EVALUATION OF THE QUALITY OF SLEEP OF THE PROFESSIONAL SOLDIERS POPULATION

The aim of this study was to identify sleep problems in a select group of professional soldiers. For the study used a questionnaire containing the Athens Insomnia Scale by Soldatos, allowing klinimetric evaluation of sleep disorders reflecting mainly insomnia. Material Data were obtained from 200 professional soldiers. The results showed no pathological abnormalities of sleep study population, however, the results show some reduction in the prevalence of symptoms of sleep quality based on the selected factors. The health status of all the soldiers experiencing combat stress requires periodic and thorough control since the diagnosis of disorders is difficult and they can appear even after a long period of lived events. This may lead to look for other ways to deal with problems; the use of psychoactive substances or drug abuse. Therefore it is extremely important to use therapeutic activities.


Introduction
With the development of civilization, people are subjected to the influence of adverse external factors that may contribute to the reduced quality of life.External stimuli, causing stimulation, stress and other negative emotional states contribute to the pathology of the functioning of the human body.A phenomenon more common among adults is reducing the quality of sleep or sleep disorders, or irregularity occurring during one of the basic physiological needs of the body.
In the literature, the most common is considered the division of sleep disorders given by Bilikiewicz et al. (2002).According to this it may appear insomnia or disorder occurring in the form of insomnia, which may be temporary for the duration of several days, due to a work shift, sudden stressful situations or sudden crossing time zone.Lasting up to three weeks insomia manifested, among others the sudden somatic disease or chronic stress

Material and methods
The studies used purposeful selection and a select group of former professional soldiers.Permission to carry out tests gave Undersecretary of State in the Ministry of National Defence on the basis of Decision No 78 / MON of the Minister of National Defence of 15 February 2008.
The study material consisted data obtained from 200 soldiers, including 26 women (13%) and 174 men (87%).The respondents ranged in age from 22 to 49 years; the average age was M = 32.96 with a standard deviation SD = 5.82.The group consisted of 16 officers, 82 NCOs and 102 privates (Table 1).Job experience surveyed ranged from 1 year to 30 years (M = 8.31; SD = 5.90).The sub-group of soldiers who participated in the mission of the war consisted of 73 people, including 4 women (5.5% of the total study population) and 69 men (94.5% of the total study population) aged 23 to 49 years (M = 34, 27; SD = 5.26).Professional experience in this subgroup ranged from 1 year to 30 years (M = 11.29,SD = 4.73).Most of them (45 people; 61.6%) participated in the mission of war 1 time in two missions attended 16 people representing 21.9% of the respondents, 6 persons (8.2%) went 3 times, and 3 people (4.1%) went successively 4 and 5 times.The statistical analysis examined soldiers were divided into 3 groups: staff who have never participated in a military mission (n = 127), the soldiers who went on a mission 1 time (n = 45) and the military who participated in the mission 2 and more times (n = 28).Data from respondents was obtained by diagnostic survey, the survey technique (Babie, 2009).Used tool; questionnaire containing the Athens Insomnia Scale by Soldatos (2000) allows klinimetric evaluation of sleep disorders reflecting mainly insomnia.It consists of 8 questions for which the respondent marked the one of the 4 possible answers.Each of the answers are assigned points (from 0 to 3) and the sum of their shows on the severity of the symptoms of sleep disorders.Obtaining 5 points or less indicates normal course of sleep stages, from 6 to 10 points is on the border of norms and should pay attention to the basic rules of sleep hygiene and further observation and eventual therapy, while above 10 points indicates insomnia and the necessity of detailed diagnostics and the appropriate therapy strategy (Fornal-Pawłowska et al., 2011).

