Concerns about the future linked with poor sleep quality in US army special operations soldiers withdrawing from Afghanistan

Abstract: Understanding how policy changes, such as a drawdown from a major military campaign, impact service members can provide information on how best to preserve service member health and resilience during these events. US special operations forces (SOF) units served in Afghanistan continually from September 2001 until the US drawdown in 2020/2021. Due to the unprecedented nature of a drawdown and a lack of research during times of military transition, it was unclear how members of these units felt during this event. It was also unclear how their attitudes about the drawdown were related to health outcomes, such as sleep. We hypothesised that soldiers with relatively negative attitudes about the drawdown would be sleeping fewer hours and would have poorer sleep quality than those with positive attitudes. Confirmation of this hypothesis could suggest that insufficient sleep is a marker of psychological distress during times of transition in military populations. A survey was administered to SOF soldiers during the drawdown. Data were collected in the month prior to the collapse of the government in Kabul (22 July to 13 August 2021). The intended sample size was truncated, as the survey was halted after this event occurred. Thirty-five participants reported their attitudes about the drawdown and how they felt it was impacting their readiness. They also reported how they believed the US should support Afghanistan in the future. Lastly, they reported their sleep quality and duration during the month prior. Participants reported sleeping poorly during the prior month with a mean sleep duration of 6.66±0.79 hours per night, and a mean sleep quality rating of 63.39%±21.63% out of 100%. Soldiers who reported increased stress, decreased morale and decreased motivation since the drawdown began reported poorer sleep quality. Sleep quality differed between groups with opposing beliefs about future involvement in Afghanistan: those who believed their unit should stay/return to Afghanistan had significantly poorer sleep quality than those who believed they should support Afghanistan only through airstrikes or not at all. These findings suggest that poor sleep quality could be an indication of psychological distress that requires intervention. Leaders and providers could ask soldiers about their sleep—rather than their psychological health—during times of transition and could provide additional support to those who report sleeping poorly. Soldiers may be more likely to report that their sleep quality is poor than to report that they are feeling anxious or depressed. Insufficient sleep may degrade readiness and resilience, two factors that are particularly important during transition periods when unexpected events could arise. Poor sleep during a transition could have lasting impacts on the health and readiness of soldiers during the next phase of their career—either in the military or in the civilian sector. Follow-on studies should continue to explore how major military transitions impact the readiness of individual service members and the readiness of the armed Forces in general.