Trauma, The Body and Sleep Pt. 1

In this three-part series, I will be looking at the impact of trauma on the body and sleep. In this first part, we’ll look at trauma in general.

Trauma is an experience that has lasting, negative effects on an individual’s well-being and ability to function. A single traumatic event can lead to psychological trauma, or it can build up over time in response to ongoing stress.

While the definition of trauma has changed over time. It’s clear that experiencing a potentially traumatic event is common. In fact, research suggests that almost 90% of people are exposed to at least one potentially traumatic event during their lives.

Experiencing trauma can increase the risk of mental and physical health issues, including suicide; if you or anyone you know is thinking or talking about suicide, contact a health professional immediately or organisations such as The Samaritans for support and advice.

The Impacts of Trauma on Sleep

Sleep issues are common after a traumatic experience. Alertness and hyperarousal related to the effects of the body’s stress response often contribute to the symptoms of insomnia. Many people have difficulty falling asleep, wake up more often during the night, and have trouble falling back asleep after a traumatic event.

Trauma can also affect sleep architecture, which means that it can change how the body moves through sleep cycles and stages. Although experts are still working to understand the implications of the changes observed in sleep architecture after trauma, rapid eye movement (REM) sleep appears to be the stage most affected. REM sleep is important for storing memories and processing emotions, and dreams during REM sleep tend to be more fantastical and bizarre.

Distressing dreams and nightmares are common to trauma. Survivors often have dreams about the traumatic event12 that either directly replay the experience or contain trauma-related emotion, content, and symbols. Researchers hypothesize that trauma-related dreams are caused by the brain’s fear response combined with hyperarousal, and may represent the mind’s attempt at integrating a traumatic experience.

While sleep issues after a traumatic experience can be distressing, they may also be an important opportunity for treating and healing from trauma. Research suggests that being able to sleep after a traumatic event can reduce intrusive trauma-related memories and make them less distressing. Targeting sleep issues in the early treatment of trauma may reduce the risk of developing PTSD.

Sleep Disorders After Trauma

Insomnia is one of the most common sleep issues related to trauma and resolves on its own in the majority of trauma survivors. More severe and persistent sleep disorders are usually seen in people with higher levels of post-traumatic stress and PTSD. While rare, sleep disorders that may develop after trauma include nightmare disorder, periodic leg movement disorder (restless leg syndrome), sleep terrors, and REM sleep behavior disorder.

Childhood Trauma and Sleep

Childhood trauma can continue to impact a person’s health long after childhood has ended. In a study by the CDC and Kaiser, which investigated the impact of childhood traumas on the lives of 17,000 adult participants. This seminal study found that adverse childhood experiences or ACEs, increase the risk of mental and physical health problems later in life, including depression, anxiety, heart disease, and even early death.

One way in which childhood trauma increases the risk of diseases later in life may be through the development and adverse effects of sleep problems. Up to one half of children show some of the symptoms of PTSD after trauma, including hyperarousal and trouble sleeping. Trauma can have a significant impact on childhood brain development, so sleep problems may persist or get worse as the child progresses through adolescence and into adulthood.

Compared to adults with few or no ACEs, adults with a significant amount of childhood trauma are more than twice as likely to have trouble falling asleep and are also twice as likely to feel tired after a full night’s sleep. The effects of ACEs on sleep can last for up to 50 years, with each ACE experienced in childhood increasing the risk of not getting enough sleep as an adult by 20%.

Trauma experienced during childhood can also affect the severity of insomnia in adulthood. In adult patients diagnosed with insomnia, those with a high number of ACEs wake up more often during the night and have more disturbed sleep than those with few or no ACEs.

Tips for Sleeping After Trauma

It’s normal for a traumatic experience to affect the quantity and quality of your sleep. Be patient with yourself and try to have realistic expectations about the time it will take for your body to heal. Working with a doctor, psychologist or counselor can help you create reasonable, achievable goals for coping with sleep issues after trauma. Here are a few other tips for sleeping as you heal from trauma:

• Maintain your usual sleep schedule: Routine is important for getting restful, quality sleep. Going to sleep and getting up at the same time every day, even on weekends, helps your body be more prepared when it’s time to rest.
• Sleep where you feel safe: Consider what changes would make your sleeping environment feel safer while you’re recovering. Maybe that’s having someone else sleeping next to you or on the couch for a while, keeping a phone within reach, or keeping a dim light on in part of the bedroom.
• Engage the relaxation response: Relaxation exercises are one way to encourage a relaxation response and calm the body and mind before bed.
• Don’t force sleep: If you find yourself tossing and turning for more than around 20 minutes, try a warm bath, reading, or listening to calming music, before going back to bed when you feel tired.
• Understand that your symptoms may be normal: There is no right way to process a traumatic experience, but it’s essential to get help; doctors, counsellors, and social workers are trained in helping people cope with and heal from the consequences of a traumatic event.

 In part two of Trauma, The Body and Sleep, a closer look will be taken at the role of trauma and the body’s response.