The Relationship Between Trauma and Sleep

Today is World Sleep Day, a day that raises awareness of the importance of sleep and the benefits it can bring. This year’s theme is ‘Quality Sleep, Sound Mind, Happy World’, focusing on the relationship between sleep and mental health.

Sleep affects mental health and vice versa. Trauma especially can have a lasting impact on how people sleep, and it can also make symptoms worse.

Trauma and the Body

The body reacts strongly when faced with a potential threat. There are several options that it might take:

• Fight – arguing with or retaliating against the threat. The fight response can include shouting, physical aggression, or crying.
• Flight – the body may recognise that there is no chance of physically overpowering a threat. As a result, the person may feel encouraged to run away. If a person flights, they may leave a room or isolate themself.
• Freeze – when the body and brain are overwhelmed by a threat, they may freeze entirely. The freeze response can cause people to seem distant, dissociated, and numb.

These fear responses are the body’s way of protecting the person. Every response triggers a flood of hormones throughout the body, causing muscles to tense in preparation and breathing to speed up.

After the event has passed, the body tries to return to baseline, reducing the amounts of stress hormones in the system. However, it often struggles to reach this baseline once more, leading to the development of post-traumatic stress disorder (PTSD).

Common reactions to trauma include:

• Hypervigilance – feeling more on guard after a traumatic event or always being on the lookout for potential threats and dangers.
• Hyperarousal – similar to hypervigilance, hyperarousal is the feeling of being on edge and alert after a traumatic event. Even small events can trigger the body’s alarm system.
• Feeling unsafe – many people struggle to feel safe after experiencing a traumatic event and often feel much more anxious as a result.

Trauma and Sleep

Because of these reactions, sleep problems are common after a traumatic experience.^[1] People are often on edge and anxious, constantly scanning for danger, causing them to struggle with relaxing enough to drop off.

When people do manage to sleep, they can often be plagued with nightmares surrounding the traumatic event they experienced. In some instances, these nightmares can cause them to wake up and prevent them from going back to sleep. Some may also worry about the loss of control they experience as they sleep, as they are not awake to defend themselves or look for potential threats.

Trauma also affects how the body cycles through sleep stages, limiting the amount of rapid eye movement (REM) sleep that people get. REM sleep is directly linked to storing and processing memories, impacting how the traumatic event is processed.

Childhood trauma can significantly impact sleep throughout a person’s life. Adults with several adverse childhood experiences (ACEs) are over twice as likely to have issues falling asleep and often report feeling tired after a full night’s sleep.^[2]

Getting enough sleep and targeting sleep disorders after a traumatic event can reduce the risk of people developing PTSD.^[3]  However, after experiencing a traumatic event, people may not know how to improve their sleep.

Improving Sleep After Trauma

If you are struggling with sleep after a traumatic experience, there are many things that you can do to help yourself:

• Build healthy sleeping habits – try to create healthy sleeping habits that work for you. These could include putting away all screens an hour before bed, drinking some relaxing herbal tea, or using an eye mask or earplugs to block any distracting sights and sounds.
• Maintain a sleep routine – establishing a bedtime routine that begins around an hour before bedtime signals to the body that it is time to start winding down. Try to keep your bedtime and wake up time consistent every day, and if you don’t feel tired after trying to get to sleep, do not try and force rest – get up and read a book or make some herbal tea to sip until you are sleepy.
• Create a comfortable sleeping space – ensure your bedroom is calm, safe, and comfortable. Consider what would make you feel safer when you sleep, whether that’s keeping a small light on or sleeping next to someone.
• Practice relaxation techniques – worry and anxiety can creep in when trying to sleep at night, so try some relaxation techniques to help you unwind. Breathing exercises and bedtime meditations can help to calm your body and mind before sleep.
• Pay attention to your diet – avoid large amounts of sugars and caffeine during the afternoon, as they can keep you awake at night. Try to eat at least three hours before bed as a heavy meal can disrupt sleep, but make sure you aren’t hungry either.
• Avoid drugs and alcohol – being unable to sleep or sleeping poorly can be incredibly distressing, and some people try to self-medicate with drugs and alcohol to cope. This can have even more negative consequences in the long run, as people may become addicted to these substances, causing more damage to their mental health.

It is important to remember that struggling with sleep is normal when recovering from a traumatic experience. Although sleep may not come easier instantly, consistently practising these techniques can help to signal to your brain that you are safe and that it is time to relax.

Conclusion

Sleep can improve your mental health, but mental health problems – especially trauma – can impact your sleep. Many techniques can help improve sleep after a traumatic event, but these may not be enough. Do not hesitate to reach out for support and treatment for trauma and PTSD.

If you have a client or know of someone struggling with trauma and sleep, reach out to us at Khiron Clinics. We believe that we can improve therapeutic outcomes and avoid misdiagnosis by providing an effective residential program and outpatient therapies addressing underlying psychological trauma. Allow us to help you find the path to realistic, long-lasting recovery. For more information, call us today. UK: 020 3811 2575 (24 hours). USA: (866) 801 6184 (24 hours).

Sources:

^[1] Babson KA, Feldner MT. Temporal relations between sleep problems and both traumatic event exposure and PTSD: a critical review of the empirical literature. J Anxiety Disord. 2010 Jan;24(1):1-15. doi: 10.1016/j.janxdis.2009.08.002. PMID: 19716676; PMCID: PMC2795058.

^[2] Chapman DP, Wheaton AG, Anda RF, Croft JB, Edwards VJ, Liu Y, Sturgis SL, Perry GS. Adverse childhood experiences and sleep disturbances in adults. Sleep Med. 2011 Sep;12(8):773-9. doi: 10.1016/j.sleep.2011.03.013. Epub 2011 Jun 24. PMID: 21704556.

^[3] Vandrey R, Babson KA, Herrmann ES, Bonn-Miller MO. Interactions between disordered sleep, post-traumatic stress disorder, and substance use disorders. Int Rev Psychiatry. 2014 Apr;26(2):237-47. doi: 10.3109/09540261.2014.901300. PMID: 24892898; PMCID: PMC4052373.