Nightmares and sleep problems
It is common for survivors of sexual violence to have sleep problems.
Problems may include:
- Problems getting to sleep, such as lying awake and not being able to fall asleep
- Problems staying asleep, for example waking up early in the morning or through the night
- Poor quality sleep so you do not feel refreshed by the sleep you do get
- Fear of going to sleep and experiencing nightmares
- Fear of beds and the associations of night time
The trauma of sexual violence may lead to nightmares. These are more than simply ‘bad dreams’. You may feel that the attack or an aspect of the abuse is really happening to you in your sleep. This is very frightening.
If you experience nightmares regularly, it is likely that you will be apprehensive about sleeping. Try to remind yourself that nightmares are an effect of the abuse you experienced. You are not going mad and it is possible to develop ways of reducing the nightmares and of coping with the after effects. It can be helpful to try to understand the nightmares as part of your recovery. Your brain is recalling images or sensations which it needs to process before moving on.
There are things you can do to improve your sleeping and reduce the anxiety, stress and other issues which can lead to sleep problems and nightmares.
How do nightmares and sleep problems affect survivors of sexual violence?
Sleep problems, when they are long-term, can affect your emotional and physical health. If you are experiencing nightmares regularly as well as other intrusive thoughts or flashbacks to the abuse, you may feel as if you cannot escape what has happened.
There can be a vicious cycle of anxiety, stress and sleep problems/nightmares If this is happening to you, it is a natural response to your experience of sexual violence.
To improve sleep habits
- Try not to go to bed until you feel tired. It can help to avoid taking naps during the day and to take regular exercise (not within 4 hours of going to bed).
- Check your sleeping arrangements. Think about comfort, temperature, light and noise levels. If you have something special which you find comforting – a pillow, a teddy or a photograph – take this to bed with you or have it close by in case you need it.
- Learn to de-stress before bed, for example by having a warm bath and a milky drink. Try to eat early - well before you go to bed - and avoid rich, spicy or sugar-rich foods, red meat and cheese.
- If you self-medicate with alcohol or drugs - prescribed or illegal - it may feel as if they help in the short-term. But, over time they can become problematic. It may be helpful to seek medical advice or to find other ways of coping. Even moderate drinking and smoking can affect your quality of sleep.
- Other things that can help to build into your routine are:
- Trying to get rid of difficult thoughts by writing them down or drawing images which play on your mind
- Trying to interrupt unwanted thoughts with activities or positive thoughts about a person or place
- Practise a relaxation technique before you go to bed. Breathe in deeply, in for a count of 5 and out for a count of 5. Put your hand on your tummy and watch this rise and fall as you breathe. Consciously tense and relax your muscles, in turn: start with your toes and work up.
- Mindfulness is a technique that helps you to focus on the present moment - your breathing, your thoughts and feelings. Mindfulness helps you to observe your thoughts and feelings without judging yourself and to become more aware of any changes in how you see or feel about yourself. Mindfulness can help to relax you before sleeping or if you wake up from a nightmare.
- Try out complementary remedies. Yoga, meditation, homeopathy or herbal remedies, such as lavender or valerian, may help.
- Don’t try to force sleep. It will only make you feel more anxious. Try keeping your eyes open instead and, as they start to close, tell yourself to resist. The more you try to stay awake, the sleepier you’ll become.
- Do not stay in bed. If you cannot sleep, get up after 20 minutes and go through your relaxation routine again.
To manage nightmares
- Remind yourself that nightmares are not real. They are very distressing but they are a memory of what happened; they are not happening now.
- Keep a diary of when you have nightmares to see if there are any patterns. Do your nightmares have the same images or content? Talking to someone about these can help take the image or event out of your head. This may help you feel more in control. If you can see patterns to your nightmares, a support worker could help you to develop ways of changing or coping with these.
- When you wake from a nightmare try to ‘ground’ yourself in the present. There are many ways to do this. Remind yourself that the nightmare is not real, but that it is natural to feel fear and stress. Notice your environment and try to establish a routine that you find soothing and can rely on if you have a nightmare, either through the night or in the morning. Some people find it helpful to practise relaxation techniques, to have a warm drink, listen to music, to write down their feelings, read, have a bath, call a helpline, speak to someone they trust.
- Practise relaxation techniques, deep breathing, yoga, or anything that helps you reduce stress and anxiety.
- Develop a safe place image – a place in your mind which makes you feel safe or comfortable. Imagine the feelings, the sounds, the temperature and the sights. It could be real or from your imagination. Practise visiting this safe space when you are feeling good, so when you need it, you can go there
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