Results
The results showed a good or average quality of sleep in the studied group of professional soldiers (Table 2).However, in this population they were also people of low quality requiring a detailed diagnosis and therapy.In relation to the number of completed peacekeeping missions and stabilization operations, among examined soldiers observed one being statistically significant difference [X2 (df = 4) = 13.362;p < 0.01], which concerned the indicator sleep continuity (Table 3).The analysis shows that the problem is the smallest among soldiers who have decided to participate in peacekeeping or stabilization operation several times -as many as half of them sleeps overnight in a continuous manner, and 36% wakes up occasionally.In the subgroup of stationary soldiers prevailed occasional awakening while frequent interruptions in sleep were most common in the military, who went on a mission once and decided not to do it again.Over 22% of them are experiencing frequent awakenings during the night.The degree of military showed differences in the examined soldiers under the terms of two of the eight indicators of sleep problems.In both cases, the results of the analysis seem to indicate greater severity of the problem in a group of non-commissioned officers (Table 4).Compared with other groups, often they face the problem of interrupted sleep, which complains of more than 18% of non-commissioned officers.In addition, 12% of them estimated the total time of their sleep as definitely insufficient.However, the results suggest that these ailments are the smallest among the officers.Half of them sleeps all night in a continuous manner, and nearly 63% believed that the time spent on sleep during the day for them is entirely satisfactory.Satisfying sleep time was characterized by the almost 68% privates.Experience of direct participation in the fighting and exchanging fire with the enemy during the event of military missions was associated with total sleep time per day (Table 5).All the soldiers who have not experienced such an event, judged as sufficient sleep time, or slightly less than satisfactory.In contrast, every tenth military, who survived contact with the enemy fire rated total time of his dream as very insufficient.Like in the case of direct participation in the fighting, the fact of physical injury during military mission was associated with shorter total sleep time (Table 6).Slightly more than 13% of soldiers who have been injured or involved in the incident in which someone was injured or killed, rated sleep duration as clearly insufficient, while the problem has not occurred at all among respondents who participated in the mission, but not suffered physical damage.

Discussion
The study group of soldiers was characterized by good or slightly reduced quality of sleep.The results of statistical analysis showed a reduced quality of sleep in a group of non-commissioned officers.However, the results suggest that these problems are the slightest among the officers.The results are consistent with studies available in the literature (Chou et al., 2016), in which the officers were characterized by the lowest intensity of sleep problems than the remaining military personnel.This may be due to greater resistance, better professional Marta Ste ˛pien ´-Słodkowska, Przemysław Ustianowski, Anna Starkowska, Katarzyna Kotarska preparation, experience as well as specific personal qualities of officers that meet the protective function, making them more resistant against mentally difficult and stressful situations.An example of such factor may be a sense of coherence, a type of resource resistance unit when it has a conviction that stimulus coming from the external and internal environment are consistent, clear and explicable and access to appropriate resources allows you to cope with them.This feature has been determined by the author of the theory Antonovskiego "resourcefulness".Sense of coherence, as research has shown, reduces the risk of mental disorders caused by job stress (Basińska, 2007).Another feature affecting the functioning of the human being is emotional intelligence.It is the ability to correct perception, assessment and expression of emotions.High levels of emotional intelligence may be a factor in protecting the physical and mental health.It also helps to overcome the effects of stress experienced in life (Martowska, 2012).
Research Nowicki et al. (2016) demonstrated that reduced sleep quality is very widespread phenomenon in the adult population of Poles and the most frequently mentioned is the difficulty in falling asleep.Sleep disorders affect women more often than men.They are also an integral part of various forms of depressive disorders (Heitzman, 2009).Epidemiological studies conducted among American soldiers (Strelau, 2009) have shown that PTSD and depression were more frequent among those taking part in the mission in Iraq (19%) and Afghanistan (11.3%).Studies Ulmer et al. (2015) involving 1,238 participants; veterans and active duty military soldiers show a higher prevalence of various symptoms of sleep disorders among war veterans, compared with the general population.Epidemiological data from employees of military service on these disorders presented by the Mysliwiec et al. (2013) demonstrate the occurrence of mild obstructive sleep apnea (called.Obstructive sleep apnea -OSA) in 27.2% surveyed, moderate or severe in 24.0% and insomnia in 24.7% of the surveyed soldiers.
Results of studies Rusch et al. (2015) emphasize the importance of raising the quality of sleep in reducing symptoms of depression, trauma and cognitive performance among military personnel.Group of soldiers diagnosed with insomnia was defined as a group of high risk for the development of disturbances coexisting: depression, posttraumatic stress disorder, and other due to sleep disorders.The aim of this study was to examine whether improving sleep quality soldiers will be associated with the weakening of the symptoms of post-traumatic stress, depression, and improve the quality of life of patients.Also checked whether are there changes in the concentration of neurotrophic factor brain derived neurotrophic factor -BDNF and insulin-like growth factor-1 -IGF-1.The initial stage involved in conducting clinical trial and laboratory analysis of the blood.Then, cognitive-behavioral disorders was conducted.The results showed a significant decrease in symptoms of depression and post traumatic experience and a significant increase in IGF-1 which suggests that the action applied effectively improve the quality of sleep and are an effective method of reducing the symptoms of depression and post-traumatic stress disorder.The positive results of cognitive-behavioral therapy in reducing sleep disturbance also highlights the publication Bramoweth and Germain (2013).
The soldiers participating in military activities are exposed to many negative consequences as a result of sustained combat stress, which in turn can decrease in quality of life by the occurrence of problems disrupting daily functioning.Over the last years, the expression of perceiving the needs of psychological support was developed and implemented documents regulating procedure, scope and forms of psychological help.The health status of all the soldiers experiencing combat stress requires periodic and thorough control because diagnosis of disorders is difficult and they can appear even after a long period of time after the event lived.Many people also suppresses her fear, anxiety and other problems fearing further service in the army and the future of employment (Dudek, 2003).This in turn may lead to look for other ways to deal with problems; use psychoactive substances or drug abuse (Korzeniewski, 2008).Therefore it is extremely important to use therapeutic actions.

