Circadian, light, and sleep skills program: Efficacy of a brief educational intervention for improving sleep and psychological health at sea

OBJECTIVES: Military service poses unique threats to sleep and circadian health, and the shipboard environment presents further challenges. Disrupted sleep and circadian rhythms are linked to myriad health and safety issues that compromise readiness, including negative psychological health outcomes. Thus, one advantage of mitigating sleep problems includes the possibility of also enhancing mental health.

PROCEDURES: We evaluated the efficacy of the Circadian, Light, and Sleep Skills program for shipboard military personnel for improving sleep, and examined the impact of sleep on mental health in participating sailors. Questionnaires were administered to US sailors (N = 150) assigned to three ships (one control, two intervention) before the program (T1), immediately afterward (T2), and 2-4 months later, after a period at sea (T3). Outcomes included motivation to improve sleep; sleep and circadian knowledge; frequency of sleep-promoting behaviors; sleep quality (Pittsburgh Sleep Quality Index); and mental health symptoms. Satisfaction with specific program elements and perceived relevance were also examined.

MAIN FINDINGS: Sleep and circadian knowledge, frequency of sleep-promoting behaviors, and sleep quality improved from T1 to T3 in the intervention versus control group. Sleep quality also mediated the effects of the underway (at sea) period on mental health. The intervention was well received, with high satisfaction and perceived relevance ratings.

PRINCIPAL CONCLUSIONS: A brief 30-min intervention before an underway period improved sleep, circadian, and psychological health outcomes in shipboard sailors, even months later. Broader dissemination of this program may provide significant positive impact with minimal investment of resources.