Military Review English Edition January-February 2017 | Page 95

SLEEP BANKING 628 Army accidents and 32 deaths.10 Sleep loss results in deficits that affect performance effectiveness and safety in operational and nonoperational environments. Sleep is a biological need, and it is critically important for soldier health. The lack of sleep and increasing number of sleep disorders among service members is a major public health concern. In 2014, up to 14 percent of soldiers across the Army were diagnosed with a sleep disorder.11 Those lacking sufficient sleep are more likely to suffer from chronic diseases such as hypertension, diabetes, depression, obesity, and cancer; they tend to have a higher mortality rate, a lower quality of life, and less overall productivity.12 Sleep—or the lack thereof— amounts to being a health, safety, and readiness issue. With readiness at stake, we can no longer ignore the fatigue of the force or allow cultural barriers to continue to inhibit improvement of this larger public health issue. In Army organizations, losing is not an option; the cost of poor performance is high, so mitigating the risks associated with sleep loss and fatigue is imperative. Cultural Barriers Military culture historically does not place a priority on sleep. This is evident in a well-known Army recruiting slogan: “We get more done by nine o’clock than most people do all day.” We know that optimal sleep is critical to mission success. Soldiers and leaders associate poor sleep with impaired reaction time, poor judgment, accidents, and low morale. However, despite mission degradation, a cultural acceptance of suboptimal sleep and a perception that lack of sleep is the “Army way” prevail in the force.13 The idea of allowing soldiers to optimize sleep, report to work at 0900, and conduct physical training in the afternoon for a seven- to ten-day period before a training event would be quickly dismissed in many circles in the Army. Yet, high-performing teams are willing to change their cultures if a behavior is no longer productive. Having a supportive command climate in the brigade, one that was open to change, was vital to creating an opportunity for performance enhancement and conducting the sleep banking assessment. Once Maj. Amy Thompson, the command team was U.S. Army, is the bribriefed on the science begade surgeon for the 1st hind sleep banking, to inArmored Brigade Combat clude discussion of other Team, 1st Infantry Division. MILITARY REVIEW  January-February 2017 studies on sleep and performance such as the Harvard Hospital study, the Stanford men’s basketball team sleep extension study, the high schools delayed-start study, and the Harvard Police study, the brigade commander directed one of his subordinate units to support the trial.14 Then, after gaining “buy in” from the highest level of leadership, the subordinate commanders pushed the initiative to the company and platoon levels. Operationalizing Sleep Banking Knowledge of the Performance Triad, the brigade’s engagement in the Army Sleep Summit, and a brigade command climate that empowered innovation combined to create momentum toward a sleep-banking initiative. Encouraged by the brigade command team, subordinate-unit leadership deliberately focused on fighter-management improvement by operationalizing sleep banking before gunnery in an infantry unit. As a trial, 2nd Platoon, Company C (Charlie Company), 3rd Battalion, 66th Armored Regiment, was chosen to conduct sleep banking before a February 2016 field training exercise (FTX), during which the unit would fire Gunnery Table (GT) VI.15 During this FTX, soldiers would conduct twenty-four–hour operations, sleeping when possible—many times in a Bradley Fighting Vehicle (BFV)—and typically would average three to five hours of sleep daily for seven days, depending on leadership roles. The trial would compare GT VI scores from an October 2015 FTX to scores from the February 2016 FTX to determine if sleep banking affected gunnery performance. Additionally, evaluators would receive subjective feedback from the soldiers during the sleep-bank week and during the sleep-restricted period to discover further the effects of sleep banking on performance, health, and wellness. The company commander scheduled time for the brigade medical team to educate the platoon on the science behind sleep and the potential benefits of sleep banking before the FTX. Capt. Brad Jones, U.S. Army, is the commander of Company C, 3rd Battalion, 66th Armor Regiment, 1st Armored Brigade Combat Team, 1st Infantry Division. Capt. Jordan Thornburg, U.S. Army, is the physician assistant for 3rd Battalion, 66th Armor Regiment, 1st Armored Brigade Combat Team, 1st Infantry Division. 93