Subscribe to RSS
![](/products/assets/desktop/img/oa-logo.png)
DOI: 10.1055/s-0044-1787529
Sleep Quality and Its Predictors in Brazilian Marines
![](https://www.thieme-connect.de/media/10.1055-s-00056804/EFirst/lookinside/thumbnails/10-1055-s-0044-1787529_23jul0007oa-1.jpg)
Abstract
Objectives The objective of this study was to evaluate the quality of sleep and its associated factors in marines (Fuzileiros Navais - FN) of the Brazilian Navy.
Material and Methods The participants included 1,248 military personnel who responded remotely to the following instruments: anamnesis, Pittsburgh Sleep Quality Index, Epworth Sleepiness Scale, International Physical Activity Questionnaire, Eating Habits Scale, and the K10 Questionnaire. Anthropometric information was obtained from a database. Subgroup analysis (good x poor sleep) and regression analysis were performed to verify the factors associated with poor sleep quality.
Results A total of 74.12% of the military were characterized by poor sleep quality. There were differences between sleep quality and sociodemographic, behavioral, and professional factors. Age, being an Officer, and physical activity were protective factors, while living with young children, having more energy in the evening, daytime sleepiness, having problems at work, distress, and regular eating habits were predisposing to poor sleep.
Discussion Marines of the Brazilian Navy have a high prevalence of poor sleep quality associated with personal, family, and occupational factors as contributors to the problem, indicating the need to develop health actions that favor good sleep hygiene in these professionals.
Keywords
inadequate sleep - armed forces - fatigue - operational capacity - military personnel - national securityPublication History
Received: 30 July 2023
Accepted: 07 February 2024
Article published online:
13 June 2024
© 2024. Brazilian Sleep Association. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)
Thieme Revinter Publicações Ltda.
Rua do Matoso 170, Rio de Janeiro, RJ, CEP 20270-135, Brazil
-
References
- 1 Tufik S, Andersen ML. O sono: da neurobiologia à prática médica. Rio de Janeiro: Dilivros; 2022: p.25-51
- 2 Mysliwiec V, Pruiksma KE, Brock MS. et al; STRONG STAR Consortium. The Military Service Sleep Assessment: an instrument to assess factors precipitating sleep disturbances in U.S. military personnel. J Clin Sleep Med 2021; 17 (07) 1401-1409
- 3 Godos J, Grosso G, Castellano S, Galvano F, Caraci F, Ferri R. Association between diet and sleep quality: A systematic review. Sleep Med Rev 2021; 57: 101430
- 4 Grandou C, Wallace L, Fullagar HHK, Duffield R, Burley S. The effects of sleep loss on military physical performance. Sports Med 2019; 49 (08) 1159-1172
- 5 Caldwell JA, Knapik JJ, Shing TL, Kardouni JR, Lieberman HR. The association of insomnia and sleep apnea with deployment and combat exposure in the entire population of US army soldiers from 1997 to 2011: a retrospective cohort investigation. Sleep 2019; 42 (08) zsz112
- 6 Bernhardt KA, Kelley AM, Feltman KA, Curry IP. Rest and activity patterns of Army aviators in routine and operational training environments. Aerosp Med Hum Perform 2019; 90 (01) 48-52
- 7 Choi Y, Son B, Shin WC. et al. Association of Dietary Behaviors with Poor Sleep Quality and Increased Risk of Obstructive Sleep Apnea in Korean Military Service Members. Nat Sci Sleep 2022; 14 (14) 1737-1751
- 8 McEwen BS, Karatsoreos IN. Sleep Deprivation and Circadian Disruption Stress, Allostasis, and Allostatic Load. Sleep Med Clin 2022; 17 (02) 253-262
- 9 Wang F, Boros S. The effect of physical activity on sleep quality: a systematic review. Eur J Physiother 2021; 23 (01) 11-18
- 10 Faris ME, Vitiello MV, Abdelrahim DN. et al. Eating habits are associated with subjective sleep quality outcomes among university students: findings of a cross-sectional study. Sleep Breath 2022; 26 (03) 1365-1376
- 11 Farhadian N, Moradi A, Nami M. et al. The nexus between sleep disturbances and mental health outcomes in military staff: a systematic review. Sleep Sci 2022; 15 (03) 356-362
- 12 Eysenbach G. Improving the quality of Web surveys: the Checklist for Reporting Results of Internet E-Surveys (CHERRIES). J Med Internet Res 2004; 6 (03) e34
