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Many people have trouble sleeping sometimes. This is even more likely, though, if you have PTSD. Trouble sleeping and nightmares are two symptoms of PTSD.
“I wasn't sleeping. I was taking Ambien to sleep and I was waking up hungover but without the previous night of partying.”
John Angel, Jr.
U.S. Marine Corps 2003-2008
John Angel, Jr.
Why do people with PTSD have sleep problems?
They may be "on alert." Many people with PTSD may feel they need to be on guard or "on the lookout," to protect himself or herself from danger. It is difficult to have restful sleep when you feel the need to be always alert. You might have trouble falling asleep, or you might wake up easily in the night if you hear any noise.
They may worry or have negative thoughts. Your thoughts can make it difficult to fall asleep. People with PTSD often worry about general problems or worry that they are in danger. If you often have trouble getting to sleep, you may start to worry that you won't be able to fall asleep. These thoughts can keep you awake.
They may use drugs or alcohol. Some people with PTSD use drugs or alcohol to help them cope with their symptoms. In fact, using too much alcohol can get in the way of restful sleep. Alcohol changes the quality of your sleep and makes it less refreshing. This is true of many drugs as well.
They may have bad dreams or nightmares. Nightmares are common for people with PTSD. Nightmares can wake you up in the middle of the night, making your sleep less restful. If you have frequent nightmares, you may find it difficult to fall asleep because you are afraid you might have a nightmare.
They may have medical problems. There are medical problems that are commonly found in people with PTSD, such as chronic pain, stomach problems, and pelvic-area problems in women. These physical problems can make going to sleep difficult.
What can you do if you have problems?
There are a number of things you can do to make it more likely that you will sleep well:
Change your sleeping area
Too much noise, light, or activity in your bedroom can make sleeping harder. Creating a quiet, comfortable sleeping area can help. Here are some things you can do to sleep better:
Use your bedroom only for sleeping and sex.
Move the TV and radio out of your bedroom.
Keep your bedroom quiet, dark, and cool. Use curtains or blinds to block out light. Consider using soothing music or a "white noise" machine to block out noise.
Keep a bedtime routine and sleep schedule
Having a bedtime routine and a set wake-up time will help your body get used to a sleeping schedule. You may want to ask others in your household to help you with your routine.
Don't do stressful or energizing things within two hours of going to bed.
Create a relaxing bedtime routine. You might want to take a warm shower or bath, listen to soothing music, or drink a cup of tea with no caffeine in it.
Use a sleep mask and earplugs, if light and noise bother you.
Try to get up at the same time every morning, even if you feel tired. That will help to set your sleep schedule over time, and you will be more likely to fall asleep easily when bedtime comes. On weekends do not to sleep more than an hour past your regular wake-up time.
Try to relax if you can't sleep
Imagine yourself in a peaceful, pleasant scene. Focus on the details and feelings of being in a place that is relaxing.
Get up and do a quiet activity, such as reading, until you feel sleepy.
Watch your activities during the day
Your daytime habits and activities can affect how well you sleep. Here are some tips:
Exercise during the day. Don't exercise within two hours of going to bed, though, because it may be harder to fall asleep.
Get outside during daylight hours. Spending time in sunlight helps to reset your body's sleep and wake cycles.
Cut out or limit what you drink or eat that has caffeine in it, such as coffee, tea, cola, and chocolate.
Don't drink alcohol before bedtime. Alcohol can cause you to wake up more often during the night.
Don't smoke or use tobacco, especially in the evening. Nicotine can keep you awake.
Don't take naps during the day, especially close to bedtime.
Don't drink any liquids after 6 p.m. if you wake up often because you have to go to the bathroom.
Don't take medicine that may keep you awake, or make you feel hyper or energized right before bed. Your doctor can tell you if your medicine may do this and if you can take it earlier in the day.
Talk to your doctor
If you can't sleep because you are in pain or have an injury, you often feel anxious at night, or you often have bad dreams or nightmares, talk to your doctor.
There are a number of medications that are helpful for sleep problems in PTSD. Depending on your sleep symptoms and other factors, your doctor may prescribe some medication for you. There are also other skills you can learn to help improve your sleep.