Continued: Veterans battle enemy at home: sleep

SAN DIEGO. CALIF.

By the time the sun began to rise one recent Friday over his Mira Mesa neighborhood, Mitch Hood had been up for about 18 hours.

He punched a caffeine tablet out of a blister pack and washed it down with two cans of Red Bull. He finished it off with a gulp of Pepsi.

He figured this would keep him awake four more hours. Then, he jumped back into his video game.

Hood, 25, spent two tours with the Marines in Iraq. Now, like many other veterans and millions of civilians, he faces a new enemy: sleep.

"I'm afraid I'm going to have nightmares and I'm going to get stuck there," he said. "I try with all my strength not to sleep."

When he eventually crashes and sleep overtakes him, Hood relives combat, or sometimes his mind creates new horror-filled scenarios. Once, he punched his fiancée, Natalya Gibson, while having a nightmare. She insisted that it didn't hurt, but Hood has not stopped apologizing.

Sleep and wakefulness issues were the most common health problems described by recently returned soldiers, researchers at Walter Reed Army Medical Center found in a study published last year.

About 36 percent of Army troops who have been back from Iraq for a year said they struggled nearly every day with feeling tired; 34 percent said they had difficulty falling asleep, staying asleep or sleeping too much nearly every day. A third of the total U.S. adult population reports sleep problems, but studies have shown that such problems are much more common in combat veterans than in other young adults, said Steve Woodward, a sleep expert at the Department of Veterans Affairs center on post-traumatic stress disorder. About 70 percent of veterans being treated for the disorder have sleep problems, he said.

Sleep is a vulnerable state, Woodward said. "When animals are exposed to a severe threat ... the basic adaptation is to wake up more frequently," he said.

Bill Rider, a 63-year-old Vietnam veteran, knows the signs. He has seen Hood and others like him in group meetings he helps organize in Oceanside for combat veterans of different generations.

Some veterans have told him of how they long for sleep, bingeing on alcohol for sedation. Others, like Hood, fear it. Rider has seen veterans stay up for 72 hours and work themselves into a delirious, manic state.

"I gave up my tranquillity, as many of the other warriors did, so the rest of America can have theirs," he said.

Thinking about Hood, he said, "That was me 30 years ago."

During his tours in Iraq in 2003 and 2004, Hood dug trenches and hauled 100-pound cables as a field wireman in Marine Wing Communications Squadron 38 out of Marine Corps Air Station Miramar. The pressure was always on during those assignments, he said, because the communication lines were essential for air strikes and medical evacuations.

In 2004, Hood returned to San Diego from Iraq and left the Marines two years later with an honorable discharge. He is now an online student, studying computer science. A few months ago, he found out that he had a herniated spinal disc and sciatica, forcing him to use a cane.

Hood thinks the pain probably makes his sleep less restful, but the main problems are the terrifying dreams that begin almost immediately after he closes his eyes.

A doctor has prescribed a low-dose antidepressant called Trazodone, which has a sedative effect. "I use it here and there," Hood said. But, "it basically sticks me in an eight-hour nightmare fest, so that's not a solution for me."

In time, Hood tried to avoid sleep. One day recently, he arose at noon Thursday after about three hours of bad sleep. He dreamed that he was in the middle of a chemical attack and awoke wondering why he wasn't wearing his chemical suit. It took a few minutes of looking around the bedroom and hearing Gibson's voice to bring him back.

The dream was veined with the fear he felt during one incident in Iraq. Sirens went off indicating a possible chemical attack. Hood couldn't make it back to the bunker, so he was lying face-down in a gutter. He couldn't get his gas mask to seal. Twenty minutes later, the all-clear siren finally sounded.

He was trying to banish the chemical attack nightmare from his thoughts when he showed up at the 7 p.m. weekly meeting of the American Combat Veterans of War in Oceanside. As group members went around the conference table describing work and medical issues, Rider, the Vietnam veteran, looked over at Hood. "You look great, by the way," Rider said. "Do you feel better?"

Hood wondered whether it was his new haircut. "No," he told Rider. "No, not really."

Ray Metcalf, a 74-year-old Korean War veteran, approached Hood and another young Iraq veteran during a smoke break and asked, "Do you have bad dreams?"

As the young men nodded, Metcalf recounted a nightmare he had a few weeks ago about getting shot down in a helicopter in Korea. Metcalf told them he read in a booklet on post-traumatic stress disorder that it's best to get out of bed if you can't sleep. He recommended going into the living room to watch a movie.

Hood listened intently.

"Sleep deprivation ... is an ongoing discussion," said Rider, who helped found the combat group in 2001.

It's the enemy that isn't beaten easily.