- 13 Buysse DJ, Reynolds III CF, Monk TH, Berman SR, Kupfer DJ. The Pittsburgh Sleep Quality Index: a new instrument for psychiatric practice and research. Psychiatry Res 1989; 28 (02) 193-213
- 14 Johns MW. A new method for measuring daytime sleepiness: the Epworth sleepiness scale. Sleep 1991; 14 (06) 540-545
- 15 Matsudo S, Araújo T, Marsudo V, Andrade D, Andrade E, Braggion G. Questinário internacional de atividade f1sica (IPAQ): estudo de validade e reprodutibilidade no Brasil. Rev. bras. ativ. fís. Saúde. 2001; 6 (02) 05-18
- 16 Gabe KT, Jaime PC. Development and testing of a scale to evaluate diet according to the recommendations of the Dietary Guidelines for the Brazilian Population. Public Health Nutr 2019; 22 (05) 785-796
- 17 Dos Santos Quaresma MV, Marques CG, Magalhães ACO, Dos Santos RVT. Emotional eating, binge eating, physical inactivity, and vespertine chronotype are negative predictors of dietary practices during COVID-19 social isolation: A cross-sectional study. Nutrition 2021; 90: 111223
- 18 Kessler RC, Andrews G, Colpe LJ. et al. Short screening scales to monitor population prevalences and trends in non-specific psychological distress. Psychol Med 2002; 32 (06) 959-976
- 19 Brasil. Normas sobre Treinamento Físico Militar e Testes de Avaliação Física na Marinha do Brasil (CGCFN-108). Marinha do Brasil, RJ:: Comando-Geral do Corpo de Fuzileiros Navais.; 2021
- 20 Alberti KGMM, Zimmet P, Shaw J. Metabolic syndrome—a new world-wide definition. A consensus statement from the international diabetes federation. Diabet Med 2006; 23 (05) 469-480
- 21 Jackson AS, Pollock ML. Generalized equations for predicting body density of men. Br J Nutr 1978; 40 (03) 497-504
- 22 World Health Organization (WHO). Obesity: preventing and managing the global epidemic. Geneva:: WHO; 2000
- 23 Milagres LC, Martinho KO, Milagres DC, Franco FS, Ribeiro AQ, Novaes JFD. Relação cintura/estatura e índice de conicidade estão associados a fatores de risco cardiometabólico em idosos. Cien Saude Colet 2019; 24 (04) 1451-1461
- 24 Siri WE. Body composition from fluid spaces and density: analysis of methods. Lawrence Berkeley National Laboratory. 1956. Mar.
- 25 Tufik S, Andersen ML. O sono: da neurobiologia à prática médica. Rio de Janeiro: Dilivros;: 2022. . p. 245-273
- 26 Wang Z, Chen B, Li W, Xie F, Loke AY, Shu Q. Sleep quality and its impacts on quality of life among military personnel in remote frontier areas and extreme cold environments. Health Qual Life Outcomes 2020; 18 (01) 227
- 27 Roustaei N, Jamali H, Jamali MR, Nourshargh P, Jamali J. The association between quality of sleep and health-related quality of life in military and non-military women in Tehran, Iran. Oman Med J 2017; 32 (02) 134-130
- 28 Plumb TR, Peachey JT, Zelman DC. Sleep disturbance is common among servicemembers and veterans of Operations Enduring Freedom and Iraqi Freedom. Psychol Serv 2014; 11 (02) 209-219
- 29 Iahnke V, Moraes C. Associação de atividade física com qualidade do sono de jovens militares: um estudo transversal. Revista de Educação Física. J Phys Educ (Maringá) 2022; 91 (01) 26-35
- 30 Oliveira DIPD. Prevalência de sintomas musculoesqueléticos e associações com sensibilização central e qualidade do sono em militares do corpo de bombeiros do Distrito Federal. Brasília.: Dissertation [Master̀s in Rehabilitation Sciences] – University of Brasilia;; 2020
- 31 Pinto JDN, Perin C, Dick NRM, Lazzarotto AR. Avaliação do sono em um grupo de policiais militares de elite. Acta Paul Enferm 2018; 31 (02) 153-161
- 32 Cellini N, Canale N, Mioni G, Costa S. Changes in sleep pattern, sense of time and digital media use during COVID-19 lockdown in Italy. J Sleep Res 2020; 29 (04) e13074
- 33 Barker M, Gilles A, Ghani S. et al. 207 Sociodemographic, Behavioral, and Health-Related Factors Associated with Sleep Among Native Hawaiians and Other Pacific Islanders. Sleep (Basel) 2021; 44 (Suppl. 02) A83
- 34 Tvaryanas AP, Greenwell B, Vicen GJ, Maupin GM. The commander's wellness program: assessing the association between health measures and physical fitness assessment scores, fitness assessment exemptions, and duration of limited duty. Mil Med 2018; 183 (9-10): e612-e618
