National Defence committee  Yes, it's available to everyone.

National Defence committee  Not to my knowledge.

National Defence committee  Yes.

National Defence committee  As I said, I talked to Dr. Jetly recently, and I do believe that sleep is one of the main components they're looking at integrating. I don't know exactly what shape it has taken.

National Defence committee  On sleep debt, I can give you a very concrete example. Let's say as a person you need eight hours of sleep, which is on the long side, as most of us need seven hours of sleep, but let's say that you need eight. Because of work, during the weekdays or school days, you can only get six and a half, so you have five days a week where you accumulate an hour and a half of sleep debt.

National Defence committee  We have to have a longitudinal perspective study to really address this very important question conclusively. We don't have that. What we do have is prospective studies that kind of implicitly looked at the relationship between sleep and mental health outcomes and found that those with more sleep problems, with more mental health issues and difficulties post-deployment....

National Defence committee  The only place where sleep shows up in pre-deployment or post-deployment assessments that are mandatory in the U.S., and I'm sure in Canada as well, is one of the screening questions asked about nightmares and another one asked about insomnia. The nightmare question is embedded in the PTSD screening, and the insomnia question is embedded in the depression screening, as if those sleep disorders are secondary to having the other disorders.

National Defence committee  I didn't talk about that during my presentation to make sure I would be within the 10 minutes. What you see there, the yellow and the red spots are hot spots in the brain, areas of the brain that are more active in one condition, for example, during sleep as compared to wakefulness.

National Defence committee  I wish I could, but I can't. I can only speculate. The study showed that during sleep in animals—I believe they were rats, not mice—brain cells shrink, which increased the amount of liquid that can be cleared through the cerebral spinal fluid. One of the implications for that animal study was that it may be a way for the brain to get rid of the toxins that accumulate while we're awake and that it happens while we're asleep.

National Defence committee  No, I used two samples: active duty service members in the army, which was where most of the studies have been done; and one of the largest civilian studies that we have about sleep needs and sleep duration in the general population. This is a contrast of what we expect to see in the general civilian population versus what we find with active duty service members, in this case, army members.

National Defence committee  I don't know because they would have to be informed not only by the kind of observations we have and we find when we look at this relationship between sleep and mental health. With military service members from the get-go, I believe, there's a self-selection bias. To be able to even complete the training, you have to be able to take quite a bit.

National Defence committee  Yes, with the chronic...and starting from this basis of resilience and building on this, under any kind of chronic challenge, it doesn't matter how tough you are, at some point you will break, and sleep is often one of the factors that we put aside, that we don't think about. Actually, the more sleep deprived we are, the worse we are at evaluating how well we're functioning, so eventually we think that we're not affected by it anymore, but objective measurements show that we're actually continuing to decline in any kind of performance that we measure.

National Defence committee  No, it does not, and it should not either.

National Defence committee  Yes, we usually see reductions or effect sizes above 0.5. There is moderate to large effect size in improvements in daytime PTSD. That would be a reduction of at least 30% to 50% in daytime symptoms severity by treating sleep. If you sleep better, you're less reactive. You're in a better mood.

National Defence committee  That is reported over a 24-hour period.