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.