) Explore relationships between workload, sleep, and well-being. METHODS Sixty-two Combat Engineer trainees (59 male, 3 female; age: 25.2 ± 7.2 years) wore an ActiGraph GT9X to monitor daily energy expenditure, physical activity, and sleep. Rating of perceived exertion (RPE), sleep quality, and fatigue were measured daily, subjective well-being was reported days 1, 5, 9, 13 and 15. Multi-level models were used for the analysis. RESULTS Well-being was affected by a combination of variables including workload, subjective sleep quality, sleep duration, and sleep efficiency. RPE and subjective sleep quality were consistently significant parameters within the models of best fit. CONCLUSIONS Perceptions of well-being were lower during the field training when physical workload increased, and sleep decreased. Energy expenditure was comparatively low, while daily sleep duration was consistent with field training literature. Subjective assessments of workload and sleep quality were consistently effective in explaining variations in well-being and represent an efficient approach to monitor training status of personnel.
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Affiliation(s)
- Sean Bulmer
- Deakin University, Centre for Sport Research, School of Exercise and Nutrition Sciences, Geelong, VIC 3220, Australia
| | - Sean L. Corrigan
- Deakin University, Centre for Sport Research, School of Exercise and Nutrition Sciences, Geelong, VIC 3220, Australia
| | - Jace R. Drain
- Defence Science and Technology Group, Fisherman’s Bend, Melbourne, VIC 3207, Australia
| | - Jamie L. Tait
- Deakin University, Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Geelong, VIC 3220, Australia
| | - Brad Aisbett
- Deakin University, Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Geelong, VIC 3220, Australia
| | - Spencer Roberts
- Deakin University, Centre for Sport Research, School of Exercise and Nutrition Sciences, Geelong, VIC 3220, Australia
| | - Paul B. Gastin
- La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Bundoora, VIC 3086, Australia
| | - Luana C. Main
- Deakin University, Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Geelong, VIC 3220, Australia
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Factors Predicting Training Delays and Attrition of Recruits during Basic Military Training. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19127271. [PMID: 35742522 PMCID: PMC9223722 DOI: 10.3390/ijerph19127271] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Revised: 06/09/2022] [Accepted: 06/09/2022] [Indexed: 01/22/2023]
Abstract
Ensuring a balance between training demands and recovery during basic military training (BMT) is necessary for avoiding maladaptive training responses (e.g., illness or injury). These can lead to delays in training completion and to training attrition. Previously identified predictors of injury and attrition during BMT include demographic and performance data, which are typically collected at a single time point. The aim of this study was to determine individual risk factors for injury and training delays from a suite of measures collected across BMT. A total of 46 male and female recruits undertaking the 12-week Australian Army BMT course consented to this study. Injury, illness, attrition, and demographic data were collected across BMT. Objective measures included salivary cortisol and testosterone, step counts, cardiorespiratory fitness, and muscular endurance. Perceptions of well-being, recovery, workload, fatigue, and sleep were assessed with questionnaires. Baseline and mean scores across BMT were evaluated as predictors of injury and attrition using generalized linear regressions, while repeated-measures ANOVA was used for the group comparisons. From the 46 recruits, 36 recruits completed BMT on time; 10 were delayed in completion or discharged. Multiple risk factors for injury during BMT included higher subjective ratings of training load, fatigue, and stress, lower sleep quality, and higher cortisol concentrations. Higher ratings of depression, anxiety, and stress, and more injuries were associated with a higher risk of delayed completion. Higher concentrations of testosterone and higher levels of fitness upon entry to BMT were associated with reduced risk of injury and delayed completion of BMT. Ongoing monitoring with a suite of easily administered measures may have utility in forewarning risk of training maladaptation in recruits and may complement strategies to address previously identified demographic and performance-based risk factors to mitigate injury, training delays, and attrition.
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