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Treating Sleep Problems in Trauma Survivors with Insomnia and PTSD

First of all,

Although sleep is crucial for both our physical and emotional health, many trauma survivors still struggle to get enough of it, which frequently causes disruptions in their daily lives. Insomnia and post-traumatic stress disorder (PTSD) frequently combine, making matters worse for people who are already struggling with the fallout from trauma. For the purpose of creating treatments that effectively address sleep disruptions in trauma survivors, it is imperative to comprehend the complex link that exists between insomnia and PTSD.

The Relationship Between PTSD and Insomnia:

An exposure to a traumatic event might result in the development of post-traumatic stress disorder (PTSD). Hyperarousal, avoidance behaviors, intrusive recollections, and detrimental changes in mood and cognition are some of its symptoms. Of these, sleep disruptions are the most common and severe. Oftentimes, insomnia (difficulty getting asleep, staying asleep, or non-restorative sleep) coexists with PTSD, exacerbating survivors’ overall discomfort.

There is a complex and reciprocal relationship between PTSD and sleeplessness. Sleep disruptions are early markers of a person’s susceptibility to developing PTSD since they frequently occur before the onset of symptoms. On the other hand, PTSD makes insomnia worse, leading to a vicious cycle in which sleeplessness makes PTSD symptoms worse and vice versa.

Mechanisms of PTSD-Related Sleep Disorders:

In people with PTSD, a number of mechanisms contribute to the onset and maintenance of sleep disturbances:

Chronic hyperarousal, a state in which people maintain a high level of alertness and physiological engagement, is linked to PTSD. It is challenging to go asleep and stay asleep because of this hyperarousal, which throws off the body’s natural circadian rhythm.

Nightmares and Disturbing Flashbacks: These are two of the most common symptoms of post-traumatic stress disorder (PTSD). They often interfere with sleep, causing frequent awakenings and difficulties falling back asleep. Sleep disruptions are made worse by the terror that accompanies these situations.

Avoidance Behaviors: People who suffer from post-traumatic stress disorder (PTSD) frequently use actions to block out thoughts, memories, and feelings connected to the trauma. To further disrupt sleep, these avoidance strategies can also extend to activities associated to sleep, such skipping bedtime or sleeping in places that remind one of the trauma.

Physiological Modifications: Post-traumatic stress disorder (PTSD) is linked to modifications in the neurobiological systems that control sleep, such as the sympathetic nervous system and the hypothalamic-pituitary-adrenal (HPA) axis. Disturbances in the architecture of sleep and general quality of sleep may result from dysregulation of these systems.

Handling Sleep Problems in Survivors of Trauma:

It is critical to treat insomnia in the setting of PTSD since sleep problems have a substantial negative influence on the rehabilitation and general well-being of trauma survivors. Promising outcomes have been shown when comprehensive therapy techniques address sleep difficulties as well as PTSD symptoms. Among the tactics are:

Trauma-focused psychotherapy: 

Prolonged exposure therapy (PE) and cognitive processing therapy (CPT), two evidence-based treatments, directly address symptoms of post-traumatic stress disorder (PTSD), including sleep difficulties. These treatments can lessen avoidance tendencies and process traumatic memories to help with insomnia symptoms.

Evidence-based and structured, cognitive behavioral therapy for insomnia (CBT-I) is a treatment option for sleeplessness. It focuses on recognizing and combating unhelpful ideas and actions associated with sleep, encouraging relaxing methods, and creating wholesome sleeping routines. CBT-I modifications made specifically for PTSD sufferers have shown promise in enhancing sleep quality.


Certain drugs may be administered to address both PTSD symptoms and sleep difficulties, albeit they should be taken sparingly and under the supervision of a licensed healthcare professional. SSRIs, or selective serotonin reuptake inhibitors, are frequently prescribed to treat post-traumatic stress disorder (PTSD) and may help enhance the quality of sleep.

Education on Sleep Hygiene: 

Educating trauma survivors about good sleep hygiene might help them develop habits that promote restful sleep. This entails sticking to a regular sleep schedule, setting up a peaceful sleeping environment, and avoiding stimulants like caffeine right before bed.

Progressive muscle relaxation and deep breathing exercises are examples of mindfulness-based therapies and relaxation techniques that can assist people with PTSD in controlling their hyperarousal and lowering their anxiety levels, which in turn improves their ability to sleep.

In summary:


One common and crippling symptom of PTSD that has a major negative influence on a person’s quality of life and eventual healing is insomnia. Understanding the reciprocal relationship between PTSD and insomnia is essential to putting into practice treatments that effectively address both disorders at the same time. Healthcare professionals can help trauma survivors heal and regain restful sleep by treating sleep disturbances in the context of trauma treatment.