Conclusions
The respondents did not show soldiers pathological symptoms of sleep disorders, however, the results show some symptoms of reduction sleep quality based on the selected factors.The mere fact of a mission not decide the intensification of sleep problems and their greatest intensification was observed in those soldiers who have decided on a mission only once and among non-commissioned officers.The high military rank and the fact that multiple participation in the military mission seemed to be associated with better quality of sleep (more continuity and satisfactory duration), which may indicate a greater psychological resistance and coping strategies in difficult situations among the more experienced military.In addition, noted the relationship between the decrease in the quality of sleep and the fact traumatic experiences during military mission.Soldiers who have experienced fire contact with an opponent and / or suffered physical injury or participated in the event in which a man was injured or killed on the battlefield often evaluated a total sleep time as too short.
There are among others The Act of 19 August 2011 by veterans of activities outside the country, Regulation of the Minister of National Defence of 12 March 2012 on psychological assistance given to veteran soldier or veteran injured soldier and the closest family members, Decision No. 44 / MON of the Minister of National Defence of December 29, 2009 on the Vol. 18, No. 2/2017 Evaluation of the Quality of Sleep of the Professional Soldiers Population prevention of psychological in the Armed Forces of the Republic of Polish or protective program of psychological peacekeepers outside the country and their families, Secretary of State for.Social and Professionalism MON of 20 July 2010.Currently, each mission participate specially trained specialists, especially psychologists who have specific tasks, among other things, participate in the tasks contingent support commanders in resolving conflicts, organize meetings and serve to support the soldiers participating in traumatic events, conduct individual and group consultations.

Table 1 .
Characteristics of the study population

Table 2 .
Distribution of the results of measuring the quality of sleep in a group of professional soldiers

Table 3 .
Symptoms of sleep disorders among soldiers, depending on the number of completed military missions

Table 4 .
Symptoms of sleep disorders of soldiers, depending on the military rank

Table 5 .
Symptoms of sleep disorders among soldiers who participated in direct combat while military mission . 18, No. 2/2017 Evaluation of the Quality of Sleep of the Professional Soldiers Population

Table 6 .
Symptoms of sleep disorders among soldiers during a military mission were injured or involved in the incident in which someone was injured or killed