PTSD and Sleep

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Date:
Friday, March 8, 2013

enemy in combat, but was not bothered by that experience, nor the fact that he had run over children after receiving orders not to stop his vehicle under any circumstances when he was part of the convoy. Rather, the dream that disturbed him was of the barrel of a pistol put next to his head and its trigger being pulled, after which he defecates in his trousers.  His dream was based on actual experience in Afghanistan.  As a practical joke, his direct superior told him that he had been accused of treason, and that he was about to be executed.  His superior pulled out a pistol and pulled the trigger.  The gun was not loaded.  “I was terrified,” he said.  “It was the only time in my life that I crapped my pants.”

Iraq.   Sitting in front of me was a broken man.  He had suffered traumatic brain injury from an improvised explosive device, had an uncontrollable twitch, and was in the sleep clinic because of severe sleep problems.  His recurring dream was that he was running over a young child who had run in front of his truck, which was part of a convoy.  He could have stopped his truck, but the orders were clear: he must not stop his truck under any circumstances.

Civilian life.   A woman in her 20s came into the clinic.  She had narcolepsy, a condition in which people have severe daytime sleepiness as well as hallucinations (actually vivid dreams, as she would fall asleep).  She also suffered severe insomnia because of recurring dreams.  The dreams were always the same.  She was being raped by her stepfather.  This had happened more than 10 years before.

Similarly, a man in his 30s with severe insomnia and recurrent nightmares dreamed he was being raped by a male schoolteacher. He, too, had suffered sexual trauma many times, at the hands of this teacher about 20 years earlier.

Diagnosing and Treating Sleep Disorders in People with PTSD

As the patients in my experience have shown, the sleep symptoms of PTSD are profound.  Research suggests that the sleep disturbances can in turn