PTSD and Sleep - the nightmare continues…
You’re tossing and turning. You don’t like the dark, but also can’t stand the light. Thoughts are inconsistent, fast-paced, relentless. The whole idea of sleeping now gives you unbearable anxiety.
Post-traumatic stress disorder (PTSD) is a mental health condition that affects individuals who have experienced or witnessed a traumatic event. PTSD can cause a range of symptoms, including nightmares, flashbacks, and difficulty sleeping. Sleep disturbance is one of the most common symptoms of PTSD, affecting up to 90% of individuals with the disorder. In this article, we will explore the relationship between PTSD and sleep, including the types of sleep disturbance experienced by individuals with PTSD and the impact of sleep disturbance on overall health and well-being.
Types of Sleep Disturbance in PTSD
Individuals with PTSD may experience a range of sleep disturbances, including:
Nightmares: Nightmares are vivid, disturbing dreams that occur during REM (rapid eye movement) sleep. Individuals with PTSD often have nightmares that reenact the traumatic event they experienced. These nightmares can be so vivid that they may wake up in a state of panic or distress, making it difficult to fall back asleep. In contrast, the content of your nightmares may have nothing to do with the trauma you endured, but are nonetheless upsetting and hard to shake even hours after you’ve woken up.
Insomnia: Insomnia is a sleep disorder characterized by difficulty falling asleep, staying asleep, or waking up too early. Individuals with PTSD may have trouble falling asleep because they are worried about having nightmares or because they are hyper-vigilant and alert to potential danger (thanks to an overactive fight/flight response!). They may also wake up frequently during the night or have difficulty returning to sleep after waking up.
Hypersomnia: Hypersomnia is a sleep disorder characterized by excessive daytime sleepiness. Individuals with PTSD may experience hypersomnia because their sleep is disrupted at night, leading to daytime fatigue.
Sleep apnea: Sleep apnea is a sleep disorder characterized by pauses in breathing during sleep. Individuals with PTSD may be at increased risk for sleep apnea due to high levels of stress and anxiety, which can contribute to breathing problems during sleep.
Impact of Sleep Disturbance on Overall Health and Well-being
We all know sleep is important. It affects literally every aspect of overall well-being…in a big way. The impact of sleep disturbance on individuals with PTSD can be significant and therefore the poor sleep quality and quantity can lead to a range of negative health outcomes, including:
Physical health problems: Sleep disturbance is associated with a range of physical health problems, including obesity, diabetes, and cardiovascular disease.
Mental health problems: Poor sleep quality and quantity are associated with an increased risk of depression, anxiety, and can worsen any pre-existing mental health condition such as ADHD or OCD.
Cognitive problems: Sleep disturbance can lead to cognitive problems, including difficulty concentrating, memory problems, and reduced reaction time. People with PTSD often complain of “cloudy thinking”, likely linked to poor sleep.
Impaired daily functioning: Poor sleep quality and quantity can impact daily functioning, including work and school performance, relationships and basic self-care.
Treatment for Sleep Disturbance in PTSD
There are several evidence-based treatments for sleep disturbance in individuals with PTSD. These treatments include:
Cognitive-behavioral therapy for insomnia (CBT-I): CBT-I is a type of therapy that aims to identify and change negative thoughts and behaviors that contribute to insomnia. CBT-I typically involves a combination of cognitive therapy, behavioral therapy, and relaxation techniques.
Prazosin: Prazosin is a medication commonly used to treat high blood pressure. It has also been shown to be effective in reducing nightmares in individuals with PTSD. Talk to your family doctor for more information on medications that could be helpful.
Mindfulness-based interventions: Mindfulness-based interventions, such as mindfulness-based stress reduction (MBSR), have been shown to be effective in reducing sleep disturbance in individuals with PTSD. Mindfulness helps the person be present in the moment, detach themselves from unhelpful thoughts, and accept their thoughts and feelings without judgement.
Sleep hygiene: Sleep hygiene refers to healthy sleep habits, such as maintaining a regular sleep schedule, avoiding caffeine and alcohol before bedtime, and creating a comfortable sleep environment. A trained therapist can help you take a thorough look at all your sleeping habits to make sure they are conducive to the best sleep possible.
For some people with PTSD, the lack of good quality sleep is the reason they initiate therapy. You may be noticing the toll it’s taking on your mental and physical wellness everyday. Sleeping well, even after experiencing a trauma, is possible, and a trained therapist can help you get to that reality again.
Find out more about therapy for PTSD and trauma, offered at Brookhaven Psychotherapy.
