Addressing-Sleep-Issues

Healing From Trauma: Addressing Sleep Issues After Trauma or Chronic Stress

Sleep is one of the systems most frequently affected by trauma and chronic stress, however, it is also one of the most important things needed when helping the body recover!

If a person with trauma or chronic stress doesn’t intentionally allow the trauma or stress to process and their body to fully recover, the effects of that trauma and stress can linger in their body.

Adults with PTSD are very familiar with the sleep problems associated with trauma. Falling asleep, staying asleep, and nightmares are all common issues. It is common to be in a chronic state of sleep deprivation.

Those with early childhood attachment trauma can have the same types of problems with sleep.  Because their trauma was pre-verbal and during developmental ages, their form of PTSD looks different than that trauma experienced later in adult life. Nevertheless, the effects on sleep can look very similar.  

However, for someone who has had trauma, whether in early childhood attachment trauma or with traumatic events in adults who have lingering PTSD symptoms, sleep is often difficult, which makes consistent, good rest even harder.

Making restful sleep a priority seems to have a cultural stigma of weakness associated with it. In my training, this was especially reinforced with constant messages like, “You can sleep when you are dead” being used to encourage a constant state of alertness and maximizing output and achievement.

I am going to share two studies with you today that completely contradict that message and stigma. You will actually accomplish more and be your best self emotionally, physically, and mentally when you make quality rest a daily priority.

Sleep Deprivation Continues the Cycle of Stress and Trauma

Sleep issues are also a contributing factor to trauma and chronic stress.Sleep deprivation puts the brain and body in a vulnerable position for everyday life events, which causes the day-to-day life to be more stressful and traumatic. This continues a cycle of re-traumatization and chronic stress.

In the brain, sleep deprivation decreases brain activity and function in the parts involved in alertness, attention, and logical thinking (thalamus and prefrontal cortex). Sleep deprivation makes the brain work harder, and yet, still accomplish less.

Anybody with chronic sleep problems can tell you about the effects on their concentration, memory, mood, and emotions!

Sleep Deprivation Causes Us to Experience Life and People as More Threatening

Did you know that having a sleep debt also makes you experience life and people as more threatening?

What is not commonly known is the effect of sleep deprivation on the amygdala, the area of the brain responsible for interpreting the environment and social cues for potential threats. The amygdala subconsciously assesses all the cues in our environment (sights, sounds, smells, touch, pain, and pressure) and decides whether someone or something is a threat to our emotional, psychological, or physical well-being.

The amygdala is what triggers the nervous system to create that “gut feeling.” Our gut feeling is not always logical or something that we understand, but it is the most accurate in that moment of assessment, whether our system feels safe or not.

In 2007, a study was done assessing the effects of sleep deprivation on the function of the emotional brain and amygdala (Yoo, et al). For one night, one group of otherwise healthy young adults were either kept awake, while the control group slept normally at home. The following day they all came in for brain imaging (functional MRI).

The result? Those who were sleep deprived had a 60% greater activation of the amygdala and more areas of the amygdala that responded to negative stimuli. In other words, those who were sleep-deprived had a much stronger survival response to their environment than those who were not sleep-deprived.  

Exposed to the same environment, a person who is sleep-deprived will have a greater stress response.  

For those individuals with early attachment trauma or adults with PTSD and who have not healed or recovered, their nervous system is still primed and ready to go into survival, panic, and freeze mode when they feel scared. Since sleep-deprivation causes the brain (amygdala) to feel more threatened, the trauma and chronic stress continues to accumulate.  

The individual with a history of trauma and a sleep debt will continue to be retraumatized by life’s emotional challenges, because of the effects of sleep deprivation on their brain.

The Effects of Sleep Loss on Emotional Reactions

Another study looked at medical residents in training and the effects of disrupted sleep-wake cycles on their emotional reactivity to work events (Zohar, et al).  

The work events they studied were both ones that disrupted their work flow (negative goal-disruptive events) or that were opportunities for growth and efficiency (positive events).  

The results showed a fascinating insight that is essential to know for healing yourself or your child from trauma and chronic stress!

In the study, sleep loss intensified the negative reaction to disruptive events, and a positive emotional reaction to enhancing events was blunted. It becomes clear that sleep loss will make you more reactive to stress, and less responsive to positive events.

Lack of adequate restful sleep will also make hyperactivity worse with distractions and things that disrupt work flow and concentration.

