Trouble sleeping can be helped and we can work to promote healthy rest and counteract the insomnia abuse often induces. There is no sure-fire way to end insomnia, and professional may need to be involved as a lack of sleep can cause real health issues. No one-trick will fic but you can work with you’re circadian rhythm or sleep/wake cycle to promote better sleep. Healing is possible.

The Science Of Sleep:

The sleep/wake cycle is a daily pattern that determines when it’s time to sleep and when it’s time to be awake. For most humans, the ideal cycle includes 7 -9 hours of sleep followed by 15-17 hours of wakefulness. If you’re dealing with mental illness, trauma, illness or chronic health issues that number might rise.

The body has a series of processes that set the stage for this cycle. For example, different chemicals and hormones rise and fall over roughly 24 hours, causing you to feel tired at predictable times. One such chemical is adenosine, which accumulates in your blood throughout the day. The longer you’re awake, the higher the level of adenosine in your blood, until eventually you tip into a desperate-for-sleep mode. When you do drift off, your adenosine level drops, beginning the cycle again.

Melatonin is another hormone that helps to regulate the sleep/wake cycle. Your melatonin level starts to rise in the late afternoon and continues to creep up through the night, and then falls in the early hours of the morning, as your body prepares to wake.

Trauma & Sleep:

Trauma causes sleep disruptions through hypervigilance and hyperarousal cause the function of the parasympathetic nervous system to be dysregulated. With this impaired function the body can not easily bring itself into a calm and restful state.

Nightmares related to trauma are symptomatic of PTSD, and for those with C-PTSD nightmares, in general, are a symptom. Nightmares cause fear to sleep, disrupted sleep and can lessen the number of restful sleep people can achieve.

Triggers related to seep, darkness and beds can make sleep so hard when triggers are happening. Flashbacks are not conducive to being able to fall asleep. Vulnerability related to sleep can also be hard for trauma survivors.

Depression is one of the most common causes of poor sleep. Depression can prevent restful sleep and cause insomnia and also hypersomnia which can have a result of then causing insomnia. This can become a painful cycle.

Environment:

An environment that you set up to promote sleep is key. It makes you more comfortable and helps create a routine, which is known to regulate the Wake/Rest cycle and circadian rhythm. It also helps your mind know sleep time when you’re in this place.

• Make your room your preferred temperature as best you can, turn the lights down and reduce noise as much as possible.
• Get a stuffed animal, blanket or other comforting items (never too old in our book)
• Set up pillows and blankets in the most comfortable way for you. If you deal with chronic pain you can research and test out pillow placements. Set this up before you lay down, you can move them as needed, but setting them up first is good. (Like pillows under knees for lumbar pain and muscle strain)
• Try things like lavender essential oils or light a candle (before you sleep, do not leave lit while asleep). Laender can promote a decrease in anxiety and again gives your mind an outside cue it’s time to rest.
• Play music, sleep tracks, listen to an audiobook or podcast this can help keep thoughts swirling before bed. make sure its something that calms you down and not worked up. Something you’ve listened to before is often a good bet.
• If possible do work and socializing in another place than the bedroom. Reserving the bed for sleep has been shown to help. The mind will associate bed with sleep. 
• Trying weighted blankets or toys can be helpful to make you feel safe and can help with chronic pain. 
• It’s okay to do things like check under the bed, have a nightlight, sleep without the door open or other things that can reduce fear. If it becomes compulsive or needed to do repetitively then it can become an issue itself, but it’s not childish to make the environment feel as safe as possible.

Get In A Routine:

Having regular times when you practice your Activities of Daily Living (ADLs) is known to help sleep. Examples of ADLs are brushing teeth, showering, changing clothes, eating, drinking water, using the toilet, brushing hair and similar behaviours.

Performing ADLs in a constant pattern helps the body be ready to regulate sleep. ADLs being regularly is also good for the feelings of being out of control that PTSD can cause. Regular ADLs are good for our wide health and can help keep up with those basic behaviours anxiety, depression, fatigue and memory issues trauma can induce.

• Eat consistently and at the same time, as work/school allows. Don’t push to the point of making yourself sick, but even if your appetite is low some food is better than none. For sleep and overall health.
• Foods that promote healthy sleep:
  • Almonds: Help melatonin production, High in magnesium and calcium which promote muscle relaxation. 
  • Chamomile, Lavander, Lemon Balm, and Passionflower tea: All shown to have some level of help for coping with anxiety and sleep difficulties.
  • Tart Cherry Juice: Still in preliminary research, but has shown benefits in combating insomnia. Has a high melatonin content itself, and can reduce inflammation lowering pain.
  • Walnuts: Helps promote Melatonin and serotonin regulation. Magnesium promotes muscle relaxation.
  • Warm Milk: Contains tryptophan, calcium, vitamin D, and melatonin. All important for sleep. 
• Foods that make sleep harder
  • Coffee: A stimulant for the caffeine content keeps people awake. Caffeine can also have some withdrawal symptoms, so when dealing with these addictive tendencies sleep is harmed again. 
  • Energy Drinks: Aso contains caffeine has the same effects as coffee
  • Caffeinated teas: again for caffeine
  • Chocolate: This is more specific to having it close to bedtime, this is linked to theobromine, which increases heart rate and causes sleeplessness
  • Soda with high caffeine content
• Drink water, always mention this with self-care, no particular reason but it is good. Keep some by you when sleeping too.
• Try and do physical activity at regular times. I know work and school can make this so very hard. But regular movement pattern is important in wake-sleep patterns. 
• Avoid products with nicotine, this, of course, is an addiction and its own set of problems. But good to know that it can heighten insomnia and nightmares.

