Brief Behavioral Therapy for Improved Sleep: A Process Improvement Project

According the CDC, over one-third of Americans are not achieving the recommended seven hours of sleep per night which can cause a significant increased incidence of chronic disease including diabetes, heart disease, depression and cancer (CDC, 2017). It has been estimated that as many as 600,000 service members and veterans have been diagnosed with conditions related to sleep disturbances (Mysliwiec et al. 2013). Achieving high quality sleep is mission essential within the active duty population. Multiple tools are available to evaluate sleep disturbances, but the subjective nature of sleep quality is difficult to assess (Schutte-Rodin, Broch, Buysse, Dorsey and Sateia, 2008). For this Doctor of Nursing Practice (DNP) project, the Pittsburgh Sleep Quality Index (PSQI) was used as a measurement to assess squadron sleep health. Brief behavioral treatment for insomnia (BBTi) has proven to be a highly effective, evidence based treatment for sleep disturbances (Troxel et al., 2015). This service is provided within the Family Health clinic by the Behavioral Health Optimization Program (BHOP). The goal of this project was to increase sleep health awareness. Employing a community outreach approach, squadrons were provided education on the importance of achieving quality sleep and encouraged to attend the Sleep Enhancement Class (SEC).The cumulative PSQI data indicated unit sleep quality to be deficient, demonstrating poor quality sleep. Of the 67 individuals performing the PSQI the sleep averaged 5-6 hours per night, consistent with literature that reports ADSM receiving less than the recommended 7 hours (Luxton et al., 2011). The SEC attendance slightly increased following the intervention, but due to the anonymous nature of the project, the increase cannot be attributed directly to the educational intervention. While not the initial intent, this project allowed for open dialogue and in-person delivery of evidence-based resources and actionable data for leadership.