Complex PTSD and Sleep: How to Get Your Life Back
Complex PTSD and sleep difficulties are hard to manage on their own.
Unfortunately, if you have CPTSD, you most likely have sleep issues.
Often, when our clients come to us, they struggle with even getting into bed because of the level of stress that trauma has left in their bodies.
This traumatic stress makes it hard to calm down at night, and they avoid bedtime because it means tossing and turning, nightmares, and flashbacks. It can be to the point that many don’t sleep til dawn.
With the right sleep treatment, many clients with CPTSD improve their sleep.
The difference between Post Traumatic Stress Disorder (PTSD) and Complex PTSD (CPTSD)
PTSD is the brain's reaction to a traumatic event that was too intense for the brain to make sense of.
It is experienced through reliving the traumatic event, struggling to decrease the level of stress hormones in the nervous system, and avoiding anything that reminds the person of the traumatic event.
The symptoms of PTSD don’t just impact the person during the daytime, but also impact their sleep quality, contributing to daytime fatigue and impacting the rest of their daily life.
For most people who struggle with PTSD, the traumatic event that caused the PTSD symptoms is what we call a single-incident trauma. Or a big event that happened once or for a short period.
When it comes to complex trauma, the trauma usually occurred for a long period of time (years) and most often happened in childhood.
For example, the person came from a home that was not safe or stable, so they regularly felt unsafe or were in dangerous situations. This results in trauma.
Experiencing trauma for a long period of time results in PTSD symptoms that are more complex because they come with extra symptoms. These include difficulties with:
Emotion regulation
Self-perception
Relationships with others
Intrusive thoughts
Other negative thought patterns
If you’re struggling to sleep and believe it’s due to CPTSD, reach out for support today. We’re here for you.
How Complex PTSD impacts sleep
One of the most consistent CPTSD symptoms is sleep disturbance.
Whether it’s:
Chronic insomnia
Nightmares or night terrors
Night sweats
Restless sleep
Difficulties with dreams
Even hypersomnia
These sleep disorders are a part of having CPTSD.
The hardest part of having Complex PTSD and sleep issues is that they make each other worse. The mental health issues make your sleep worse, and the poor sleep worsens mental health.
The less sleep the person gets, the higher the CPTSD severity.
This means that you must treat both simultaneously. If you don’t treat both the CPTSD and sleep disturbances, they are going to continue to be a problem and will exacerbate each other.
How trauma interferes with sleep
We already talked about the cumulative nature of sleep and posttraumatic stress disorder/CPTSD, but why does trauma impact sleep in the first place?
In order to get restful sleep, it’s important to feel relaxed and calm so that your body can fall and stay asleep.
The problem with PTSD is that the body is no longer able to get calm enough to sleep well. This is even more extreme when the trauma was prolonged and extreme, as with CPTSD.
Trauma and Complex trauma affect the body in that the nervous system is in constant overdrive, looking for more danger. The person really struggles to turn the constant searching for danger off.
The brain is also constantly flooded by stress chemicals, which means that it feels like it is in danger all the time. So the mind is searching for the danger that the body is experiencing.
All of this, plus long-term insomnia and other sleep disruptions, contribute by disturbing sleep patterns.
This makes it hard for the body to know when it is time to go to sleep and when it should actually be sleeping.
The sleep symptoms of complex PTSD
Here are the sleep disorder symptoms that occur with CPTSD:
Light sleep: the body stays alert even during sleep
Flashbacks: reliving sensory experiences from the trauma
Insomnia symptoms: both difficulty falling asleep and difficulty staying asleep
Fear of falling asleep: sleep becomes a trigger, and so it’s avoided if at all possible
Nightmares: terrifying dreams that interfere with your ability to sleep happen during REM sleep.
Unfortunately, even when the traumatic experiences that caused CPTSD are being treated by eye movement desensitization and reprocessing (EMDR) or one of the other trauma-focused therapies, it doesn’t make the changes needed to help you sleep better.
