Trauma, especially the kind that produces Post Traumatic Stress Disorder (PTSD) alters the bran in a host of ways. One major result of trauma is a change in sleep patterns. Those changes in sleep result in a host of other mental and behavioral changes. Children who are abuse or neglected or witness a traumatic event have problems sleeping. Rates of sleep disorders in abused children and adults with PTSD range from 50% to 90%. The majority of all people who experience trauma have a sleep disruption that causes other mental health problems.
While the trauma and the resulting change in sleep often go unreported, other changes in behavior get noticed. These issues frequently follow child victims of trauma into adulthood. Adult victims of trauma have the same types of outcomes and they or others may think they are just acting childish. There are reasons the brain changes and things that can be done about those changes.
Not everyone who witnesses a traumatic event develops PTSD- we know that. There is a whole area of study on the topic of resilience and why some people can bounce back and others become “traumatized.” Even people with very high resilience can develop PTSD if they experience enough trauma often enough. Children who are abused, molested or neglected are at high risk, so are woman who are abused and anyone witnessing the horrors of modern warfare often enough is likely to develop PTSD.
One result of exposure to trauma is an increase in attention to things that look like the cause of the trauma. We call this hyper vigilance and many times it is a good thing.
Say you walk into the street and are hit by a car. In the future you will be much more careful. If it happens to you as a child you may grow up to be afraid to cross streets. You may even become fearful when your children need to walk to school and feel the need to go with them to keep them safe.
A woman who is beaten and raped by some men wearing a particular color of clothing, something gang related or a sports teams logo, will be very careful when she sees that style of clothing again. This may keep her safe if she avoids dangerous situations. But sometimes the increased vigilance becomes a problem.
When someone becomes afraid to leave the house or to go where there are crowds because that feared person can’t be seen? What if they become afraid of all people? What if a dangerous person changes their clothing and they do not get recognized because that woman is looking out for only one clothing style? The vigilance is now turned up too high and focused on too little.
A child who is punished for a poor score on a test may try harder the next time. But if the punishment is excessive – if it turns to abuse- that child may do anything to avoid taking a test – for the rest of their life!
How does this excess vigilance, which started out to protect the person begin to rob them of sleep and undermine their mental health?
The human body and brain moves through a series of sleep stages during the night. Some stages are deep and some are shallow. Most people reach a shallow stage and then fall back asleep. Not someone with PTSD.
Children with PTSD as a result of abuse have difficulty falling asleep. Their sleep is shallower all through the night because of the hyper vigilance. They wake up many times during the night. When they wake up they become fearful. Is something dangerous about to happen? Was there a sound that woke them up?
Children with disrupted sleep as a result of a past trauma are more likely to wet the bed. They are also more likely to get up and check the house to see if they are safe. They may sleep walk. They may have sudden awakenings as a result of the smallest of noise and it may be hard to get to sleep again after the awakenings. They often have nightmares and sometimes night terrors when they awaken suddenly screaming in fear.
Now lack of sleep at night makes the person with PTSD very tired the next day. They often get diagnosed with ADHD or Bipolar disorder. I question sometimes, with the clients I see, if the large amount of trauma they experienced in childhood did not cause the brain to grow and connections to form that resulted in the Bipolar condition. Since there is a genetic component to many mental illnesses children who have the gene risk factor may also have parents who have a mental illness. This is not an argument for taking more children away from parents. What I am suggesting is that we need more early intervention. Kids who grow up with PTSD may have trouble being appropriate parents and the problem gets passed on before it is recognized.
During the REM sleep stage memories are moved from short term memory to long term memory. Poor sleep can result in things that were learned one day being forgotten when the person gets up the next morning. Lack of sleep can also result in conditions that look like psychosis. Staying awake to long by choice or from PTSD results in the brain making things up. Before long you can have problems telling if something is real or if you are dreaming it up. You may walk around all day more than half asleep.
People who are traumatized, with or without PTSD and who have a sleep disruption as a result, are much more likely to abuse alcohol or drugs. In many drug treatment programs clients who report trauma in the past exceed 50%, sometimes the rate approaches 100%.
When the thoughts of the past keep you awake at night it appears to make sense to take something to help you sleep. Many people turn to Alcohol which does not make things better, it makes them worse.
As a person drinks more the body develops a tolerance to the alcohol. It takes more and more alcohol to knock the drinker out. Being unconscious is not the same thing as sleeping. This is one reason a person who drinks and passes out is so tired the next morning.
So there you have it. Trauma especially in large doses, the PTSD kind, results in poor sleep. The poor sleep results in lots of symptoms that look like other problems. The treatment of choice here is to work with someone who specializes in treating the Trauma or PTSD and at the same time make getting lots of good sleep a priority.