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. 2016 Jul 1;39(7):1399-410.
doi: 10.5665/sleep.5972.

The National Veteran Sleep Disorder Study: Descriptive Epidemiology and Secular Trends, 2000-2010

Melannie Alexander  1   2 , Meredith A Ray  3 , James R Hébert  1   2   4 , Shawn D Youngstedt  5 , Hongmei Zhang  3 , Susan E Steck  1   2 , Richard K Bogan  6 , James B Burch  1   2   7
Affiliations

The National Veteran Sleep Disorder Study: Descriptive Epidemiology and Secular Trends, 2000-2010

Melannie Alexander et al. Sleep. .

Abstract

Study objectives: A large proportion of individuals affected by sleep disorders are untreated and susceptible to accidents, injuries, long-term sequelae (e.g., risk of cardiovascular disease, cancer, psychiatric disorders), and increased mortality risk. Few studies have examined the scope and magnitude of sleep disorder diagnoses in the United States (US) or factors influencing them. Veterans are particularly vulnerable to factors that elicit or exacerbate sleep disorders.

Methods: This serial cross-sectional study characterized secular trends in diagnosed sleep disorders among veterans seeking care in US Veterans Health Administration facilities over an eleven-year span (FY2000-2010, n = 9,786,778). Electronic medical records from the national Veterans Administration Informatics and Computing Infrastructure database were accessed. Cases were defined using diagnostic codes specified by the American Academy of Sleep Medicine. Age-adjusted annual prevalence was summarized by sex, race, combat exposure, body mass index, and comorbid diagnoses (cardiovascular disease, cancer, mental disorders).

Results: Sleep apnea (47%) and insomnia (26%) were the most common diagnoses among patients with any sleep disorder. There was a six-fold relative increase in total sleep disorder prevalence over the study period. Posttraumatic stress disorder, which tripled over the same time period, was associated with the highest prevalence of sleep disorders (16%) among the comorbid conditions evaluated.

Conclusions: The results indicate a growing need for integration of sleep disorder management with patient care and health care planning among US veterans.

Commentary: A commentary on this article appears in this issue on page 1331.

Keywords: insomnia; military; posttraumatic stress disorder; sleep apnea; veteran.

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Figures

Figure 1
Figure 1
Flowchart of United States veterans who entered the Veterans Health Administration (VHA) system from FY2000 to FY2010.
Figure 2
Figure 2
Age-adjusted prevalence of sleep disorders among United States veterans seeking care through the Veterans Health Administration, FY2000–2010 (n = 9,786,778).
Figure 3
Figure 3
Age-adjusted prevalence of CURRENT PROCEDURAL TERMINOLOGY (CPT) CODES for sleep procedures among United States veterans seeking care through the Veterans Health Administration (FY2000–2010, n = 9,786,778).
Figure 4
Figure 4
Age-adjusted prevalence of sleep disorders by CARDIOVASCULAR DISEASE (CVD) status among United States veterans seeking care through the Veterans Health Administration (FY2000–2010, n = 9,786,778).
Figure 5
Figure 5
Age-adjusted prevalence rate of sleep disorders by CANCER status among United States veterans seeking care through the Veterans Health Administration (FY2000–2010, n = 9,786,778).
Figure 6
Figure 6
Age-adjusted prevalence of sleep disorders by POSTTRAUMATIC STRESS DISORDER (PTSD) status among United States veterans seeking care through the Veterans Health Administration (FY2000–2010, n = 9,786,778).
See this image and copyright information in PMC

Comment in

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