Returning Home from a War Zone

Service members returning home from a war zone will usually experience a variety of reactions. Common physical reactions may include:

  • Sleep difficulties
  • Stomach upset
  • Headaches
  • Rapid heartbeat or breathing
  • Existing health problems becoming worse

Common mental and emotional reactions may include:

  • Nightmares
  • Insomnia
  • Flashbacks
  • Anger
  • Feelings of guilt, nervousness, self-blame, or helplessness
  • Feeling sad, rejected or abandoned
  • Agitated and easily upset
  • Hopeless

Common behavioral reactions may include:

  • Difficulty concentrating
  • Hypervigilance
  • Avoiding other people
  • Drinking or smoking too much or using drugs
  • Poor self care
  • Aggressive driving habits

Having these reactions does not mean you have PTSD. Remember, these are common reactions to returning from the war zone. You may find it takes a year or longer to feel normal again. However, if these feelings continue longer than six to eight weeks, or if they begin to infringe on your daily life, you may want to consider seeking help.



One of the most interesting things I find with PTSD is there are so many different symptoms or ways it affects us; hypervigilance, sleeplessness, isolation, flashbacks, and on and on. Avoidance is one of those symptoms that we may indulge in without even realizing we are doing so.

Excessive sleeping is a form of avoidance, and there are times I find myself using it as a coping mechanism. If I am so tired I can’t participate in activities I probably should be involved in, it becomes a good excuse to not take part. Excessive sleeping can look like depression too as it can also be a driving force in that way.

Avoidance prevents us from engaging in life, and that is not healthy. We need challenge in our lives and we need interaction with other people.   Avoidance prevents that. Sometimes the challenge becomes forcing ourselves to participate in events in our lives so we don’t indulge in avoidance.


A good night’s sleep can make such a difference in your life! For those of us with sleep difficulties, it may take some effort to ensure a good night’s sleep.  According to a study by the Institute of Medicine, 50 to 70 million adults in the United States have a sleep or wakefulness disorder.  Many of us often don’t get enough sleep: the average adult needs 7 to 8 hours each night.  Some people can get by with less, and some people require more, but 7 to 8 hours will usually let you make it through the next day without feeling like a zombie.

It can help if you can tell whether you’re sleepy or tired. While they may seem like the same thing, they aren’t.  If you’ sleepy, you’ll find yourself fighting to stay awake.  If you’re tired, you may feel fatigued, but you will still be fairly alert.  If you feel drowsy during the day, you probably didn’t get enough sleep the night before.

If your sleep problems last more than a month, you should talk to your doctor. You may be tested to see if you have a contributing condition such as arthritis, acid reflux or even depression.  Or, you may find the medications you’re taking affect your sleep.  In that case, your doctor may suggest alternative drugs that will won’t disrupt your sleep as much.

The problem with not getting enough sleep is that it is linked to the development of a number of chronic diseases and conditions, including diabetes, cardiovascular disease, obesity, and depression. While you might question how sleep difficulties can contribute to obesity, consider that those of us who are up at night often eat out of frustration to compensate for being awake!

Some tips to help you sleep better include:

  • Make sure your bed is comfortable and provides adequate support.
  • Use your bedroom only for sleeping, not for reading, watching television, or listening to music.
  • Do not eat large meals before bed.
  • Do not exercise before bed.
  • It may help to journal what you’re thinking before going to bed if you are plagued with racing thoughts when you lie down.
  • Limit the alcohol, caffeine, and nicotine you use as you near bedtime.
  • Try taking a warm bath, meditate, or listen to calm music before going to bed.

Getting a good night’s sleep is important and it makes a huge difference in the quality of day you’ll have. A little bit of effort can make a big difference in sleeping soundly.  Sweet dreams!


All of us experience those nights when we can’t sleep. For those of us with PTSD, they may happen more often than is usual.  Last night I was up almost all night.  It’s my own fault.  I didn’t think ahead, and went out with a friend for supper.  I had a large diet Coke with my meal.  Normally, I drink caffeine-free, diet beverages, but this restaurant didn’t offer the caffeine-free variety, so, I took what I could get.  I paid for it too.

