PTSD and Sleep

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Date:
Friday, March 8, 2013

Nightmares in PTSD
by Meir H. Kryger, M.D.

The stories are eerily similar.  The patient awakens from a terrifying recurrent dream, sweating, heart beating fast, and often unable to fall sleep again that night.  Some are elderly men, others are young women.  Some have suffered trauma on the battlefield, others at home.  

In my more than 30-year career in sleep medicine, I have treated civilians, active duty soldiers, and veterans in Canada and across the United States.  For some, the trauma was recent; for others, it occurred 30 to 50 years before.  Some experienced violence directly while others simply witnessed it.  Many carry a survivor’s guilt that is central to the psychic disturbance.  What they all have in common is that a traumatic experience has gripped them and won’t let them sleep.

#N/A
In 'The Veteran' (1885), Thomas Eakins depicts subject George Reynolds' battle scars, and hints at deeper wounds to the soul

The patient stories below are disturbing to read.  They are remarkable to me in that they portray an historical snapshot of the violence that people living in North America have experienced since the 1940s, from the unique perspective of a sleep physician.  I share them with you to give you a sense of how close the relationship is between traumatic events and sleep, and how powerful is the sleeping mind.   

Holocaust.  The patient in front of me was in his 60s, referred to me because of a sleep problem.  Every night for about 35 years he awakened in a cold sweat, his heart beating rapidly from a dream about terrible events he witnessed in a concentration camp during the Holocaust.  The dream and the result were always the same — he could not go back to sleep because of fear.  I never asked him exactly what he dreamt because it was early in my career, and I was reticent.  His doctor did not know what to do with him and neither did I.  It was a problem that would continue to challenge me throughout my career in sleep medicine.

D-Day.  Soon thereafter, another gentleman was referred to me with insomnia.  The patient's sleep