- 35 Chou HW, Tzeng WC, Chou YC. et al. Stress, sleep and depressive symptoms in active duty military personnel. Am J Med Sci 2016; 352 (02) 146-153
- 36 Wright Jr KP, Bogan RK, Wyatt JK. Shift work and the assessment and management of shift work disorder (SWD). Sleep Med Rev 2013; 17 (01) 41-54
- 37 Varghese NE, Lugo A, Ghislandi S, Colombo P, Pacifici R, Gallus S. Sleep dissatisfaction and insufficient sleep duration in the Italian population. Sci Rep 2020; 10 (01) 17943
- 38 Varma P, Conduit R, Junge M, Jackson ML. Examining sleep and mood in parents of children with sleep disturbances. Nat Sci Sleep 2020; 12: 865-874
- 39 Tufik S, Andersen ML. O sono: da neurobiologia à prática médica. Rio de Janeiro:: Dilivros; 2022: p.11-24
- 40 Reid KJ, Zee PC. Principles and practice of sleep medicine: Circadian disorders of the sleep-wake cycle. Amsterdam:: Elsevier; 2005: p. 691-701
- 41 Eickhoff E, Yung K, Davis DL, Bishop F, Klam WP, Doan AP. Excessive video game use, sleep deprivation, and poor work performance among US Marines treated in a military mental health clinic: a case series. Mil Med 2015; 180 (07) e839-e843
- 42 McGinnis GR, Thompson ST, Aguilar CD, Dial MB, Tandy RD, Radzak KN. Chronotype and Social Jetlag Influence Performance and Injury during Reserve Officers' Training Corps Physical Training. Int J Environ Res Public Health 2022; 19 (20) 13644
- 43 Tonon AC, Carissimi A, Schimitt RL, de Lima LS, Pereira FDS, Hidalgo MP. How do stress, sleep quality, and chronotype associate with clinically significant depressive symptoms? A study of young male military recruits in compulsory service. Br J Psychiatry 2020; 42 (01) 54-62
- 44 Demir Zencirci A, Arslan S. Morning-evening type and burnout level as factors influencing sleep quality of shift nurses: a questionnaire study. Croat Med J 2011; 52 (04) 527-537
- 45 Fullagar HH, Skorski S, Duffield R, Hammes D, Coutts AJ, Meyer T. Sleep and athletic performance: the effects of sleep loss on exercise performance, and physiological and cognitive responses to exercise. Sports Med 2015; 45 (02) 161-186
- 46 Hoge CW, McGurk D, Thomas JL, Cox AL, Engel CC, Castro CA. Mild traumatic brain injury in U.S. Soldiers returning from Iraq. N Engl J Med 2008; 358 (05) 453-463
- 47 Toblin RL, Riviere LA, Thomas JL, Adler AB, Kok BC, Hoge CW. Grief and physical health outcomes in U.S. soldiers returning from combat. J Affect Disord 2012; 136 (03) 469-475
- 48 Taylor DJ, Pruiksma KE, Hale WJ. et al; STRONG STAR Consortium. Prevalence, correlates, and predictors of insomnia in the US Army prior to deployment. Sleep 2016; 39 (10) 1795-1806
- 49 Meadows SO, Engel CC, Collins RL. et al. 2015 Department of Defense Health Related Behaviors Survey (HRBS). Rand Health Q 2018; 8 (02) 5
- 50 Kim TK, Lee HC, Lee SG, Han KT, Park EC. The combined effect of sleep duration and quality on mental health among Republic of Korea armed forces. Mil Med 2016; 181 (11) e1581-e1589
- 51 Padez C, Mourao I, Moreira P, Rosado V. Long sleep duration and childhood overweight/obesity and body fat. Am J Hum Biol 2009; 21 (03) 371-376
- 52 Spiegel K, Tasali E, Penev P, Van Cauter E. Brief communication: Sleep curtailment in healthy young men is associated with decreased leptin levels, elevated ghrelin levels, and increased hunger and appetite. Ann Intern Med 2004; 141 (11) 846-850
- 53 Nishiura C, Noguchi J, Hashimoto H. Dietary patterns only partially explain the effect of short sleep duration on the incidence of obesity. Sleep 2010; 33 (06) 753-757
- 54 Sefton JM, Burkhardt TA. Introduction to the tactical athlete special issue. J Athl Train 2016; 51 (11) 845
- 55 Havenetidis K, Bissas A. A structured review of literature on body composition profiles in Navy personnel: current practices and considerations for the future. J R Nav Med Serv 2019; 105: 40-46
- 56 Rush T, LeardMann CA, Crum-Cianflone NF. Obesity and associated adverse health outcomes among US military members and veterans: Findings from the millennium cohort study. Obesity (Silver Spring) 2016; 24 (07) 1582-1589
- 57 Barlas FM, Higgins WB, Pflieger JC, Diecker K. 2011 Health related behaviors survey of active duty military personnel. Department of Defense. 2013