Rest for the Whole You: PTSD and Sleep

Let us begin with a simple question: when did you last wake up rested?

If you had to think about it, you are not alone. More than one in three adults in this country do not get enough sleep, and for veterans and service members living with post-traumatic stress, the number of restless nights can feel endless. You lie down tired, your body is heavy, and your mind is still on watch. Then someone tells you to "just relax," as if you had not already tried that a hundred times.

I know something about fighting sleep. For as long as I can remember, I have awakened at 3 or 4 in the morning. As a child, my early rising was treated as a problem, and as an adult, it was given a name: insomnia. I took sleeping medication for years, trying to force my body into a schedule that was never designed for it. It was not until I paid attention to my body's natural timing that I stopped needing the pills, because my body knew when it needed sleep. I share this because the answer to poor sleep is rarely found in one pill, one tea, or one tip. It is found in looking at the whole person.

When the Body Is Still on Duty

Post-traumatic stress disorder (PTSD) is best understood as a recovery that stalled. After a traumatic event, most people experience symptoms that ease over a few months. With PTSD, something got in the way of that natural recovery. Memories come uninvited, often right as you are falling asleep or when the house finally gets quiet. You avoid people, places, and conversations that remind you of what happened. You stay on guard, scanning, listening, and bracing, long after the danger has passed.

Imagine how many service members were trained, drilled, and rewarded for staying alert, reacting fast, and expecting the worst. That training served a purpose. The problem is that no one issues the off switch when you come home. A sound, a smell, or a certain hour of the night can set off the alarm before your thinking mind has a chance to weigh in, and your body responds as if the danger is happening now.

Understand this as well: painful memories alone are not PTSD, and poor sleep alone is not PTSD. Sleep trouble has many causes, which is exactly why we have to look at all of them.

The Whole Person: Six Areas That Affect Your Sleep

Sleep is shaped by every area of your life. I look at six areas: relational, financial, emotional, nutritional, physical, and spiritual. Picture them as six slices of one pie. When one slice is out of order, the others feel it, and your sleep usually tells on it first. The free handout on this page includes the chart and a place to rate each area so you can see where to start.

Relational

Trauma can shake your trust in others and in yourself. Some people respond by pulling away, and isolation makes everything heavier. Tension at home late in the day keeps the body on alert long after the conversation ends, so settle a conflict, or set it down, earlier in the evening rather than carrying it to bed. Ask the people you live with to support your sleep habits, and practice the simple discipline of giving and receiving kindness. Healthy relationships are built on honesty and limits, and both of those protect your rest.

Financial

Money worries have a way of showing up at bedtime, and they never come alone. Rather than letting them run through your mind at midnight, give them a time and place during the day. Before bed, set aside 15 to 30 minutes to write a worry list: each concern, followed by one next step you can take tomorrow. Pay bills in the daytime and outside the bedroom. Your bed was not made to be a home office.

Emotional

When the noise of the day falls away, the mind often replays what it has been carrying. Guilt can feel like proof that you did something wrong, but a feeling is not a fact. Hindsight gives you information you did not have in the moment, so judge your past self by what you knew then. And when you catch yourself saying, "I feel like I'm a bad person," recognize that you are describing a thought, not a feeling.

When your mind gets loud, bring your body back into the room. Breathe slowly into your belly through your nose and out through pursed lips for five to ten minutes. Run cool water over your hands. Name the things you can touch. Keep something small in your pocket, like a smooth stone or a little peppermint oil, to remind you where you are. Working through the trauma itself with a mental health professional may also be warranted.

Nutritional

Eating fills you up. Nourishing fuels you. A person can eat all day and still be malnourished, and a malnourished body does not rest well.

Hydration comes first. Every cell in your body depends on clean water, and most people simply do not drink enough of it, especially in the winter. When the body runs dry, it shows up as a shorter temper, a foggier head, a heavier mood, and poorer sleep. Drink water throughout the day and ease off in the evening, so a full bladder does not become your alarm clock.

Watch your timing. Caffeine can take up to eight hours to wear off, so keep it before noon. Alcohol may knock you out, but it breaks up your sleep later in the night, so leave it out of your evenings. Finish a light dinner about three hours before bed, because a sugary or carb-heavy meal late in the day can spike your blood sugar and wake you. Marjoram is great in soups and makes an excellent dinner for a restful night, without feeling hung over the next day.

Magnesium supports calm nerves, a steady mood, and quality sleep. You will find it in collards, spinach, kale, beans, black pepper, and real cocoa. Real cocoa is much gentler than coffee, with roughly 10 to 12 milligrams of caffeine in a cup compared to 95 to 165 in drip coffee. Choose raw cacao or natural cocoa that is as unprocessed as you can find, with little to no sugar, and enjoy it 30 to 90 minutes before bed.

I once worked with someone who was dealing with cluster headaches, poor sleep, low water intake, and depression. I encouraged them to see their medical doctor and request comprehensive blood work. The results showed low iron and low magnesium. They began taking magnesium, iron, and a B-complex vitamin and improved their nutrition using my book, Dollars and Nutri-Sense: Polymaths, Recipes, and Adventures. Within a few weeks, they reported better sleep, no more headaches, and a remarkable improvement in mood. This is why I tell everyone to get an annual checkup with a full blood panel. You cannot correct what you never measure.

