If you have PTSD, chances are fairly good that you are also having nightmares. Add a little depression or anxiety in with your PTSD, and it increases your likelihood of having nightmares. Nightmares are difficult to deal with because they increase your fear, anxiety, feelings of helplessness, panic, and screaming or crying in your sleep. Absolutely no fun. But the negative effects of having these nightmares continue even after you wake. PTSD nightmares can result in a higher increase in REM sleep than normal, an increase in night-time awakenings and extended periods of being awake, decreased amounts of deep, restorative sleep, decreased sleep time, and problems functioning the day after due to exhaustion.
The negative effects don’t stop there either. PTSD nightmares keep you in your traumatic “flight or fight” mode of heightened arousal. You may find you avoid going to bed at a reasonable time because you are apprehensive about having more nightmares. PTSD nightmares may even prompt you to turn to using drugs in an attempt to prevent additional nightmares. PTSD nightmares have a negative impact on your quality of life.
Treatment for PTSD nightmares is often an arduous journey, slow and frustrating, but treatment can help. Stress reduction and relaxation techniques can help calm you before sleep. Image Rehearsal Therapy (IRT) is a cognitive-behavioral therapy where you focus on a different ending for your nightmares, replaying the scenario over and over so eventually the new ending will replace the nightmare ending. There has also been some success using orientation techniques to ground you in the present moment following a nightmare.
There are several other considerations those with PTSD nightmares should keep in mind. Recent research indicates that many people who have PTSD nightmares also have sleep apnea. This research indicates that restricted oxygen intake keeps the brain from its normal attempts to sooth itself, and this makes the nightmares worse. Treating the sleep problems may well resolve the nightmare issue.
Other possible treatments include somatic therapy where you focus on movement and sensations to work through the physical and emotional aspects of the trauma, and EMDR or Eye Movement Desensitization Reprocessing therapy.
Whatever form of treatment you try, remember that PTSD nightmares do respond to treatment and life can get better. You deserve a calm, peaceful life. Don’t let PTSD nightmares keep you from it!