PTSD and Sleep Problems
Post-traumatic stress disorder, or PTSD, is a cluster of symptoms that occur after exposure to a shocking or dangerous event. Researchers say that up to eight percent of every 100 Americans will have PTSD at some time in their lives, and around eight million suffer from PTSD each year. Military personnel are especially at risk, with estimates of those serving in Iraq, Afghanistan, and Vietnam ranging from 11 to 20 percent in any given year. As many as 30 out of every 100 Vietnam veterans have had PTSD in their lifetimes.
PTSD and Sleep
Sleeping problems occur frequently among people with a PTSD, and difficulty falling or staying asleep is one of the most commonly reported symptoms of the disorder. These complaints fall into three categories:
- • Difficulty falling asleep
- • Difficulty staying asleep
- • Nightmares
Because of these issues, people with PTSD often come to dread bedtime. They may also be afraid of acting out bad dreams or waking abruptly during nightmares. Because they are in a state of hyperarousal, they may be especially sensitive to sounds and see sleep as a loss of control. In the end, the cycle perpetuates itself. A lack of sleep at night leads to more sleep during the day, and that makes it harder to sleep at night.
Treatment can be as simple as changing sleep habits, and getting treatment for PTSD may sometimes be necessary. There is no guarantee, however, that PTSD treatment will end sleep problems, and not all sleep problems in people with PTSD are caused by the disorder.
New Studies about Sleep and PTSD
As many as nine out of ten veterans of conflicts in Afghanistan and Iraq reported having trouble falling asleep or staying asleep after they returned home. In 2018, the February edition of Journal of Clinical Sleep Medicine, the official publication of the American Academy of Sleep, published the results of a pilot study showing a new approach that combines cognitive-behavioral therapy, or CBT, with image rehearsal to improve sleep in veterans with PTSD.
Cognitive behavioral therapy is the front line therapy for long-term insomnia, and image rehearsal therapy is used to treat nightmare disorder. Both insomnia and nightmares have symptoms similar to PTSD.
In the study, 22 veterans with PTSD-related sleep problems participated. Eleven of them were given a mixture of image rehearsal therapy and cognitive behavioral therapy for insomnia for trauma-related nightmares. The control group got prescription drugs, including antidepressants, sleeping pills, and mood stabilizers. The treatment lasted for around twelve weeks.
Preliminary results showed that the group with CBT and image rehearsal therapy made significant improvements in both PTSD and sleep symptoms. More extensive research is needed to test the efficacy of the approach.
Another study, however, proposed a more extreme alternative, and that was sleep avoidance after stressful events. In this case, researchers theorized that sleep is necessary to preserve memories. Without sleep, the trauma cannot be transferred to memory.
In the meanwhile, the best approach to PTSD-related sleep problems is to see a good doctor. A good evaluation by a sleep clinic is essential to successful diagnosis and treatment, regardless of the cause.
Contact Valley Sleep Center today for more information!