PTSD and Sleep

In honor of Post Traumatic Stress Disorder (PTSD) Awareness Day, it’s time to connect over how experiences of traumatic stress and PTSD impact sleep.

How does PTSD impact sleep?

Since PTSD is a state of persistent excessive arousal after experiencing or witnessing a traumatic event, folks that live with PTSD can struggle with sleep. The three main ways that this manifests is insomnia, nightmares, and sleep apnea. Two diagnostic criteria for PTSD are insomnia symptoms – hyperarousal (trouble falling asleep and/or staying asleep) and intrusion (nightmares and/or night terrors).

What does sleep disturbance look like with PTSD?

Some ways in which folks with PTSD may experience sleep disturbances include avoiding going to sleep because of fear of nightmares or being vulnerable while sleeping, increased arm and leg movements during sleep, talking in their sleep, feeling on guard or hypervigilant, or preferring background noise over silence.

So what gives?

More than ¾ of patients with PTSD report sleep issues. Folks with PTSD are also more likely to experience co-occuring issues like sleep apnea and other sleep disorders. Though originally psychology and sleep experts thought that focusing on treating trauma would help with insomnia and sleep disturbances, but in fact, there is some evidence that sleep issues may be part of what maintains PTSD as well. It’s a tricky minx! 

Often, folks that live with PTSD experience a higher level of persistent nervous system arousal (hypervigilance) and fear of sleep, since sleep is a state of vulnerability and lowered control over one’s circumstances. Folks with PTSD may also fear having nightmares or night terrors that may feature physical body movements or talking in their sleep. 

A challenging part of this is that reduced sleep and sleep issues can make folks with PTSD less responsive to trauma-focused therapy. 

What are some ways I can deal with my PTSD-related sleep issues?

Check out this article on easy ways to sleep better. 

Some other things that can help:

• Accepting that sleep issues are a common part of having PTSD. Your body is trying to protect you, and you might have to find alternative ways to get the rest you need.
• Increase feelings of safety in your daily life. If you feel safer sleeping in the living room than your bedroom, try sleeping there. If it’s helpful for you to have a light on while you sleep, do that.
• Try being away from everyday triggers if you sleep better elsewhere. Visit a friend’s house, go camping, or visit family in your hometown if those might help.
• Sleep whenever and wherever you are able to rather than trying to sleep at night.
• Try moving to expend your energy and tire yourself out during the day.
• Cognitive Behavioral Therapy for Insomnia (CBT-I) has been found to reduce fear of sleep and hyperarousal significantly. CBT-I includes therapeutic interventions to target each part of a sleep disorder, including learning about sleep and how to sleep better, help with relaxing the body and mind, help with reframing thoughts and beliefs around sleep and rest, and more. Docbotic’s sleep tool, Sleepbot, is based on CBT-I interventions and can significantly help you if you’re struggling with sleep.