"In the Army, we do more before 9 a.m. than most people do all day" is a standard bit of military bravado. It's as much about the discipline instilled in soldiers as it is about the fact that their strenuous training takes place under less-than-ideal health conditions -- like waking up before dawn to exercise, which can create a cycle of sleep deprivation.
That's partly why 10 percent of active duty soldiers have a diagnosed sleep disorder, and almost half have a "clinically significant" sleep problem, according to a report the Army released last year. And fatigue was a contributing factor in 628 Army accidents and 32 soldier deaths between 2011 and 2014.
Now, the Army is trying to change its sleep culture with a wellness campaign called the Performance Triad, which is based on three pillars: nutrition, exercise and sleep. And since more sleep was predicted to be the toughest sell among senior leadership, it has taken center stage in the campaign. Five bases around the country have been conducting a year-long pilot study to try to improve soldiers' sleep. As these trials end -- all are due to wrap up by next month -- the Army is figuring out how to channel its findings into recommendations for the entire military branch.
There's An App For That
The five Army bases experimenting with sleep interventions are:
Fort Bragg in North Carolina
Fort Campbell in Kentucky
Fort Carson in Colorado
Fort Riley in Kansas
Joint Base Lewis-McCord in Washington
Some soldiers at these five sites use Fitbits to track their sleep. They are allowed to do Physical Training -- a tough, daily cardio and strength regimen -- at 4 p.m. instead of at 6:30 a.m. And their nightly "bed checks," when a sergeant inspects sleeping soldiers in barracks, have become quieter and earlier: Previously, an alarm would sound in each barrack while a sergeant went on these rounds, keeping soldiers awake for up to two hours. Now, the alarms are shorter and beds are checked all at once.
"The afternoon PT was a dramatic switch at first, since early-morning PT is the 'Army way,'" Jordan Thornburg, battalion physician assistant at Fort Riley, told The Huffington Post. "But they quickly came to love it. Their morale was better, they were less irritable, and their performance went up. Which makes sense because waking up later is more in line with their natural circadian rhythms."
Surprised to hear someone from the Army talking so casually about circadian rhythms, otherwise known as our "body clock"? Don't be. The Army's new regimen is grounded in cutting-edge sleep science.
That science is available to soldiers, and anyone else who wants it, through the Performance Triad smartphone app.
"Our millennial soldiers don’t want books," said Lt. Col. Ingrid Lim, the lead sleep expert at the office of the Army Surgeon General. "So we'll meet people where they want to be met: on their phones, computers and through video."
The app has a sleep log for tracking rest, a feature that can tell you the best time to hold meetings, and even modules that teach mindfulness and breathing interventions.
Of course, none of this would be an easy sell unless it had promising results.
Sleep interventions have dramatically affected the performance of the 80 participating soldiers at Fort Riley, according to the base's physician assistant, Jordan Thornburg. Soldiers improved their "gunnery tables," or marksmanship, from 75.6 percent to 91.9 percent. Qualitatively, he said they had higher morale, were more punctual and had improved endurance.
It also improved the quality of life for soldiers with families: They could spend more time with their kids before school and eat breakfast at home.
“Fatigue was a contributing factor in 628 Army accidents and 32 Soldier deaths between 2011 and 2014.”- The Army's "Health of the Force" report, 2015
And while sleep interventions hold the most promise for soldiers stationed on bases, there is also the hope for performance benefits for those deployed in the field.
Bases are experimenting with a practice called "sleep banking," by which soldiers learn to "save up" extra hours of sleep in the nights before a period when they know they will be sleep-deprived.
Any improvements in sleep, which is key to decision-making and response time, could be invaluable for soldiers in combat.
"Whenever fighting happens, sleep is the first thing to go, and is the most problematic for soldiers," Lim said. "If we succeed in making it an Army-wide priority, perhaps that can change."
Thornburg, who served as an engineer officer in both Iraq and Kuwait, agrees. He regularly worked 27-hour shifts, which led to a short attention span and countless accidents.
"Think about when you’re driving a car: After so many hours, you stop paying attention. That's exactly what happened to us, we were basically sleepwalking," he said.
He added that sleep banking is "intuitively practiced" in some deployed units already, but the pilot sites' systematic testing will help formalize a way to spread the practice throughout the Army.
'The Army Way'
The Army report that described the extent of soldiers' sleep issues noted that "despite mission degradation resulting from sleepiness, a culture of suboptimal sleep and a perception that lack of sleep is 'the Army way' prevails in the force."
Lim cites culture as the single biggest challenge in getting soldiers to sleep more, despite its proven performance benefits.
"There are these culture wars between older and younger folks," Lim said. "Almost every unit we go to, a senior soldier will say, 'Well, I was sleep-deprived when I was younger, so I don't see why it's a problem.'”
Lim and Army leaders agree that positive performance results could go a long way toward helping senior leaders buy in to the value of more sleep. Thornburg suggested they probably can't afford not to care.
"We want our soldiers to be in peak form from their training, not worn down," he said. "And in the field -- frankly, I think it could reduce deaths."