PTSD and Sleep

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Date:
Friday, March 8, 2013

to await rescue.  He was terrified and in pain, and after a few hours, another helicopter arrived and evacuated him.  He remembered very little about that trip except the oxygen mask.

Rwanda.  I did not take care of Canadian Senator Lt. Gen. the Hon. Roméo Dallaire, but he contributed his story to the foreword of my book, Principles and Practice of Sleep Medicine  (Elsevier, 2010):

“I was the Canadian Force Commander of the United Nations Assistance Mission for Rwanda between October 1993 and August 1994.  During that time, a genocide resulted in the deaths of 800,000 people, and I was an eyewitness, having heard, smelled, seen, and touched thousands and thousands of mutilated, bloated bodies of innocent civilians while trying to arrange a peace during a civil war while much of the world stood idly by.  My sleep suffered, my health suffered, and I developed the symptoms of posttraumatic stress disorder. “

Bosnia.  A soldier on active duty came in complaining of insomnia, awakening from sleep with a terrifying nightmare.  In his recurring dream, he saw his best friend bleeding and dead, next to a building. The soldier had been on a peacekeeping mission in Bosnia.  He was a driver.  He had backed up his truck, failing to see his friend behind the truck, and crushed him.  He came to the clinic for a sleeping pill to keep from waking up; he was too ashamed to be treated for posttraumatic stress disorder.

9/11.  I was practicing medicine in Winnipeg, Canada, when the terrible events of 9/11 unfolded.  There was a rash of patients who were referred for insomnia.  Some of them reported symptoms of posttraumatic stress disorder with nightmares related to the terrible images they had seen on television.

Afghanistan.  He was a tough-looking soldier, physically fit, short-cropped hair, and neatly dressed.  He came to the clinic with severe insomnia and a request for refill of his medications.  He was being actively treated for posttraumatic stress disorder, but had been referred to the sleep clinic to see whether we could do something about his nightmares.  He boasted that he had killed many