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Sleep and Posttraumatic Stress Disorder (PTSD)

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If you are in an immediate crisis, please go to your nearest Emergency Room, or call 911, or call 1-800-273-TALK (1-800-273-8255) to talk to someone right now.

Sleep and Posttraumatic Stress Disorder (PTSD)

Many people have trouble sleeping sometimes. This is even more likely if you have PTSD. Having trouble sleeping and nightmares are two symptoms of PTSD.

Why do people with PTSD have sleep problems?

There are many reasons why people with PTSD may have trouble sleeping:

Changes in your brain:

PTSD can cause changes in the brain making it difficult to sleep. Many people with PTSD may feel they need to be on guard or "on the lookout," to protect him or herself from danger. It is difficult to have restful sleep when you feel the need to be always alert.

Medical Problems:

There are medical problems that are commonly found in people with PTSD such as chronic pain, stomach problems, and pelvic-area problems in women. They physical problems can make going to sleep difficult.

Your Thoughts:

Your thoughts can make it difficult to fall asleep. People with PTSD often worry about general problems or worry that they are in danger. If you have not been able to sleep for several nights (or even weeks), you may start to worry that you won't be able to fall asleep. These thoughts can keep you awake.

Drugs or Alcohol:

Some people with PTSD use drugs or alcohol to help them cope with their symptoms. Drinking and using drugs can make it more difficult to fall asleep.

Upsetting Dreams or Nightmares:

Nightmares are common for people with PTSD. Nightmares can wake you up in the middle of the night, making your sleep less restful. Or, you may find it difficult to fall asleep because you are afraid you might have a nightmare.

Hearing a Noise:

Many people with PTSD wake up easily if they hear a noise. You may feel that you need to get up and check your room to make sure you are safe.

What can you do if you have problems?

Whatever the cause, there are things you can do:

Your sleeping area

Your sleeping area and what you do during the day can affect how well you sleep. Too much noise, light, or activity in your bedroom can make sleeping harder. Creating a quiet, comfortable sleeping area can help. Here are some things you can do to sleep better:

• Use your bedroom only for sleeping and sex
• Move the TV and radio out of your bedroom.
• Keep your bedroom quiet, dark, and cool. Use curtains or blinds to block out light. Consider using soothing music or a "white noise" machine to block out noise.

Your evening and bedtime routine

Having an evening routine and a set bedtime will help your body get used to a sleeping schedule. You may want to ask others in your household to help you with your routine.

• Don't do stressful or energizing things in the evening
• Create a relaxing bedtime routine. You might want to take a warm shower or bath, listen to soothing music, or drink a cup of noncaffeinated tea
• Go to bed at the same time every night. And get up at the same time every morning, even if you feel tired
• Use a sleep mask and earplugs, if light and noise bother you.

If you can't sleep

• Imagine yourself in a peaceful, pleasant scene. Focus on the details and feelings of being in a place that is relaxing
• Get up and do a quiet or boring activity until you feel sleepy
• Don't drink any liquids after 6 p.m. if you wake up often because you have to go to the bathroom.

Your activities during the day

Your habits and activities can affect how well you sleep. Here are some tips:

• Exercise during the day. Don't exercise after 5 p.m. because it may be harder to fall asleep
• Get outside during daylight hours. Spending time in sunlight helps to reset your body's sleep and wake cycles
• Don't drink or eat anything that has caffeine in it, such as coffee, tea, cola, and chocolate
• Don't drink alcohol before bedtime. Alcohol can cause you to wake up more often during the night
• Don't smoke or use tobacco, especially in the evening. Nicotine can keep you awake
• Don't take naps during the day, especially close to bedtime.
• Don't take medicine that may keep you awake, or make you feel hyper or energized, right before bed. Your doctor can tell you if your medicine may do this and if you can take it earlier in the day.

Talk to your doctor

If you can't sleep because you are in great pain or have an injury, you often feel anxious at night, or you often have bad dreams or nightmares, talk to your doctor.

There are a number of medications that are helpful for sleep problems in PTSD. Depending on your sleep symptoms and other factors, your doctor may prescribe some medication for you. There are also other skills you can learn to help improve your sleep.

What is Posttraumatic Stress Disorder (PTSD)?
PTSD FAQs
Treatment of PTSD
How common is PTSD?
What can I do if I think I have PTSD?
Helping a Family Member Who Has PTSD
How is PTSD Measured?
Traumatic Stress in Female Veterans
FAQs About PTSD Assessment
DSM-IV-TR criteria for PTSD
FAQs About PTSD Assessment: For Professionals

Trauma Exposure Measures

Chart - Trauma Exposure Measures
Potential Stressful Events Interview (PSEI)
Stressful Life Events Screening Questionnaire (SLESQ)
Trauma Assessment for Adults-Self-report (TAA)
Trauma History Questionnaire (THQ)
Trauma History Screen (THS)
Traumatic Events Questionnaire (TEQ)
Traumatic Life Events Questionnaire (TLEQ)
Traumatic Stress Schedule (TSS)
Combat Exposure Scale (CES)
Evaluation of Lifetime Stressors (ELS)
Life Stressor Checklist-Revised (LSC-R)

Trauma Exposure Measures

PTSD Screening Instruments

Below is a list of links to information on select PTSD Screens, brief questionnaires completed in order to identify people who are more likely to have PTSD. A positive response to the screen does not necessarily indicate that a patient has Posttraumatic Stress Disorder. However, a positive response does indicate that a patient may have PTSD or trauma-related problems and further investigation of trauma symptoms by a mental-health professional may be warranted.

Chart - Screens for PTSD
Short Form of the PTSD Checklist - Civilian Version
Short Screening Scale for PTSD
The SPAN
SPRINT
The Primary Care PTSD Screen (PC-PTSD)
Trauma Screening Questionnaire (TSQ)
Beck Anxiety Inventory - Primary Care (BAI-PC)

PTSD Screening

PLEASE NOTE: Screens are to be used to determine possible problems, and positive cases should be followed up by assessment with a structured interview for PTSD.

Common Reactions to Trauma

People experience a range of reactions following trauma. Here you will find information on what these common reactions are, including anger, nightmares, sleep problems, and more.

Avoidance
Nightmares
Anger and Trauma
Sleep and Posttraumatic Stress Disorder (PTSD)
What Are the Traumatic Stress Effects of Terrorism?
Common Reactions After Trauma

If you are in an immediate crisis, please go to your nearest Emergency Room, or call 911, or call 1-800-273-TALK (1-800-273-8255) to talk to someone right now.