How Veterans with PTSD Can Get a Better Night's Sleep

PTSD impacts up to 23% of the nation’s veterans at some point in their lives. Symptoms such as disturbing nightmares and chronic insomnia are common for those struggling with PTSD, making a good night's sleep feel impossible. 

Unfortunately, not only is getting quality sleep crucial for maintaining good mental health, but poor sleep can often worsen symptoms of already present mental health conditions.

Alternatively, poor mental health can also have a significantly negative impact on sleep, which can further impact those struggling with PTSD. 

However, there are practical and effective solutions available to all veterans struggling with the impact of PTSD on their sleep.

Understanding PTSD-Related Sleep Problems in Veterans

How PTSD affects sleep patterns and quality

Those with PTSD frequently report issues with being unable to fall asleep, having a restless night, and waking up earlier than they wanted–all of which can impact their daily life regarding energy levels, focus, and mental well-being. 

One of the most common symptoms is nightmares, which are dreams that can induce fearful or anxious feelings. These dreams can cause you to wake up at night, further complicating a good night's sleep.  

Insomnia, another typical product of PTSD, is defined by problems falling or staying asleep throughout the night and is often accompanied by chronic tiredness during the day. 

Impact of poor sleep on mental and physical health

Poor sleep hurts both physical and mental health. In particular, the type of poor sleep associated with PTSD can cause changes in the brain that can lead to issues with cognitive functions during the day, such as memory, emotion, behavior, and problem-solving. Sadly, these types of sleep problems are also associated with a higher likelihood of risk-taking behavior, depression, and suicide.

Establishing Healthy Sleep Habits

Develop a consistent sleep schedule and bedtime routine

Fortunately, there are ways of combating the sleep problems associated with PTSD. Establishing healthy sleep habits is one strategy to consider. Sticking to a regular sleep schedule can be great for your mental and physical health, ensuring you get enough rest to deal with the challenges of everyday life. Avoiding bad habits such as consuming food too late and not taking in alcohol, nicotine, and caffeine too close to bedtime can also help.

Create a comfortable sleep environment conducive to relaxation

Another good habit to improve the quality of your sleep is to create the most comfortable sleep environment for yourself. To do this, consider how different conditions affect your ability to relax: 

• Temperature: Do you prefer a warm or cool room? 
• Physical comfort: Have you got a comfortable mattress, pillows, and bedding?
• Light: Can you dim the light to prepare for sleep?
• Noise: Is your environment quiet enough for restful sleep?
• Clutter: Is your environment tidy?
• Privacy: Do you have enough privacy to relax and get restful sleep?

Limit exposure to screens and stimulating activities before bedtime

Another sleep habit worth investing in is limiting screen time and other stimulating activities directly before bed. This means ditching screen-based activities like scrolling your phone or playing video games an hour before bed and doing something relaxing like taking a bath or reading a book. 

Coping With Nightmares

Strategies for managing PTSD-related nightmares

Since nightmares are one of the most common symptoms of PTSD-related sleep issues, there are some specific techniques designed to reduce anxiety and distress that have been proven helpful.   

Progressive Muscle Relaxation (PMR)

PMR is a technique that helps you fall asleep faster and be more relaxed, which can minimize nightmares. The process is straightforward and can be used whenever the need arises. In essence, the PMR technique requires you to tense and release muscles in your body, which releases tension and aids in relaxation. 

Image Rehearsal Therapy (IRT) 

Another coping mechanism is IRT, a type of evidence-based cognitive behavioral therapy (CBT). Treatment entails reviewing your nightmares after they occur and then rewriting them in a more positive and reassuring light. 

Importance of seeking professional help if nightmares persist or worsen

While the above techniques may be helpful for those suffering from PTSD sleep issues, often, expert help is necessary to address PTSD-related problems thoroughly, and it can have a significant impact on the results of treatments. 

Managing Insomnia

Cognitive-behavioral therapy for insomnia (CBT-I)

CBT-I is a cognitive behavioral therapy designed specifically to treat insomnia. CBT-I focuses on handling ideas that keep those who have PTSD in an awakened state so they are better able to relax and sleep. While this treatment can be intense, it is considered to be one of the best ways to treat insomnia. Some of the most effective CBT-I techniques for veterans with PTSD include:  

• Stimulus Control: This strategy enhances the brain's connection between bed and sleep (rather than wakefulness). 
• Sleep Restriction: This involves limiting your time in bed to sleep only. That means not lying in bed reading or gaming during the day and getting up if you cannot sleep at night. 

Both of these techniques can help veterans with PTSD improve the quality of their sleep because they reinforce the connection in the brain with the bed and going to sleep. 

Role of medication and alternative therapies in managing insomnia

Medication and alternative therapies can also be helpful for veterans with PTSD suffering from sleep issues. Medication can help to balance chemicals in the brain to allow for increased mental health and provide relief from symptoms. While prescribed drugs can help treat PTSD symptoms, other strategies may work as well. These activities include:

• Acupuncture 
• Aromatherapy
• Biofeedback
• Guided Imagery 
• Herbal Remedies
• Hypnosis 
• Massage
• Meditation 
• Relaxation
• Yoga

Managing Hypervigilance and Hyperarousal

Hypervigilance and hyperarousal are common in PTSD and can impact sleep. Hypervigilance is when an individual constantly assesses personal threats in their immediate vicinity. 

Hyperarousal is a state that impacts mood, causing a person to be paranoid, angry, and irritable. 

Techniques for promoting relaxation and reducing physiological arousal before bedtime

Since hyperarousal and hypervigilance make it incredibly hard to relax, getting to sleep and staying asleep can be very challenging for those with PTSD. The good news is that there are techniques that can be used to minimize physical arousal before bedtime and promote relaxation. 

One such tool is called a guided body scan based on ancient practices. Like PMR (progressive muscle relaxation), you can gradually bring your attention to different parts of your body, simply noticing the sensations and feelings there. 

Lifestyle Factors and Self-Care Practices

In addition to seeking treatment for PTSD-related sleep disorders, it can also help to make some lifestyle changes and practice self-care. Exercising regularly, eating nutrient-dense foods, staying hydrated, and using stress management techniques can all help improve the quality and duration of your sleep.

Seek Support at Jackson House

It can be incredibly helpful to seek support from mental health professionals who specialize in assisting veterans with PTSD. Several factors contribute to poor sleep in veterans, and professional treatment may be the missing piece preventing you from receiving proper rest. Contact Jackson House to learn more about our veteran's program and how we might assist you.