This content was created by the National Sleep Foundation

If you struggle to sleep following a traumatic experience, you’re not alone. Nearly all trauma survivors experience some type of sleep trouble, such as insomnia. But for anywhere from half to three quarters of people, it’s vivid dreams that make it difficult to sleep soundly.

Having flashbacks to traumatic events, also called re-experiencing, is a hallmark symptom of posttraumatic stress syndrome. For roughly half of PTSD patients, those flashbacks occur at night, while sleeping. And these are more common among those who’ve served in the military. For instance, 53% percent of Vietnam veterans experience vivid nightmares, compared with just three percent of civilians.

Some people have nightmares that are exact replays of the trauma that they experienced, and these are called “replicative nightmares.” Others have nightmares that are related to the trauma indirectly or symbolically.

Nightmares following trauma are different than ordinary nightmares. They can happen earlier in the night and during different stages of sleep than typical dreams. They also seem to be related to sleep-disordered breathing: Sometimes treating underlying breathing problems can help to reduce or even eliminate violent nightmares.

Specific types of therapy, like Image Rehearsal Therapy and Visual Kinesthetic Dissociation, can also help with trauma-related nightmares.

Whatever the cause, trauma and stress can disrupt your sleep in many ways. It can set off your body’s fight-or-flight response, ramping up production of neurotransmitters that keep you awake and vigilant when it’s time to sleep. But some simple strategies can help.

  1. Adjust your bedroom. Create a space to sleep in that makes you feel safe and allows you to sleep well. While typically a dark room is best for sleeping, consider using a nightlight if having some light helps you to feel secure. Having a friend or family member in the room with you or nearby may also help you to relax, if possible.
  1. Find healthy ways to blow off steam. While many trauma survivors feel tempted to use alcohol or drugs as a way to escape the memory of a stressful event, that habit can cause more sleep disturbances. Instead, try exercise, which can improve sleep—yoga is particularly relaxing. Before bed, a warm bath can also help you to wind down. Avoid news or websites that add to your anxiety.
  1. Sleep when you need to, but don’t force it. You may find that you need more sleep following a traumatic experience, or feel sleepy at different times. Brief naps or rest periods during the day may help. At night, if you find yourself lying awake, avoid letting sleeplessness become another stressful trigger. Get out of bed and do a quiet activity elsewhere until you feel ready to try to sleep again.