Sleep Deprivation Undermines a Therapeutic Relationship

As I write this, I am thinking of when I first started out trying to heal my son from Reactive Attachment Disorder. The stress on me was intense! His behaviors had me in a constant state of fear. I was fearful for my future, his future, and sometimes my very life.

Not only was every behavior retraumatizing me, but the cues – his facial expressions and body language- that I would pick up on, suggested that he might do something. My amygdala was on overdrive, and due to the addition of sleep deprivation on top of this, my perceptions of his social cues were frequently off.  

The importance of restful sleep cannot be minimized if you or your child are recovering and healing from trauma!

Healing from attachment trauma cannot occur between sleep deprived people, because of how sleep loss affects the emotional areas of the brain, putting it in a state of over-reactivity to stress and misperceived threats.

Getting Good Sleep at Night is Worth the Investment of Time and Money.

Good rest is essential for the emotional part of our brains to perceive our environment as safe, bring down our self-protective walls, and engage in authentic connections with others.   

With good rest, we are able to be our best selves, have stable emotions, a clear head, and a more accurate view of what is a threat and what is just an inconvenience.

Getting restful sleep does not happen naturally for individuals with a history of attachment trauma or PTSD. It will require an investment of time and money to seek information and try various things to see what helps for that individual.

Pushing ourselves to do more and compromising on sleep will actually decrease our ability to get stuff done and will, ironically, make us more stressed about all of the things we still have to do. More sleep will result in better concentration, mood, ability to make good decisions, and will help us to interact with others in a positive rather than self-protective way.

Sleep Journal

If you are ready to take this on, I recommend starting a sleep journal where you will record what you learn, when you start an experiment, and how things change.  

Like goals, the more specific you are, the more the journal will aid you in this process of healing as a useful tool.

Make an appointment with yourself and set aside time to browse the internet on different things that have worked for other people with PTSD. 

Start with the category of sleep issues your or your child has: (1) falling asleep or (2) staying asleep.

Once you have a place to start, acquire information and set up experiments trying to change only one or two things for at least five nights in a row, and then record what happens.  

Some of the categories of factors that affect sleep that you can learn about and then experiment with include a routine, electronics, lights, sounds, temperature, pressure, touch (proprioception), dietary factors, and supplements.  

This can get tedious, but it’s important that you do not allow sleep deprivation to take over your life and frustrate you. It’s common for people with insomnia to get really frustrated when they are awake at night.  

This gets their nervous system back in sympathetic arousal state, and not only will it be harder to sleep, but also  it robs your brain and body of quiet rest even if it is not sleeping.  

Many find that with a plan of things they are trying, it gives them hope and helps them stay out of the frustration even though they are wide awake in the middle of the night. It’s when we don’t have a plan that can make us feel stuck, makes us feel that we are without hope, and makes us feel that things will never get better, which triggers the very fear and overwhelming state that we are trying to rewire and heal from.  

Summary

Whether a person is healing from chronic stress, trauma, is a professional, or is a tired parent who is in the role of healing another individual from trauma, getting restful sleep is one of the most important things any of us can do.

Given the stress that you’re already under, the increased trauma and stress that results from a lack of good sleep, it is well worth the investment of time now to know how to give your body the rest and rejuvenation it needs! The information you learn about your body and the tools that you pick up along the way will help you learn more about your biology and how to appropriately help it. This will be a tool that you will be able to use for the rest of your life.

Until you have found things that work for you or your child, I encourage you to let yourself feel tired, and to take naps when you can. As you start to sleep better at night, your need for naps and daytime quiet rest time will decrease. But until then, indulge and your system will love you for it.

What experience have you had with sleep problems as an after effect of trauma or chronic stress?

Are there any tips that you can share that has helped you to get better rest?

 

To Health and Healing ~

 

Dr. Aimie

 

References:

Yoo, S, Jujar, N, Hu P, Jolesz F, Walker M.  The Human Emotional Brain Without Sleep – a Prefrontal amygdala Disconnect.  Cur Biol 2007; 17(20): R877-R878  

  1. Zohar D, Tzischinsky O, Epstein R, Lavie P.  The Effects of Sleep Loss on Medical Residents’ Emotional Reactions to Work Events: A Cognitive-Energy Model.  Sleep. Jan 2005; 28(1): 47-54

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