Did you sleep well last night? If the answer is no, you’re not alone. The Center for Disease Control estimates that over 35% of Americans do not get the recommended amount of sleep. Look at the CPTSD population, and that percentage rises much closer to 100%. I’m sure the same is true for the parent population. It’s certainly true for me.
Whether I’m soothing a restless toddler, struggling with anxiety, or combating CPTSD nightmares, I rarely get a good night’s rest. Anxiety and sleep-deprivation are connected via a self-reinforcing feedback loop. Healthy slumber combats anxiety—and vice versa: feeling less anxious leads to sounder sleep. Insomnia feeds anxiety and anxiety keeps us up at night.
Not all CPTSD nightmares manifest as direct re-experiencing of the physical trauma. Sometimes they just conjure up the same feelings. I’ve woken screaming from nightmares of being stalked by a demonic presence in the wall of my childhood home or trying to escape a 200 foot tsunami headed straight for me.
Because I regularly experience nightmares almost every evening, I am often afraid to go asleep. I at times am the source of my own insomnia. There was a point in my life where sleeping was one of my favorite things to do. Now, I want to avoid it at all costs. I am prescribed a sleeping pill to help knock me out, but I still find myself trying to fight it. Between intentionally avoiding sleep, taking my sleeping meds too late, and spending most of my evening in sheer panic running from the demons that haunt me almost nightly I constantly feel exhausted and drained like I did not sleep at all.
This means that I spent my days exhausted. Mornings are almost always slow starts, riddled with lethargy. I am often late by the time I am able to get up, get myself ready, get my daughter ready, bring her to school, and head to work. I spend most of my days in a tired, anxious fog. Chronic sleep deprivation also means my emotions are even more deregulated than normal, and patience, something I definitely need as a mother of a very testy four year old, is in short supply.
I decided to learn everything I possibly can about my past, the people in it, and the people that are missing from it. I figure if I answer all my lifelong questions, find my father and his family, grow closer to my biological brother I pushed away all these years, and leave no page unturned I can finally allow myself to heal, but at no point did I think it would be this difficult.
But, no matter how difficult it is to obtain, the reality is that people with trauma desperately need sleep in order to ease anxiety. Regular CPTSD therapy is the best long-term antidote to CPTSD nightmares. While the science behind CPTSD nightmares, and dreams in general, is shaky, we know that it has something to do with adrenaline and hyperarousal of the amygdala. Which are also the systems at play during daytime panic attacks and flashbacks. So getting professional help for CPTSD also helps reduce the severity and frequency of nightmares.
As a child after I began engaging in cognitive-based therapy and regularly doing contemplative grounding techniques like mindful cooking or playing, I stopped having CPTSD nightmares. For years. I also stopped having flashback and panic attack. While I still had depressive episodes, general/social anxiety, and trigger responses, my life in general was improving.
Then once my daughter became the age I was when my trauma started, it caused everything to come back full force and then some. This time, therapy alone didn’t help. My therapist advised that there is a medication on the market that can help. It’s a high blood pressure medication called Prazosin that the VA randomly discovered was effective at stopping PTSD related nightmares.
When my doctor handed me the prescription, I was skeptical. How could nightmares be treated with medication? But I was seriously sleep deprived, and the terror from my nightmares was leaking into my waking life in the form of obsessive, fearful thoughts about my childhood.
Prazosin
Prazosin is not a magical cure-all, however. I still suffer from anxiety and depression and, unfortunately, it has some pretty debilitating side-effects. Waking up before 9 means suffering serious effects of low blood pressure like dizziness and heart palpitations. For a good portion of the day I was lethargic and wrapped in an anxious mental fog. These side-effects go away once your body adjusts to the medication. Unfortunately, my anxiety during the day was still too much for me to handle so I was put on a daytime blood pressure medicine caused Propranolol and I cannot take it simultaneously with the Prazosin so I chose to have less intrusive thoughts and less shaking during the day and decided to just keep my intrusive thoughts to the evening time.
I did discuss with my therapist other ways of trying to help someone with trauma get more sleep. She advised I should practice the following elements of healthy sleep hygiene. You don’t have to do it all, but every little bit helps.
- Go to bed and wake up at the same time, even on the weekends. If you cannot fall asleep within 30 minutes, get up and read a book or do something that is comforting to you and then return to bed to sleep after you feel more tired.
- Establish a soothing bedtime routine. Examples: take a hot bath, use a lavender-scented moisturizer, read a book, and disconnect from social media–the blue light in electronic screens is notoriously rousing.
- Refrain from caffeine several hours before bedtime.
- Do not self-medicate with alcohol. It can help you get to sleep faster, but it can lead to sleep troubles in the long run. Some wine with dinner is okay.
- If you have to nap during the day, limit it to 20 minutes.
- Exercise during the day, but not a few hours before sleep (unless it’s strength straining, which promotes tiredness).
- Make the bedroom an oasis of calm: Sleep in a cool, dark, clutter-free room. Limit your activities here to sleep and sex.
- Sleep on a comfortable mattress that gives you enough support and does not make you hot.
- Consider adapting a mindfulness meditation routine, which has been demonstrated to alleviate both sleep deprivation and CPTSD.
- Talk to your doctor about both behavioral therapy and medications to help treat your PTSD and sleep issues.
Sleeping after trauma is daunting: this much we know. But it is also true that improvements are possible if you follow just a few of these recommendations, to whatever degree you can. Test the solutions. Keep a sleep journal by your bedside. Find what works best for you. And sleep well.
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