Regulation & Relaxation Skills:

Learning tools you can help yourself relax and counter-act dysregulation of the nervous system in hyperarousal.

• Six seconds of breathing out will trigger the parasympathetic nervous system. This brings down the heart rate and tells the body to relax. One of the easiest ways to counteract hyperarousal, it’s also useful in preventing panic attacks and recovering from panic and flashbacks.
• Progressive muscle relaxation: this will help release physical tension your holding in your body and centre your breathing. a calm body is important for healthy sleep.
  • Steps:
    1. Get comfortable while lying down.
    2. Start breathing diaphragmatically.
    3. Do a body scan, start at the head and move down. Try and notice where in the body you are carrying tension.
    4. While inhaling, contract one muscle group for 5-10 seconds, then exhale and release the tension in that muscle group. Starting with the feet or the head is generally the best so you can move from top to bottom.
    5. While releasing the tension, try to focus on the changes you feel when the muscle group is relaxed.
    6. Give yourself 10-20 seconds to relax, and then move on to the next muscle group, the muscle next to the one you start with is best.
    7. Gradually work your way up the body contracting and relaxing muscle groups ending at the head or feet based on where you started.
    8. Repeat steps 3-7 a total of 2 or 3 times.
  • Imagery may be helpful in conjunction with the release of tension, such as imagining that stressful feelings are flowing out of your body as you relax each muscle group.
• Yoga before bed can be really helpful. Don’t need to be a master just some basic stretching and breath control. This combines starting the parasympathetic nervous system, and some movement. 

Counteract Rumination and Anxious Thoughts:

• This is likely counter-intuitive, but try playing a game before sleep. Like solitaire, Suduko, puzzels or even like paint by numbers. Something that requires brainpower. This stops panic and rumination, which can often prevent sleep. 
• If your willing to give it a shot meditation apps could be helpful. I know it can feel hoky, but its something I find gets easier over time. 
• Read or listen to podcasts/audiobooks that are particularly disconnected from the trauma thoughts that are upsetting you.
• Journal before sleeping to get some thoughts out.

For Disrupted Sleep:

• If you can’t get back to sleep, take a moment get out of bed and walk around. This can ease some bodily tension and can fight against that experience of just telling yourself to sleep already.
• Write down what you were dreaming, this can help you set it aside and process it while awake
• Use regulation skills mentioned above to bring the body back down to a normal state or hopefully relaxed.
• Hug your stuffed animal/blanket or other comforting objects. This doubles as grounding.
• Drink some water.
• Go through some of your sleep routines again, this can retrigger the sleep signals you’ve earned.
• Don’t push it, fighting yourself telling yourself you should sleep will make sleep harder.
• Try heavy distraction methods like reading or listening to things and try avoiding all of them. It can help work out.
• If you at all can, things like free clinics might allow you to find some help without needing insurance. 

Misc Advice:

• Go to sleep when you are tired, routines are good but if you are keyed up don’t force yourself to sleep. Engage in relaxing behaviour so you don’t drain your energy. But forcing sleep can be more harmful.
• Rest throughout the day when you need to take breaks throughout the day can help energy not be in super low supply. recharging and even naps can improve sleep for trauma survivors who deal with a nervous system that is so dysregulated.
• Don’t eat right before bed, this has been shown to make sleep harder.
• Sleeping in living rooms or other non-bedroom spaces is okay if you need to if you’re still living in the room where the abuse or assault happened. When in your own space it is good to be able to sleep on a bed in a space specific for rest.
• Meditating throughout the day helps the body learn to be able to reach a calm place, and when we use these tools to sleep it will be so much easier.
• Don’t beat yourself up about not being able to sleep. It takes time to help your brain heal so you can sleep easier.

Reaching Out:

Seeking help from a medical professional is not feasible for all people, but it can help if you have access.

If money and/or insurance is a barrier, you might still be able to get help:

• This site can help you find free/low-cost medical clinics, these aren’t necessarily going to have mental health care, but any medical needs and can be a link to mental health care. For sleep, this might be good because medical issues can be based on neurological or physiological reasons that aren’t trauma or only trauma-related.
• Health central article on finding free or reduced-price care, and care for the uninsured. 

Conclusion:

Sleep is important to our well being overall, and dealing with the way trauma is connected to the disrupted nervous system, fears of vulnerability triggers around sleep, nightmares and insomnia are hard.

But recovery can happen. Through these steps, you can improve sleep right now, and trauma processing will counteract the trauma linked problems. Better management and recovery from depression will also improve sleep.

Citations:

1. “Trauma & Sleep.” National Sleep Foundation, NATIONAL SLEEP FOUNDATION, https://www.sleepfoundation.org/articles/trauma-and-sleep.
2. “How Your Body’s Circadian Rhythm (or Sleep/Wake Cycle) Helps You Sleep.” Sleep.org, National Sleep Foundation, https://www.sleep.org/articles/sleepwake-cycle/
3. Elliott, Brianna. “The 9 Best Foods to Eat Before Bed.” Healthline, Healthline Media, 23 Oct. 2017, https://www.healthline.com/nutrition/9-foods-to-help-you-sleep#section2
4. Sateia MJ, Doghramji K, Hauri PJ, et al. Evaluation of chronic insomnia. Sleep. 2000;23:243–314.