What Causes Sleep Apnea in the Military? Key Service-Related Risks

Sleep apnea is a relatively common yet serious sleep disorder affecting approximately a billion people across the world. It is characterized by interruptions in breathing during sleep due to obstruction or collapse of the upper airways. Common symptoms include loud snoring, poor quality sleep, gasping and choking during sleep, and fatigue the next day. If left untreated, over time, sleep apnea can cause serious health complications, including cardiovascular disease. 

Military personnel and veterans experience sleep apnea at a significantly higher rate than the general population, and this is not coincidental. Factors such as the unique stresses of military life and physical injuries sustained during service all increase the risk of developing sleep apnea. Toxic exposure, particularly in military settings, is also thought to impact sleep apnea. 

The transition from active duty to civilian life often brings challenges, including sleep disorders like obstructive sleep apnea (OSA) and insomnia.

Research reveals that veterans face distinct factors that increase the likelihood of developing sleep apnea. Recognizing these service-related risks is essential for obtaining proper medical care and potentially qualifying for service-connected disability benefits, which can greatly improve your quality of life.

Impact of Stress and Mental Health

Stress can have a significant impact on sleep quality, making it difficult to fall asleep or stay asleep. Chronic stress is a common aspect of military life, which can affect the sleep of service members and veterans. Prolonged stress can disrupt the body's natural sleep-wake cycle and increase the release of stress hormones such as cortisol. This can disrupt sleep regulation and result in broken and poor-quality sleep. 

Research shows that the stress and pressure of military service reduce sleep quality. Stressful life events, like those experienced during deployment, can trigger difficulties in falling or staying asleep. This worsens existing stress, creating a vicious cycle that affects both sleep quality and psychological well-being.

PTSD, Anxiety Disorders and Sleep

Post-Traumatic Stress Disorder (PTSD) is a mental health condition caused by a traumatic experience, affecting those who served in combat roles. Sleep disorders, including frequent nightmares and insomnia, are the most common symptoms of this condition. 

Insomnia affects nearly all Vietnam veterans with PTSD and remains the most commonly reported symptom among veterans from Afghanistan and Iraq. The relationship between PTSD and sleep apnea is complex. Sleep disturbances can contribute to the development and persistence of PTSD symptoms, while PTSD itself can worsen sleep problems.

The Millennium Cohort Study found that 92% of active duty personnel with PTSD reported clinically significant levels of insomnia, compared to 28% of those without PTSD. This highlights the importance of addressing sleep issues as part of PTSD treatment.

Anxiety disorders, often occurring alongside PTSD, significantly disrupt sleep patterns. Treating these mental health issues is vital for improving sleep quality and overall health outcomes for veterans and reducing their risk of sleep disorders. 

Injuries Impacting Breathing Mechanisms

Physical injuries sustained during military service can significantly contribute to the development of sleep apnea. Traumatic brain injuries can affect breathing mechanisms. For example damage to the brainstem, which controls breathing, may result in Central Sleep Apnea (CSA). CSA is characterized by pauses in breathing during sleep due to the brain's inability to send appropriate signals to the muscles responsible for breathing.

Chronic pain also plays a key role in poor quality sleep. Pain can make it challenging to fall asleep and stay asleep, increasing the likelihood of developing sleep apnea. Additionally, the use of pain medications can further complicate sleep health. These medications may relax airway muscles, worsening the symptoms of OSA.

Wearable Gear and Respiratory Strain

The physical demands of military service can put strain on the respiratory system. Military personnel often wear protective equipment such as helmets, body armor, and gas masks, which can limit movement and apply pressure on the neck and throat. Over time, this can lead to anatomical changes and increased airway resistance, making proper breathing during sleep more difficult.

Also, the physical strain from carrying heavy loads and engaging in strenuous activities can cause chronic fatigue and muscle strain. This can affect the muscles involved in breathing, including the diaphragm and upper airway muscles. Over time, this can hurt respiratory function, contributing to the development of sleep apnea.

Irregular Sleep Schedules

Military service often requires irregular and demanding sleep schedules, which can disrupt the body's natural sleep-wake cycle. Deployments, night patrols, and the constant need to remain on high alert result in irregular sleep patterns. Without a consistent sleep schedule, there is an increased likelihood of developing sleep disorders, including sleep apnea.

Even after transitioning back to civilian life, many veterans continue to struggle with sleep issues, finding it difficult to fall asleep or stay asleep. This can worsen existing sleep problems and increase the symptoms and severity of sleep apnea.

Diet and Exercise

The lifestyle of military personnel, particularly their diet and exercise habits, can increase the risk of developing sleep apnea. During deployments, military diets may be high in calories but low in essential nutrients, which can contribute to weight gain and obesity. Obesity is one of the key causes of OSA, as excess weight can narrow airways and increase resistance during breathing.

https://www.sleepquest.com/obesity-and-sleep-apnea-a-bad-combination/

While regular physical activity generally promotes overall health, the intense and often irregular physical demands of military service can produce mixed effects on sleep. For instance, engaging in strenuous physical activity close to bedtime may disrupt sleep quality, while chronic fatigue from prolonged physical exertion can further disturb sleep patterns.

Also, alcohol intake, which is often higher in veterans, can interfere with sleep by causing insomnia, disrupting circadian rhythms, and increasing breathing-related sleep events.

Talk to Your Doctor

Many military personnel and veterans, compared to the general public, suffer from sleep apnea due to chronic stress, PTSD, anxiety, physical injuries, strain, toxic exposure, and lifestyle and environmental factors. 

If you are a veteran experiencing sleep disturbances, it is vital to see your doctor. You may have sleep apnea – and getting a diagnosis will lead to improved sleep and overall health.