Post-traumatic stress disorder (PTSD) is a psychiatric disorder triggered by experiencing or witnessing a traumatic event. Among the symptoms associated with PTSD are sleep problems, which BMC Psychiatry points out occur in as much as 70 to 92% of those with PTSD. These commonly cause shorter sleep duration and poorer sleep quality. However, PTSD and sleep are more interconnected than you may think — the previous night’s sleep can affect the next day’s PTSS (post-traumatic stress symptoms). So to help improve PTSD, good sleep is necessary. And to improve your sleep, you’ll need to identify what problem/s you have and what you can do to alleviate them.
Common Sleep Issues for People with PTSD
- Insomnia: Insomnia refers to the difficulty of falling and/or staying asleep despite being tired and is the most common sleep disorder among those with PTSD. Sarah Covert shares how insomnia is the body’s response to trauma by keeping you alert in case of danger. It’s a lingering effect of having been in a situation that required constant vigilance. Insomnia can be accompanied by the anxiety of having to go to bed due to the possibility of experiencing intrusive thoughts or flashbacks while trying to sleep.
- Hyperarousal: Hyperarousal is a severe PTSD symptom that’s characterized by extensive jittery feelings, inability to concentrate, and paranoia. SymptomFind, a health and wellness site that catalogs common and uncommon ailments, discusses the problem of waking up in the middle of the night. They cite psychological causes as the main reason for hyperarousal, in which a person can wake up sweating excessively, with a rapid heartbeat and shortness of breath. This is also associated with nightmares, sleep apnea, and insomnia, which PTSD sufferers commonly experience. A person can be more sensitive to their environment even while sleeping as the brain may register stimuli as a possible danger
- Nightmares: Dreams help experiences become integrated into long-term memory. These can also simulate events and let us try different responses, and this can help a person cope. The same is true for nightmares, which are an intense expression of our body trying to work through trauma. Nightmares related to PTSD usually subside after a few months. But sometimes, the brain has difficulties in managing the fear response, which causes long-term repetitive nightmares.
How to Address PTSD-Related Sleep Issues
- Develop a good sleep environment: One main reason that people with PTSD have sleep problems is that we’re most vulnerable when we’re asleep — so by keeping awake, we’re sure that we can stay out of danger. Because of this, it’s important to create a sleeping environment where we feel safe. A quiet and dark bedroom works best, having as few stimuli as possible that might cause you to wake up. But you can tweak your environment depending on what calms you. For example, if your trauma is connected to the dark, you can use dim lights in the bedroom so you can still see your surroundings without affecting your circadian rhythm.
- Improve lifestyle habits that affect sleep: Practicing good sleep hygiene can help reduce PTSD-related sleep problems. The Sleep Foundation suggests following a consistent nightly routine, such as unplugging from electronics and winding down 30 minutes before going to bed, to help put you at ease before sleeping. It’s also a good idea to have healthy daily habits, such as being physically active and getting some sunlight and fresh air. Having routines during the day helps support your circadian rhythm, which may limit sleep disruptions.
- Seek professional intervention: If your sleep problems are getting better despite your best efforts, it’s best to consult a professional. For those with insomnia, you may undergo CBT-I (Cognitive Behavioral Therapy for Insomnia), which focuses on cognitive restructuring and stimulus control to help them associate the bed as a place for sleep and rest. Meanwhile, Frontiers in Psychology talks about how lucid dreaming may help those experiencing nightmares. By being aware that they’re having a nightmare, they may be able to actively influence the dream to make them less threatening.Sleep disorders in people with PTSD may be common, but they should not be left unaddressed. Explore our site here on CPTSD Foundation to see how you can get professional help.
Specially written for cptsdfoundation.org by Bette Jaeger
