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By Katie Bailey, MA, LPC

Sleep & PTSD

One of the most common symptoms of PTSD is insomnia. Insomnia can mean difficulty falling asleep, staying asleep, or waking up earlier than you want to. Trouble sleeping is one of the symptoms of “alterations in arousal and reactivity.” What does that mean? Well, it means that your body is geared up to be on high alert. It’s operating as if there is a constant threat nearby and it must be ready to fight or run.

For example, imagine if you were really tired and lying in bed ready to drift off to sleep. Suddenly, someone opens the door and lets a lion in the room! How likely do you think you would be able to fall asleep? Probably not likely, even if you were really tired!

Now let’s say that there isn’t a lion in your room, but you are told that there is a lion somewhere in your neighborhood and you should be vigilant if you hear anything. You might be able to fall asleep, but your brain is still in threat mode and will likely remain in a light sleep. Your brain is ready to jump up and fight/flee if the need arises.

When people have PTSD, their brain is still in this same threat mode, even though there is no actual known threat nearby. Their brain is still operating as if they must be ready for a threat to occur. Their brain is acting as if a lion is in the room or could come in the room at any instant.

Naturally, this makes it very difficult to sleep. In fact, insomnia is often a lingering symptom even after people receive effective treatment for trauma and PTSD.

Here Are 5 Tips to Get More Sleep When You Have PTSD:

1. Maintain a set wake time.

You might have heard this advice before, but waking up at the same time each day is a vital step in helping your body begin to regulate its sleep-wake cycles. Your body uses this set time to begin production of hormones, metabolism, and other bodily functions that are governed by predictable cycles. Waking up at the same time each day helps you not be “jet lagged” (the feeling you get when you wake up at various times, it’s like traveling from LA to NY!).

2. Start a relaxing wind down routine at night.

Because PTSD can increase your anxiety and alertness, it’s important that you shut off the stresses and tasks of the day an hour or two before bed. Make this time of the day a time to look forward to. Find fun, happy TV shows to watch. Read uplifting books. Find a hobby like puzzles, crafting, or anything else you like to do. Make this part of your day the “me” time you deserve. This helps us shut off the stress from the day and signal our body that it’s time to relax.

3. Don’t go to bed until you feel sleepy.

Many people with insomnia try to make up for lost sleep by spending more time in bed. Unfortunately, spending more time in bed when you aren’t sleeping only makes your body less sleepy (so you are less likely to fall asleep) and increases your frustration with not sleeping. This only worsens the insomnia spiral leading to more time in bed and more frustration. It’s important to follow your body’s signs of sleepiness. Feeling sleepy means difficulty keeping your eyes open or feeling like you might fall asleep any moment. This is different than feeling tired, exhausted, or fatigued. Many people with insomnia are “tired but wired.”

4. Watch for bed avoidance (the opposite of the above).

Many people with PTSD have nightmares at night. Some individuals avoid going to bed because they fear they will experience nightmares. Unfortunately, when we avoid sleep and our body does not have a chance to go into REM sleep (REM is the stage of sleep when we dream), we experience what is called REM rebound. REM rebound is when our bodies make up for lost REM by spending more time in REM. This will only increase your nightmares.

If you are experiencing nightmares or having difficulty coping with nightmares after you awaken, this is a great topic of conversation with your therapist. Your trauma therapist can help you with strategies on how to cope and manage these difficult experiences.

Additionally, if you experienced trauma that occurred at night or in the bed then you may be especially fearful of sleep. Working with a trauma therapist can help you cope with and overcome these fears. Exposure to spending time in the bed can help your body learn to decrease its fear or stress response while in bed.

5. Remind yourself that sleep is an involuntary process.

I repeat. Sleep is an involuntary process. You cannot control your sleep. You cannot make yourself sleep. The harder you try to fall asleep, the harder it is to sleep. All we can do is set the stage for sleep, but we cannot force it to happen.

In conclusion, sleep is not something that we can force but we can help the process along and give our bodies the best chance to fall asleep. Sleep is important in helping us reduce anxiety and depression. Making improvements in your sleep habits can help you while you work on trauma recovery. Even with making these changes, it can take time for the body to adjust.

PTSD Trauma Treatment in Ambler, PA

Overcoming PTSD is not a solo project. Everyone working to reclaim their lives after a trauma needs help. At Lime Tree Counseling, our therapists are experts in trauma therapy. We can help you learn to sleep better as well as find relief from other PTSD symptoms such as flashbacks, isolating yourself, sexual concerns, and lack of trust in others. Contact us to schedule your initial appointment, and start your healing journey today.