The 2014 Wounded Warrior Project Alumni Survey revealed that sleep problems and post-traumatic stress disorder (PTSD) rank as the first and second greatest challenges facing veterans of war, respectively. Often the two issues go hand in hand, with difficulty sleeping and reccurent nightmares serving as hallmark symptoms of PTSD. General difficulties falling asleep can be attributed to several facets of PTSD, including the many physical effects of trauma on the body. Trauma, as well as stress and anxiety, change the chemical composition of the body and can even alter an individual’s internal clock. Related symptoms, such as chronic pain or prescription medicine, can also influence a person’s sleeping habits.
A person with PTSD may find falling asleep easy, but staying asleep a greater challenge. Nightmares centered on the source of trauma can be frequent and in some cases ceaseless, filling the body with fear and making sleep nearly impossible to maintain; they may even reach the level of night terrors. Someone with PTSD and night terrors may scream or shake violently while sleeping. The person may even appear awake to an observer, but will remain unresponsive through the duration of their nightmare. Doctors may recommend medication or therapy to help those with extreme sleep disturbances.