What Happened When I Took Sleep Meds Away From The World’s Toughest Operators
June 18, 2025A day of training with the Carl Gustaf rifle, according to one soldier with significant experience with it, can be like a full-contact football practice.
“I would equate it to getting a concussion in football, where you have headaches, nausea,” a senior non-commissioned officer told Task & Purpose. “I mean, I’ve literally seen people throw up after so many rounds.”
Long-term brain and head injuries have long been a concern for soldiers who absorb repeated shock waves in routine training with powerful weapons. A new Army study will examine how different exposures to firing .50 caliber rifles, the Carl Gustaf recoilless rifle and howitzer cannons impact soldier health. Researchers will also try to determine if factors like the type of job, medical history or sleep patterns put soldiers at higher risk for chronic health issues like those common among football players.
The research differs from previous studies in that it will not consider single, severe head injuries but instead examine the effects of many small ones over time.
“There’s been a lot of research on impacts following moderate to severe TBI and even mild TBI because that’s so common in the military,” Megan Douglas, clinical research psychologist for the Walter Reed Institute of Army Research, told Task & Purpose. “But things like repetitive head injuries, those subclinical groups, I don’t think we’ve looked as much about them.”
TBIs are among the most common injuries for soldiers
More than half a million troops have suffered traumatic brain injuries, TBIs, since 2000, according to Department of Defense estimates. Nearly 82% of those service members have been diagnosed with mild TBIs, which are diagnosed with confused, disoriented states or memory loss lasting less than 24 hours or a loss of consciousness for up to 30 minutes.
The congressionally funded Army studies will help researchers better understand “dose-specific effects of exposure to weapons” and how blast overpressure impacts the risk of long-term health issues. The findings could help add to existing Department of Defense guidelines that lay out safe distances and considerations for troops exposed to blast overpressures and help develop prognostic tools for more serious head and brain injuries, according to Douglas.
“The goals can be across many different potential intervention points, whether we prevent exposure because of risk factors or we mitigate exposure through safety measures,” she said.
One study will examine the effects of chronic repetitive head injuries and mild TBI from ‘tier 1’ weapons, which include shoulder-mounted weapons that launch rockets and grenades, .50 caliber sniper rifles and machine guns, howitzers and mortars, and specific explosive weights for breaching wall and door charges. To do this, researchers will compare soldiers in jobs like special operations, infantry and field artillery, who have more training around tier 1 weapons to others with limited exposure like combat medics.
Understanding blast overpressure
The blast overpressure exposure for infantry, artillery or special operations soldiers can vary widely because of different units’ training frequencies, soldiers told Task & Purpose on the condition of anonymity because they were not authorized to speak with the press.
Special operations soldiers overall get more training by the nature of their missions and smaller unit sizes, a senior enlisted soldier in charge of weapons training said.
“There were days that we would get dozens and dozens of Carl Gustaf rounds and then at the end of it, you’re ‘like my head hurts,’” the soldier said.
And with more frequent training comes more blast exposures. A special operations soldier might be required to train on wall and door breaches 21 days every quarter, with five to 10 charges each day. But regular armed forces might train with just 10 charges annually, according to a former special forces engineer who was an instructor at a demolitions range.
The artillery officer said he’s noticed a cultural shift in considering how all troops experience blast overpressure, including fire supporters or forward observers who are farther away from the weapons or explosions. The artillery officer also noted that training ranges vary and have different layouts, which could also be a factor in blast exposures.
“Although an artillery section will only fire 30 rounds in a batch of training, the people observing the explosions, albeit a mile away, are observing dozens of guns, and so it’s hundreds of rounds that they’re exposed to,” he said.
Drilling down into the individual
Existing research has shown long-term exposure to low-level blasts from breaching and shoulder-fired weapons can lead to higher rates of concussion and post-concussion symptoms. But with these new studies, Douglas said they’re hoping to drill down to the level of individuals and find out if certain people are at higher risk or are predisposed to brain or head injuries.
“In the past, the Army has implemented guidelines based on testing to be like, maybe this is the kind of person we want to keep out of certain roles because they might have a risk or predisposition towards these aspects,” Douglas said. “The goals can be across many different potential intervention points, whether we prevent exposure because of risk factors or we mitigate exposure through safety measures, or maybe even have potential therapeutic targets based on our data.”
Investigators will then take the data and determine if certain individuals are at higher risk for long-term health issues like traumatic encephalopathy syndrome, also known as chronic traumatic encephalopathy, or CTE — a common degenerative brain disease affecting professional football players.
“It’s similar to what we’ve seen with TBI or sports concussion research where we know that they’re at risk for these neurodegenerative issues later down the road, but they will actually be doing a blinded adjudication where they are looking at these aspects and saying whether they think they would be at risk.”
The artillery officer who spoke with Task & Purpose was previously assigned to special operations and said he noticed a difference in the health outcomes because of the communities’ emphasis on holistic health.
“There were people in special operations with multiple IED hits, severe TBI, multiple Purple Hearts that were in far better mental shape simply because they prioritize sleep for their two-decade career or eating right,” he said. “Whereas you’ll see conventional soldiers say they’re burned out after a short amount of time because they’re not probably as healthy.”
Mental health privacy
Despite ongoing efforts across the military services to combat the stigma, there are existing privacy concerns around troops’ mental health records and its impact on their careers.
Douglas acknowledged that soldiers might be worried about sharing personal information on these subjects but emphasized that the data is coded and kept private to protect research integrity. Soldiers’ mental health information will not be shared with commanders, except in situations with immediate safety concerns.
“What you say is not gonna be shared with others outside of very specific safety issues like if they intend to take their life or something like that. It will not be documented in their medical chart,” she said. “This is not for clinical purposes. It’s not for career decision purposes.”