Illustration of someone with insomnia

If you have problems getting restful sleep, it could be triggered by a sleep disorder or even post-traumatic stress disorder. Up to 70 million U.S. adults have trouble sleeping, and several million have mental health symptoms. Symptoms of either can be managed, allowing you to get a good night’s sleep.

What is PTSD?

According to the National Center for PTSD (the U.S. Department of Veterans Affairs), “PTSD (post-traumatic stress disorder) is a mental health problem that some people develop after experiencing or witnessing a life-threatening event, like combat, a natural disaster, a car accident, or sexual assault. During this kind of event, you may not have any control over what’s happening, and you may feel very afraid. Anyone who has gone through something like this can develop PTSD.”

Why Do You Have Trouble Sleeping?

  • If you’ve been diagnosed with PTSD, you may feel a constant need to be on guard to defend yourself from perceived danger. It’s hard to have a relaxing sleep when you’re preoccupied with an urge to always be alert. This can result in problems falling asleep or waking easily if you hear a noise or are otherwise disturbed.
  • Because you worry or have bad thoughts. Someone with PTSD often worries about common problems or that they’re at risk of harm. Recurring problems falling asleep can lead to worries that you’ll always have such difficulties – a vicious circle that can prevent restful sleep.
  • You partake in drugs or alcohol, believing you’ll be able to cope with your symptoms easier. The truth is, consuming large quantities of alcohol inhibits restful sleep. Alcohol reduces the quality of sleep and makes it less invigorating. The same is true for many drugs.
  • Because of bad dreams or nightmares, which are common for someone with PTSD. Nightmares can jostle you awake, robbing you of restful sleep. Frequent nightmares result in constant fear, making it harder to fall asleep.
  • Finally, you could have any number of medical issues. According to research, medical problems commonly found in people experiencing PTSD include chronic pain, stomach aches, and pelvic-area complications in women. These physical difficulties can make it hard for you to sleep restfully.

How PTSD Affects Sleep

Post-traumatic stress disorder and sleep have a contentious relationship. Even though sleep problems are characteristic of many mental health ailments, such issues in PTSD are a widely recognized warning sign of the disorder. Many symptoms are used to diagnose PTSD, but only two have a direct, line-of-sight to sleep problems: hyperarousal and intrusion, which can express as nightmares and insomnia. But there’s another question to ponder: do sleep problems precede PTSD, or does PTSD result in sleep problems? Research into this very question is ongoing.

PTSD seems to disturb sleep by lengthening the time of light sleep; reducing the duration of deep, restorative sleep; and meddling with rapid eye movement sleep, the phase of sleep associated with dreaming and nightmares. This often manifests itself as insomnia — trouble falling and maintaining sleep — and daytime tiredness. Regrettably, even after PTSD has been treated effectively, sleep issues still happen for half of those who originally experienced them.

Some studies posit that sleep problems are complex, more than “basic” symptoms of PTSD. Instead, they may be a fundamental component of diagnosis. Research circulated in the 1980s suggests that troubles with rapid eye movement sleep are a PTSD hallmark that plays an outsized role in other PTSD symptoms. But follow-up research has produced mixed results. Some studies, including those with animals, discovered a pattern of REM disruptions related to PTSD, but others didn’t.

It’s not unusual to have trouble sleeping sometimes, but it’s more probably after surviving a traumatic event and is related to PTSD.

Diagnosis & Treatment

To diagnose PTSD or a sleep disorder, your healthcare provider will:

  1. Perform a thorough medical examination involving blood tests, x-rays, and other diagnostic procedures (like an actigraphy or in-home polysomnography) as needed to discover an underlying cause for PTSD symptoms. 
  2. Encourage you to undergo a psychiatric assessment by a mental health professional. The goal is to focus on triggers like thoughts, emotions, behaviors, and personal or family history of mental illness.

After diagnosis, your healthcare provider may recommend treatment, including psychotherapy, medicine, or ketamine infusion, depending on health and symptoms.

Final Thoughts

PTSD and sleep disturbances are intertwined in a vicious circle that can leave you fearful, sad, angry, and exhausted. Both can rob you of peaceful sleep. If you experience either,  diagnosis and treatment, as well as psychotherapy, self-help, or therapy like ketamine infusion may help control symptoms. Contact us today to learn more about treatment options.

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