Effect of deployment related experiences on sleep quality of German soldiers after return from an International Security Assistance Force (ISAF) mission to Afghanistan

App-Supported Sleep Coaching: Implications for Sleep Duration and Sleep Quality

OBJECTIVES

The present study evaluated whether completers of a 12-week app-based, personalized text supported sleep coaching program demonstrated improvements in sleep continuity, sleep duration, and reduced use of sleep aids.

METHODS

Data were obtained from Sleep Reset, a 12-week consumer product that offers app-based sleep education and monitoring, along with personalized text-based sleep coaching provided by live coaches. 564 completers were included in the study. Pre-post changes for sleep latency (SL), wake after sleep onset (WASO), number of awakenings (NWAK), total sleep time (TST), sleep efficiency (SE%) and use of "sleep aids" were evaluated. To evaluate whether the program produced meaningful results, the proportion of participants who demonstrated reductions in SL, WASO, and NWAK, and increases in TST and SE% were examined.

RESULTS

Mean SL was reduced by 11 minutes, mean WASO was reduced by 28 minutes, mean SE% increased by 6.6%, and mean TST increased by about 44 minutes. Of those who reported using "sleep aids" during Week 1, 41% no longer used them by week 12. Those with low SE% at baseline demonstrated greater improvements in SL (16.2 vs 5.7mins), WASO (47.3 vs 7.2mins), SE% (11.2% vs 1.6%), and TST (65.3 vs 31.2mins). Those with ≤6 hours of sleep at baseline demonstrated greater improvements in WASO (36.8 vs 22.3mins), SE% (10.1% vs 4.3%), and TST (85.1 vs 25.5mins).

CONCLUSIONS

Participants that completed the app-based, personalized text supported coaching intervention reported subjective improvements in sleep duration and quality that suggest more beneficial effects particularly in those with lower sleep efficiency or sleep duration at baseline. An effective sleep coaching program that utilizes trained sleep coaches with access to board-certified providers, may provide a valuable resource for subclinical populations.

Investigating the impact of terrorist attacks on the mental health of emergency responders: systematic review

BACKGROUND

Terrorist attacks have strong psychological effects on rescue workers, and there is a demand for effective and targeted interventions.

AIMS

The present systematic review aims to examine the mental health outcomes of exposed emergency service personnel over time, and to identify risk and resilience factors.

METHOD

A literature search was carried out on PubMed and PubPsych until 27 August 2021. Only studies with a real reported incident were included. The evaluation of the study quality was based on the Quality Assessment Tool for Quantitative Studies, and the synthesis used the 'Guidance on the Conduct of Narrative Synthesis in Systematic Reviews'.

RESULTS

Thirty-three articles including 159 621 individuals were identified, relating to five different incidents with a post-event time frame ranging from 2 weeks to 13 years. The post-traumatic stress disorder prevalence rates were between 1.3 and 16.5%, major depression rates were between 1.3 and 25.8%, and rates for specific anxiety disorders were between 0.7 and 14%. The highest prevalence rates were found after the World Trade Center attacks. Reported risk factors were gender, no emergency service training, peritraumatic dissociation, spatial proximity to the event and social isolation.

CONCLUSIONS

The inconsistency of the prevalence rates may be attributable to the different severities of the incidents. Identified risk factors could be used to optimise training for emergency personnel before and after catastrophic events. Voluntary repetitive screening of rescue workers for mental health symptoms is recommended.