Author: Peter Colvonen
One symptom that accompanies many mental health conditions, including PTSD, is trouble sleeping. This can involve insomnia, nightmares, obstructive sleep apnea (OSA), being unable to stay asleep or anything else that keeps you from getting proper rest.
Sleep issues are especially common among Veterans who have been diagnosed with PTSD. In fact, PTSD and sleep are so closely linked that treating sleep issues can make PTSD treatment more effective.
Sleep and Mental Health
According to researchers, sleep and mental health go hand in hand. If sleep disorders go untreated, they can interfere with recovery or possibly trigger other mental health conditions, and untreated mental health issues may interfere with sleep. Similarly, treating sleep issues and other conditions separately does not resolve either of them as well as treating them together.
Sleep-specific treatment can be easy to overlook, but it is an important element in improving Veterans’ overall mental health.
Insomnia
Characterized by difficulty falling asleep or staying asleep, insomnia is the most common sleep disturbance that Veterans report. While there are many treatments available, research has shown that Cognitive Behavioral Therapy for Insomnia (CBT-I) is the most effective and it does not require medications. PTSD treatment on its own does not seem to resolve insomnia.
Provider recommendations for insomnia include the following:
- Wind down for 30 minutes before bed
- Wake up at the same time every day
- Limit caffeine use after noon
- Avoid alcohol and drugs before bed
- Avoid the regular use of hypnotic-type medications — for example, Ambien (zolpidem) — and discuss any use of these medications with a psychiatrist
Nightmares
By some estimates, up to 90% of Veterans with PTSD experience nightmares, which are bad dreams that may replay an unpleasant memory and cause the dreamer to wake up in a panic and have difficulty falling back asleep. Nightmares can cause Veterans to relive traumatic experiences, sometimes for years.
Nightmares tend to go away with evidence-based treatment for insomnia (like CBT-I), for OSA or for PTSD (prolonged exposure therapy, cognitive processing therapy).
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