Sleep disorders in acting military services: Comparative analysis of psychopharmacological and psychotherapeutic correction

Abstract

The mental health of military personnel of the Armed Forces of Ukraine is of a particular importance in the context of active hostilities in the country. Our attention is turned to the problem of frequently detected inorganic sleep disorders in patients of Zaporizhzhia military hospital, which are often associated with non-psychotic mental disorders of subclinical or clinical severity, which gives us a purpose to consider dyssomnic syndrome as a significant risk factor for adverse mental health outcomes and find new ergonomic options in sleep disorders management. The purpose of the paper is to evaluate the clinical significance of new developed psychotherapeutic approach to inorganic sleep disorders management in comparison with standard pharmacological treatment. On the base of Zaporizhzhia Military Hospital, Ukraine, with the informed consent, 44 acting military servicemen of the Armed Forces of Ukraine (males aged 19.4–58.1) with inorganic sleep disorders were included into 2-cohort clinical trial during their inpatient treatment. 20 patients, who chose psychotherapeutic treatment, formed the Cohort 1 of the study. Cohort 2 was formed with 24 patients, who preferred standard management with benzodiazepines. All participants underwent qualitative (clinical interview) and quantitative (Pittsburg Sleep Quality Index – PSQI, Epworth sleepiness scale rate) assessment of sleep characteristics twice – before treatment and just before discharge. Clinical-psychopathological, psychodiagnostic and statistical methods were used in the study. The subjects from both cohorts showed sleeping relief and reported decrease of falling asleep time, the frequency of nocturnal wake-ups and early rises. It was objectified by PSQI fall from average 11.74±3.12 and 11.79±3.23 before treatment to 6.12±3.42 and 6.04±3.12 just before discharge from the hospital in the Cohort 1 and Cohort 2, respectively. Sleep improvement came about three days earlier in the Cohort 2. An average treatment duration was 8.20 ± 3.83 days. At the same time, 9 patients (37.5 %) of this group noted more pronounced daytime sleepiness in comparison with the Cohort 1 participants, whose sleep improvement developed later. However, it was associated with better concentration and alertness throughout the day. The new developed method of psychotherapeutic correction of inorganic sleep disorders shows almost equivalent effectiveness in comparison with the standard drug treatment. Meanwhile, it has certain benefits for acting military servicemen, specifically absence of heaviness in the head or pronounced daytime sleepiness and better concentration rate as these characteristics can significantly affect the quality of combat missions.