I was several hours into the sleeplessness when I realized what I’d done. I quickly got up out of bed and went out of the room to pursue quiet activities until I became sleepy.  After watching a bit of TV and playing some soft music, I returned to bed and fell asleep quickly.  Getting out of bed is one ploy for remedying the situation.  Doing something calming until you become sleepy is another.  Some of the other tips for overcoming sleepless nights include:

  • Keep your bedroom dark, quiet and cool
  • Get regular exercise, and make sure you don’t exercise late in the day
  • No caffeine within six hours of going to bed
  • Establish a routine so you go to bed at the same time every night
  • Avoid taking naps in the middle of the day

Sleepless nights can be frustrating and may leave you feeling like you’re among the living dead the next day. Try to avoid getting caught up in negative thoughts about how your sleepless night will affect you, as it only makes it worse.  Reframe those thoughts by realizing you’ve been here before and you’ve gotten through it successfully…and you will again.  Sweet dreams.

PTSD and Nightmares

Nightmares are common when you have PTSD.  According to the Center for the Study of PTSD, 71% to 96% of those suffering with PTSD have nightmares as one of their symptoms.  You may even end up trying to avoid sleeping so you don’t experience the nightmares.  Unfortunately, nightmares are one of the ways we relive or re-experience the trauma, and it can go on for months or years.

The nightmares that PTSD sufferers have often involve are an instant replay of the original trauma.  These nightmares are different in some ways than nightmares people without PTSD experience.  They are more likely to occur earlier in the night and during different stages of sleep.  They are also more likely to involve body movement.

When you receive treatment for PTSD, it is likely your nightmares will begin to get better, or will, at least, occur less often.  One form of treatment involves Imagery Rehearsal Therapy (IRT) where you visualize a different ending for the situation so it is no longer upsetting.  Then you play this new version over and over while you are awake.  When you go to sleep, this type of treatment can reduce how often your nightmares occur.

If you have breathing problems while you sleep, getting treatment may improve your nightmares too.  At this time, more research needs to be done on the use of medications to treat nightmares from trauma, although there are some medications which are showing some promise.


Sleep and PTSD: So, What am I Doing Wrong?

Sometimes I have trouble sleeping…ok, if I’m honest, most of the time I have problems sleeping. It drives me nuts that I can be exhausted all day long, then go to bed and not be able to sleep. What’s that all about?

I have been diagnosed with PTSD. For me that means I have a long history of sleeping lightly, of being able to wake up alert and ready to fight. Nightmares and trouble sleeping are just two of the more common symptoms of PTSD.

So, what’s behind the person with PTSD having sleep problems?

I don’t have to put a lot of thought into why I can’t sleep; I understand it’s because I want to feel safe and prepared for anything. What does intrigue me though is what can I do to get around it?

The VA has some suggestions:

 Change your sleeping area. Take a good look at your bedroom: is it helping you sleep or making your sleepless nights possible? Is there too much noise, light or activity in your bedroom? Turn off the computer and the television. Turn the lights down and try putting on some soft, peaceful music. In my case, it means kicking 4 puppies out of my bed!
 Maintain a routine sleep schedule. Go to bed at the same time every night and try to wake up at the same time too. Don’t get involved in activities that require a lot of activity. That only energizes you and makes the situation worse.
 If you can’t sleep, don’t fight it. Get up and read or do something quiet until you start to feel sleepy.
 Don’t exercise within 2 hours of going to bed, but do get some exercise earlier in the day.
 Get out in the sunshine if you can. It helps reset your body’s sleep and wake cycles.
 Keep caffeinated drinks to a minimum.
 Don’t nap during the day.

If things don’t get better, consider talking to your doctor about the problem. There are drugs that can help. You might also want to look into alternative therapies such as acupuncture, massage, breathing techniques, and guided imagery.