ptsd

 

In their leaflet on Nightmares and Sleeping Problems after abuse, Rape Crisis Scotland writes:

The trauma of sexual violence may lead to nightmares. These are more than simply ‘bad dreams’. You may feel that the attack or an aspect of the abuse is really happening to you in your sleep. This is very frightening. If you experience nightmares regularly, it is likely that you will be apprehensive about sleeping. Try to remind yourself that nightmares are an effect of the abuse you experienced. You are not going mad and it is possible to develop ways of reducing nightmares and of coping with the after effects. It can be helpful to try to understand the nightmares as part of your recovery. Your brain is recalling images or sensations which it needs to process before moving on.

What are some ways people cope with poor sleep patterns and nightmares caused by abuse?

Talking about the trauma with a doctor, counselor, or trusted friend/family member is one way to relieve some of the mental strain experienced from the abuse. Practicing relaxation exercises* such as muscular or breathing exercises, yoga, meditation, or nature walks can also relieve the strain and make coping with the effects of the abuse more manageable.

 

The Center for PTSD offers suggestions for adults struggling with nightmares or sleep problems as a result of abuse they have or continue to suffer:

• If you wake up from a nightmare in a panic, remind yourself that you are reacting to a dream. Having the dream is why you are in a panic, not because there is real danger now.
• You may want to get up out of bed, regroup, and orient yourself to the here and now.
• Engage in a pleasant, calming activity. For example, listen to some soothing music.
• Talk to someone if possible.
• Talk to your doctor about your nightmares. Certain medicines can be helpful.

• Keep to a regular bedtime schedule.
• Avoid heavy exercise for the few hours just before going to bed.
• Avoid using your sleeping area for anything other than sleeping or sex.
• Avoid alcohol, tobacco, and caffeine. These harm your ability to sleep.
• Do not lie in bed thinking or worrying. Get up and enjoy something soothing or pleasant. Read a calming book, drink a glass of warm milk or herbal tea, or do a quiet hobby.

 

The National Sleep Foundation (USA) offers tips to help those coping with trauma to sleep better and more comfortably (linked above):

• Sleep in a location where you will feel most rested and safe. While the bedroom is optimal, it may not be possible to rest there soon after the trauma if you experienced violence in that room.
• Create an environment in which you can sleep well. It should be safe, quiet, cool and comfortable. While it often helps to sleep in a dark room, if keeping a nightlight on helps bring about a more safe feeling, then consider keeping the room dimly lit. It may also help to have a friend or family member stay in the room, or perhaps in a nearby room, while you are sleeping.
• Engage in a relaxing, non-alerting activity at bedtime such as reading or listening to music. For some people, soaking in a warm bath or hot tub can be helpful. Avoid activities that are mentally or physically stimulating, including discussion about your violent experience, right before bedtime.
• Do not eat or drink too much before bedtime and recognize the negative role that alcohol can have on your sleep.
• Rest when you need to rest. It is common to feel exhausted after a violent trauma, so you may need more rest or to rest differently during this time. Relaxing and resting for brief times throughout the day and taking short naps (15-45 minutes) may help.
• Go to bed when you feel ready to sleep. Try not to force sleep, which can add to the pressure of wanting to get to sleep. Developing the harmful habit of lying in bed awake for long periods when you want to sleep is counter-productive.

 

When children have nightmares:

All children have bad dreams from time to time but children who have experienced sexual assault often have nightmares every night sometimes more than once. They may have recurring dreams which are all the more frightening because they know what is coming. Nightmares can make children terrified of the dark and bed time leading to difficult behaviours. Their dreams are likely to reflect their fears and their sense of lack of control. Looking at the content of their dreams can help them to talk about what has happened.

Night terrors are different from nightmares in that they occur during non-REM cycles as opposed to nightmares which will occur during REM, or the dream state. Children often do not remember having night terrors, whereas nightmares can often be described after they are awake. Perhaps most important, children do not respond to attempts to calm or wake them.

Baby Centre offers some advice to parents dealing with children who suffer night terrors (linked above):

How long do night terrors last?

An episode may last anywhere from two or three minutes to around thirty minutes. A child having a night terror cannot be calmed down. It can be very frightening to a parent because repeated attempts to soothe the child have no effect.

How should I handle them?

Of course, you’ll want to comfort your baby, and you should, but that’s not enough. Since the baby is stuck between two sleep stages, you can try to offer him a bottle so he can go into deeper sleep, or take him out of his bed to another room, which might rouse him. If neither measure has any effect it’s important to remember, say the experts, that the child isn’t actually awake. And though it’s upsetting to see your child thrashing about in distress, attempts to comfort may not help; in fact, in many cases, your baby won’t even know you’re there.

What should I do when one occurs?

It’s best to sit nearby and wait for the episode to pass. You can try taking your child into another room or outside where the temperature is very different. This may bring him into a lighter sleep state. Within 15 to 20 minutes your child should calm down, curl up, and fall asleep again. He won’t recall the incident in the morning, and it’s best not to remind him of it.

How do I prevent them?

There are steps you can take to head off night terrors. Children who go to bed agitated or overtired are more likely to suffer these sleep disturbances. Babies under a year old usually need between 13 and 14 hours of sleep a day, including two daytime naps, whilst older children may sleep nine or ten hours at night, with a one-hour nap. So that you know your child is getting enough sleep, lengthen his nap time, let him sleep a little later in the morning, or put him to bed earlier. And make sure that there’s plenty of time for calming bedtime rituals, such as bath-time, songs, stories, and lots of cuddles. Since night terrors tend to happen in the first part of the night, after your child has been asleep for two or three hours, you can try to prevent them by gently waking him up about 15 minutes before the typical episode would start. This should alter the sleep pattern and prevent the night terror from creeping into his slumber.