Herbs have been used for rest for generations, including chamomile, marjoram, vervain, tart cherry, wild cherry bark, angelica, black cohosh, and burdock root. Each one has its own uses and cautions, which you will find in the handout. Try one herb at a time so you can tell what it is doing for you, and if you take medication, check with your prescriber or pharmacist first. If you want to study herbs more deeply, my book Herbalism: The Foundation for Cellular Wellness is a good place to start.

Your body also needs regular maintenance, much like a car that is driven every day. A full detox should be done with a trained integrated health provider, but you can begin with the basics: clean water throughout the day, kefir on a regular basis (if you are lactose intolerant, ask your provider about other options), and mineral levels where they need to be. Magnesium also helps with constipation, and a backed-up body is an unsettled body.

Physical

Your body was designed to follow nature's clock, not the daylight saving clock. In the beginning, the greater light was made to govern the day and the lesser light to govern the night (Genesis 1:16). I share this for the principle, not to preach: day and night were set long before the alarm clock was invented. By 10 or 11 at night, nature is already asleep. Sunset is your cue to begin winding down, and sunrise is your cue to wake. If the sun sets at 7, start slowing down at 7, and your body may naturally drift off around 9. If the sun rises at 5:30, that is when your body wants to begin its day, right along with the birds and the roosters.

There is no one-size-fits-all, only types and templates. Go to bed and get up at the same time every day, weekends included, and spend two to four weeks noticing when you feel sharpest and when you drag, without caffeine, nicotine, or alcohol. Your natural rhythm will show itself.

Your body makes its own melatonin when darkness falls. Melatonin pills are often overused and can impair sleep when they are not used as indicated. Support your body's own supply instead by getting outside for at least 30 minutes a day, mornings especially, even when it is cloudy. Dim the lights after sunset and put away screens an hour before bed.

Keep your bedroom cool (65 to 68°F), dark, and quiet, and keep your bed for sleep and intimacy. If you are still awake after 20 minutes, get up, do something boring in dim light, like reading an owner's manual or answering a journal prompt in a sentence or two, and return to bed when you are sleepy.

Then rule out what else your body may be trying to tell you. Get an annual checkup with a full blood panel, including magnesium, iron, vitamin D, B12, B6, selenium, calcium, and zinc. Poor sleep can come from blood sugar spikes, diabetes, kidney problems, an underactive or overactive thyroid, dehydration, sleep jerks (myoclonus), sleep apnea, restless legs, pain, or the timing of a medication. Hormones play a part as well, including the days before a menstrual cycle, the years when the reproductive system slows down for women, and lower testosterone in men. Most adults need 7 to 9 hours of sleep, teens need 8 to 10, and adults over 65 need 7 to 8 (CDC).

Spiritual

Trauma can shake your faith and your sense of meaning. Many people ask, "Why me?" That question grows out of the belief that good people are protected from bad things. Doing right lowers your risk, but it never came with a guarantee. Before you wrestle with forgiveness, ask yourself whether there is truly anything to forgive. Let your values guide your choices, and make prayer, meditation, or gratitude part of your evening wind-down. Self-care is not weakness or laziness. Do one thing each day that does you good.

Nightmares

Nightmares often replay the trauma, and they can make going to bed feel like walking back into it.

The NHS recommends grounding when you wake from a nightmare. Remind yourself how now is different from then. Move in ways you could not at the time: stand up, stretch, and look around the room. Then say it out loud: "It happened in the past. I'm safe now. This will pass."

The VA recommends cognitive behavioral therapy for insomnia (CBT-I), which reduces how often nightmares come and how upsetting they are. It usually takes about six sessions and is available in person, by video, online, and through the CBT-I Coach app. You can learn more from the VA National Center for PTSD.

And if a new nightmare shows up after you have made progress, it does not mean you are back at the beginning.

Reduce Your Time in Bed

Lying awake in bed teaches your body to be awake in bed. To reverse that, keep a sleep journal for one week and figure out how many hours you are actually sleeping. That number becomes your new time in bed, but never less than 5.5 hours. Set your wake time at sunrise and count backward to find your bedtime. At the end of each week, divide the hours you slept by the hours you spent in bed. If you slept 85 percent or more of that time, add 15 to 30 minutes. If you slept less than 80 percent, cut 15 to 30 minutes. If you fall in between, hold steady. As your sleep strengthens, your bedtime will move earlier, closer to nature's clock.

Expect to feel sleepier during the first week or two, and skip the naps. If you become drowsy behind the wheel, pull over in a safe, secure place, lock your doors, and take a 15 to 20 minute nap. You can do this on your own, and a therapist can add support and expertise if you want it.

Pay Attention to Your Patterns

Do not try to change everything at once. Try a few strategies at a time, watch what changes, and adjust before you add more. When you pile everything on at once, you never learn what actually helped.

Keep your journal for two weeks and write down your bedtime, wake time, hours slept, caffeine, alcohol, and what stressed you that day. Patterns will show themselves. You may notice that your restless nights follow difficult conversations, or that your best nights come after days you spent outside. Every small change you keep is progress worth counting.

Start With One Area

Download the free handout, Rest for the Whole You: PTSD and Sleep, on this page. Rate each of the six areas, choose the one weighing on you most, and begin there.

Knowledge that is not applied is useless information. You can keep reading about sleep, or you can start tonight. Let the church say, "Amen."

If you are in crisis or thinking of harming yourself, contact the Veterans Crisis Line: dial 988 then press 1, or text 838255. In an emergency, call 911.

For informational and educational purposes only. This is not medical advice. Seek the support of a professional with expertise in your specific concern.