Publications

The following manuscripts have been published or are currently in press. Listings are in chronological order, unless otherwise noted.

Research Publication 2
Title Publication Date/Location
PTSD Prevalence, Associated Exposures, and Functional Health Outcomes in a Large, Population-Based Military Cohort Public Health Report 2009 Jan;124:90-102

Smith TC, Wingard DL, Ryan MAK, Kritz-Silverstein D, Slymen DJ, Sallis JF, for the Millennium Cohort Study Team

Findings suggest a 2% prevalence of current PTSD symptoms in the US Military that are associated with increased reporting of exposures and decrements in functional health.

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Prospectively Assessed Posttraumatic Stress Disorder and Associated Physical Activity Public Health Reports 2011 May/Jun;126(3):371-83

LeardMann CA, Kelton ML, Smith B, Littman AJ, Boyko EJ, Wells TS, Smith TC, for the Millennium Cohort Study Team

Nearly 90% of the Cohort participate in some level of physical activity. Engagement in physical activity, specifically vigorous activity, was associated with decreased odds of PTSD symptoms. While further research is needed, a physical activity component may be valuable to treat and/or prevent PTSD among service members.

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Predeployment Sleep Duration and Insomnia Symptoms as Risk Factors for New-Onset Mental Health Disorders Following Military Deployment Sleep 2013 Jul 1;36(7):1009-1018

Gehrman P, Seelig AD, Jacobson IG, Boyko EJ, Hooper TI, Gackstetter GD, Ulmer CS, Smith TC

This study showed that combat-related trauma and predeployment insomnia symptoms were significantly associated with developing posttraumatic stress disorder, depression, and anxiety following deployment. Assessment of insomnia symptoms predeployment may help to better identify those at highest risk for subsequent adverse mental health outcomes.

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Sleep and Health Resilience Metrics in a Large Military Cohort Sleep 2016 May;39(5):1111-1120

Seelig AD, Jacobson IG, Donoho CJ, Trone DW, Crum-Cianflone NF, Balkin TJ

The presence of insomnia symptoms was significantly associated with worse self-rated health, more lost work days, lower odds of deployment, higher odds of leaving military service early, and more health care utilization, after adjustment for demographic, military, behavioral and other health covariates. Findings were similar for those reporting less than 6 hours of sleep per night. Future research should focus on the efficacy of interventions to promote healthy sleep in military populations.

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Sleep Patterns Before, During, and After Deployment to Iraq and Afghanistan Sleep 2010 Dec;33(12):1615-22

Seelig AD, Jacobson IG, Smith B, Hooper TI, Boyko EJ, Gackstetter GD, Gehrman PR, Macera CA, Smith TC, for the Millennium Cohort Study Team

Participants reported having trouble sleeping and getting less sleep either during deployment or after returning home from deployment more than nondeployed participants. Self-reported combat exposures and mental health symptoms were independently associated with increased reporting of trouble sleeping.

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Longitudinal associations of military-related factors on self-reported sleep among U.S. service members Sleep 2021 Dec 10;44(12):zsab168

Cooper AD, Kolaja CA, Markwald RR, Jacobson IG, Chinoy ED

This study examined military factors in relation to the development and reoccurrence of short sleep duration (≤5 hours or 6 hours) and insomnia symptoms (i.e., trouble falling asleep or staying asleep in the past month)over a 3-15 year follow-up period. Military factors consistently associated with an increased risk for development and/or reoccurrence of short sleep duration and insomnia symptoms included active duty service, Army or Marine Corps service, combat deployment, and longer than average deployment lengths. Officers and noncombat deployers had decreased risk for either poor sleep characteristic. Length of service and separation from the military were complex factors; each lowered risk for ≤5 hours sleep but increased risk for insomnia symptoms. Findings suggest that efforts to improve sleep prioritization and implement interventions targeting at-risk military populations, behaviors, and other significant factors are warranted.

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Contribution of Post-Trauma Insomnia to Depression and Posttraumatic Stress Disorder in Women Service Members: Findings from the Millennium Cohort Study Sleep 2023 Mar 9 | doi: 10.1093/sleep/zsac313

Carlson GC, Sharifian N, Jacobson IG, LeardMann CA, Rull RP, Martin JL

Post-trauma insomnia contributed to the development of depression and PTSD among women service members and veterans; screening for insomnia may help mitigate the development of posttraumatic mental health conditions.

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Prevalence and predictors of insomnia and sleep medication use in a large tri-service U.S. military sample Sleep Health 2021 Dec;7(6):675-682

Markwald RR, Carey FR, Kolaja CA, Jacobson IG, Cooper AD, Chinoy ED

Several deployment-related characteristics were significantly associated with the development of insomnia and/or newly-reported sleep medication use, and more than half of the sample with insomnia reported using sleep medication, indicating a high rate of medicating for insomnia. These findings may indicate an underlying systematic issue related to the inability to obtain adequate sleep in military personnel

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The bi-directional relationship between post-traumatic stress disorder and obstructive sleep apnea and/or insomnia in a large U.S. military cohort Sleep Health 2022 December | doi: 10.1016/j.sleh.2022.07.005

Chinoy ED, Carey FR, Kolaja CA, Jacobson IG, Cooper AD, Markwald RR

Study findings indicate a bi-directional relationship between the development of sleep disorders and PTSD. Military-related factors associated with new onset PTSD or sleep disorders, such as combat deployment, recent military separation, and rank, should be considered in prevention efforts for sleep disorders and PTSD.

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Longitudinal Assessment of Self-Reported Recent Back Pain and Combat Deployment in the Millennium Cohort Study Spine 2016;41:1754–1763

Granado NS, Pietrucha A, Ryan M, Boyko EJ, Hooper TI, Smith B, Smith TC

Among military personnel, back pain is among the most frequent reasons for medical visits and lost duty time, and has been associated with pain-related disability. This study found that 15.5% of participants reported recent back pain at follow-up. Our study confirmed the high burden of this condition in the military, showing that deployers with combat experiences had a 38% higher odds of reporting back pain at follow-up, and 27% higher odds of repeated back pain, compared with deployers without combat experiences. Additionally, exposures associated with a physically demanding work environment were related to a higher risk of back pain. This well-defined group of military personnel would potentially benefit from integrated prevention efforts focused on mitigating and eliminating back pain over time.

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