How Trauma Effects Sleep

How Trauma Affects Sleep


Humans have various needs; nutrition, exercise and, of course, rest. Sleep plays a crucial role in the well-being of the body and mind. Without the right amount of sleep, it is common to experience lethargy, inconsistent mood and difficulty with concentration.[i]


Trauma has a profound effect on sleep. The impact of a traumatic event, or series of events, takes a considerable toll on the nervous system. This means there will likely be some disruption to sleep in the aftermath of trauma, which, in turn, can drastically impact physical and mental well-being. To understand trauma, we need to understand how it influences unconscious and conscious states.[ii]


Healthy Sleep


To understand how trauma affects sleep, it is necessary to think about what a healthy sleeping pattern looks like. While ‘healthy’ varies from person to person, some key consistencies indicate a good night’s sleep. Most healthy sleepers can fall asleep in around half an hour of settling into bed, rarely wake up in the middle of the night, and if they do, they can easily fall back asleep.[iii] Most importantly, healthy sleep is characterised by a series of stages, beginning with light sleep and finishing with the most crucial stage, REM.


Why Do Humans Need REM?


REM (rapid eye movement) is a state of sleep characterised by heightened brain activity and vivid dreams. It is an essential part of cognitive functioning and emotional processing. At birth, babies need eight hours in this state; however, only two hours are required as adults. The intensity of REM can be illustrated by horses which can stand up during other sleep stages but must lie down during REM.[iv]


When people have experienced trauma, it becomes harder for them to access this sleeping state. As the final stage of sleep, REM prepares the brain to wake up by activating the central nervous system. At times of trauma, the brain can feel disconnected from the workings of the nervous system. It is, therefore, common that people who have experienced trauma can only sleep lightly, so often they cannot reach REM. These disruptions to the most crucial stage of sleep lead to mood disorders, an inability to consolidate memories and a decrease in overall cognitive performance.


Physiological Impact of Trauma on Sleep


Traumatic events drastically impact the physiological processes that regulate sleep. Those who have experienced trauma will find that their body shifts into a hyperarousal state with increased stress hormone production. Elevated levels of the stress hormone cortisol disrupt sleeping patterns, making it difficult for individuals to fall asleep or stay asleep for meaningful periods of time.


This dysregulation of sleep, when left unchecked, can lead to more serious disorders such as insomnia or sleep apnea. Sleep apnea, a condition characterised by breathing problems during sleep, is exacerbated by trauma-related stress. Similarly, insomnia, which causes people to struggle with falling asleep, is a common side effect of trauma.[v]


Emotional Impact of Trauma on Sleep


In addition to physiological side effects, the emotional labour associated with trauma also greatly impacts sleep. A dysregulated nervous system, unable to discharge trauma from the past, remains in a state of fight or flight. While this leads to physical changes in hormones, images of the traumatic event can also remain in the subconscious, and people will often find that their dreams reflect this.


The brain is wonderfully complicated, so it will attempt to discharge fearful memories and intrusive thoughts, often in the form of nightmares. Nightmares can be hugely anxiety-inducing and cause people to fear sleep. As a result, it is possible that traumatised people not only struggle to get to sleep, they actively avoid it.[vi]




As humans, we are programmed to crave nourishment in all its forms, and that includes rest. For people who have experienced trauma, a healthy sleeping pattern can feel inaccessible. However, there is a solution to this problem, and that is through sleep hygiene.


Sleep hygiene, much like any other form of hygiene, requires a conscious effort toward maintaining healthy habits. People with good sleep hygiene typically follow a regular sleeping pattern. They practise mindful approaches to sleep, such as avoiding stimulating activities close to bedtime, limiting caffeine consumption, and establishing a relaxing pre-sleep routine.


In addition to these small changes, it is also important to be mindful of how certain coping mechanisms can affect sleep. Drugs, alcohol, and substance misuse are common in the aftermath of trauma. However, the stimulation and desensitisation they provide drastically reduce sleep quality. Many people will find themselves in cycles of medicating to sleep, getting artificial sleep and therefore needing to continue to use medication to gain any semblance of a ‘normal’ sleeping pattern.[vii]


By prioritising physical and emotional well-being, those who have experienced trauma will find they fall asleep far more easily. Therefore, seeking therapy that actively seeks to resolve a dysregulated nervous system is of the utmost importance. Once individuals start working to alleviate their trauma, it is far more likely that they will achieve restful sleep, which, in turn, will improve cognitive function, mood, and overall health.




[i] National Institute of Neurological Disorders and Strokes (NINDS). (2019, August 13). Brain basics: Understanding Sleep.

[ii] Babson, K. A., & Feldner, M. T. (2010). Temporal relations between sleep problems and both traumatic event exposure and PTSD: a critical review of the empirical literature. Journal of anxiety disorders, 24(1), 1–15.

[iii] Harvey, A. G., Stinson, K., Whitaker, K. L., Moskovitz, D., & Virk, H. (2008). The subjective meaning of sleep quality: a comparison of individuals with and without insomnia. Sleep, 31(3), 383–393.

[iv] Blumberg, M. S., Lesku, J. A., Libourel, P. A., Schmidt, M. H., & Rattenborg, N. C. (2020). What is REM sleep?. Current Biology, 30(1), R38–R49.

[v] Chu, B., Marwaha, K., Sanvictores, T., & Ayers, D. (2021). Physiology, stress reaction. In StatPearls [Internet]. StatPearls Publishing.

[vi] Gieselmann, A., Ait Aoudia, M., Carr, M., Germain, A., Gorzka, R., Holzinger, B., Kleim, B., Krakow, B., Kunze, A. E., Lancee, J., Nadorff, M. R., Nielsen, T., Riemann, D., Sandahl, H., Schlarb, A. A., Schmid, C., Schredl, M., Spoormaker, V. I., Steil, R., van Schagen, A. M., … Pietrowsky, R. (2019). Aetiology and treatment of nightmare disorder: State of the art and future perspectives. Journal of Sleep Research, 28(4), e12820.

[vii] Irish, L. A., Kline, C. E., Gunn, H. E., Buysse, D. J., & Hall, M. H. (2015). The role of sleep hygiene in promoting public health: A review of empirical evidence. Sleep Medicine Reviews, 22, 23–36.