Little Rest for the Traumatized

--------------------------------------------------------------------------------

Medically Reviewed On: March 20, 2003

Erica Heilman

Sleep problems are common among people who have experienced a traumatic event. The act of falling asleep can become terrifying, and dreams that wait on the other side of sleep can bring trauma back, resulting in disturbing nights and little rest.

Below, sleep medicine expert Dr. Thomas Mellman of Dartmouth Medical School, talks about the challenges of trauma-induced sleep disturbance, and how it can be managed.

What are some of the common sleep disturbances that occur after a traumatic experience?
One potential result of such an exposure on one's sleep is that a person might feel the need to maintain a high level of vigilance. In other words, to be on alert or on guard. And being on guard is basically incompatible with being asleep. So one might see patterns of avoiding going to sleep, and sometimes the nighttime and the darkness can feel threatening to people who have experienced intense danger. And so there can be an alteration of sleep habits?trying to sleep during the day, fragmenting their sleep patterns and catching naps here and there as opposed to have a good, consolidated sleep at night.


Also, worry and intrusive thoughts, disturbing images of what happened might interfere with falling asleep.

Similarly, people who are reacting to a traumatic experience might find their sleep interrupted. There are certain startle mechanisms that can actually operate within sleep and so people's sleep might be interrupted by a sudden startle or apprehension that wakes them up.

Finally, particularly intense, life-threatening experiences can affect what one dreams about and the experience of dreams. A person who has experienced a severely threatening event might dream about that event. And the dream might be rather realistic in its content, which contrasts more typical dreams, which are kind of mixed-up and sometimes bizarre.

How do these sleep problems affect the daytime behavior?
The person may feel on guard, irritable and upset. The person may be fatigued because of sleep loss, and at the same time on guard and over-vigilant. This can be an uncomfortable combination and it might make focusing, concentrating and attending to the here and now more difficult.

And finally, distressing dreams can be remembered into the daytime. In a sense, they can become a form of extended trauma, or re-traumatization. Conversely, I think sometimes dreams evolve over time and can actually help facilitate a person's emotional recovery.


Continued at:
http://mens_health.healthology.com/s...rticle1686.htm