So if you’re no longer in a dangerous situation and your brain knows that you’re safe now, why does it stay in that over-alert state?
When you experience a trauma, especially one that lasts for years, your body learns that it must be on high alert at all times.
This means that it has a hard time winding down. This is a clear symptom of PTSD.
Trauma treatment and CPTSD Treatment on their own don’t include decreasing our body's activation specifically at night and around bedtime.
If our body learns to associate sleep with fear, sleep becomes very difficult, even impossible.
This makes it important to actively break that negative association.
That is something that CBT-I focuses on. It helps you to change your body's relationship to sleep so that you aren’t afraid to sleep every night.
8 Tips to get better sleep when you have CPTSD
As you may have noticed, traditional sleep hygiene, lifestyle changes, and sleep tips don't work and may actually make things worse when you have sleep disorders related to trauma.
Traditional sleep advice doesn’t work with the dysregulated nervous system that comes from complex post-traumatic stress disorder.
The key is to take the “good sleep hygiene tips” and prioritize adding a sense of safety and emotion regulation. Basically, keep complex PTSD in mind when you’re trying to improve your poor sleep.
The goal here is to help you feel safe while also practicing good enough sleep hygiene.
Here are some tips to make this work;
Avoid alcohol and drugs before bed:
While this is true for everyone, it’s especially true for those with CPTSD. The temptation to use drugs and alcohol to sleep better is also high. Unfortunately, your trauma history makes substance use and abuse more likely.“Regular” sleep schedule:
The secret when you have CPTSD is to sleep regularly, but not to be too rigid about it. Instead of having a consistent bedtime, have a space of about 30-45 minutes where you try to get to bed.Wind down time:
Give yourself around 40-60 minutes to wind down for bed. Your body needs as much time as possible to try to get into a restful state.Calm movement:
Physical activity that helps your nervous system slow down can make a big difference in releasing negative energy, especially as part of your bedtime routine. Some examples might include a calm walk around the neighborhood or a light yoga routine. Don’t try to get your cardio in at this time of night because it can interfere with sleep.Create an environment optimized for safety:
When you’ve experienced trauma, you need to have control of your environment to feel safe. Have an adjustable light and a sound machine that has calming sounds. Set up your bed so you can see the doors and windows, and make sure to remove any triggering items from the space. It’s okay to check your space before you go to sleep to allow yourself to feel safe, but avoid checking more than once.Add comfort items:
This might include stuffed animals of favorite characters, cozy blankets, or weighted blankets. You want to make sure that you have items that can help you to feel safe.Use nervous system regulation techniques:
These relaxation techniques will help your body calm down before bed. Some ideas might include journaling worries, a shower/bath, gentle yoga/stretching, or grounding exercises like deep breathing, progressive muscle relaxation, or meditation.Avoid screens in a way that makes sense:
Many people find that turning screens completely off is activating, as distraction can be one of many coping skills, so if this is you, make sure you have blue light blockers on and you’re watching something calming.
When it comes to improving your sleep, you want to pay attention to your body to figure out what helps you to calm down. If you try deep breathing and you realize it’s creating a stress response, then that’s a hint to try something else, like journaling.
Experiment and pay attention to what does and doesn’t work.
How CBT-I Can Help
If these tips:
Don’t quite cut it
You’re receiving treatment for your trauma, but still struggling with sleep deprivation
You just feel safer getting guidance from a professional to help improve your sleep
Then Cognitive Behavioral Therapy for Insomnia (CBT-I) is the best treatment approach to help you get better sleep.
CBT-I helps you to sleep better by creating positive sleep associations and teaching you to lower the stress in your body before you try to sleep at night. It also helps you to work with the negative thought patterns you might be having around going to bed at night.
When you work with a CBT-I therapist, they will tailor CBT-I specifically to your needs and help you to learn how to sleep better.
Find a CBT-I therapist
Getting a good night's sleep when you have complex PTSD can be quite a struggle. If you or a loved one is ready to learn how to better manage complex PTSD and sleep, Rhythm Wellness can help. Schedule an appointment and get started today.
