US Department of Defense
BLAST INJURY RESEARCH
COORDINATING OFFICE
Advancing Blast Injury Research to Protect and Heal Those Who Serve

Effects of Blast- and Impact-Related Concussion on Persistent Sleep Problems


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Boom, Hit, and Sleepless Nights - What Keeps Marines Awake After Deployment?

Disrupted sleep can negatively impact your health and impair both physical and mental functioning, affecting overall well-being and daily function. When sleep problems persist, they can lead to serious health complications. This study examined US Marines to determine whether the concussion mechanism of injury, i.e., high-level blast (HLB) vs impact, affects the likelihood of developing long-term sleep problems after returning from deployment and six months post-deployment.

Who Was Studied:
Over 64,000 active duty enlisted Marines completed health surveys immediately after returning home from deployment and again approximately six months later.

What Was Done:
Researchers analyzed health records from 2008 to 2012, applying statistical methods to identify factors linked to ongoing sleep problems after returning from deployment and six months post-deployment.

What Was Measured:
The study aimed to evaluate whether Marines reported sleep problems in a follow-up survey and identify the factors that may have contributed to these issues. It examined the association between various types of concussions, specifically those caused by high-level blasts (mbTBI) or physical impacts (miTBI), and the prevalence of long-term sleep disturbances. Additionally, the research considered other factors such as PTSD, depression, alcohol use, job-related exposure to low-level blasts, and sleep problems reported immediately after returning from deployment. The analysis also accounted for variables such as the Marines' sex and military rank.

What They Found:
At reassessment, nearly all the factors measured, except for sex, were linked to an increased likelihood of ongoing sleep problems. The most significant predictor was whether the individual had sleep issues immediately after returning from deployment. Additionally, having a blast-related concussion (mbTBI) significantly increased the risk of persistent sleep problems, particularly for those also exhibiting signs of PTSD or depression.

Conclusion:
Sleep disturbances are common following a concussion and can impede recovery. This study found that the circumstances surrounding the concussion, particularly if it was caused by a blast, along with mental health issues such as PTSD or depression, plays a significant role in the likelihood of persistent sleep issues over time. Individuals with blast-related concussions and associated mental health symptoms are at higher risk for long-term sleep difficulties. Therefore, health care providers should closely monitor sleep patterns in these Servicemembers to facilitate better recovery and overall health.


U.S. Marine takes a nap as he waits on an alert status
Figure 1. A U.S. Marine takes a nap as he waits on an alert status for a standing contingency mission aboard amphibious assault ship USS America (LHA 6) in the Philippine Sea, Jan. 23, 2021. (Photo credit: U.S. Marine Corps/Cpl. Brandon Salas)

References:

Effects of Blast- and Impact-Related Concussion on Persistent Sleep Problems. Samuel Y Chung, Elizabeth M Harrison, Robyn M Englert, Jennifer N Belding J Head Trauma Rehabil: 2025 Jan-Feb;40(1): E66-E74. doi: 10.1097/HTR.0000000000000974.


Funding:

This research was funded by the US Army Medical Research and Materiel Command under Work Unit No. N1518.

Last modified: 07-May-2025