Many survivors of sexual assault suffer from depression and/or Post Traumatic Stress Disorder (PTSD). As a result, they may also experience sleep disturbances and disorders. Inability to sleep can result of trauma victims being unable to feel secure and unthreatened.

Nightmares can result when an assault is replayed mentally and when there is a fear that it will reoccur. Nightmares typically involve feelings and emotions felt at the time of the assault or abuse, or immediately following, and can cause difficulty in falling sleep and staying asleep.

• Nightmares that occur after traumatic experiences may replicate the original dangerous or threatening situation.
• Individuals may report multiple nightmares within a given night, often with a recurrent theme.
• Nightmares usually end with an awakening of full alertness and lingering sense of fear or anxiety.
  • If nighttime awakenings are frequent, or if the individual avoids sleeping because of fear that a nightmare will occur, the individual may experience the following:
    • Excessive sleepiness
    • Poor concentration
    • Depression
    • Anxiety
    • Irritability

• This form of sleep disturbance is not diagnosed if the nightmares occur exclusively during the course of another mental disorder or is due to the direct effects of substance abuse (alcohol, drugs or medication) or a general medical condition.

Insomnia can be described as difficulty falling asleep, difficulty staying asleep, or waking up too early. These periods of restlessness can last a few nights or become chronic and last several months, or even years.

• Insomnia can be caused by:
  • Life events which cause physical, emotional, or mental pain
  • Anxiety about falling asleep, stress
  • Medication (a possible side effect)
  • Environmental noise or extreme temperature changes
  • Herbs, caffeine, alcohol or other substances
• Physicians and therapists may suggest trying medication or behavioral techniques to improve sleep, such as relaxation therapy, sleep restriction, and reconditioning. For more information, contact your physician.

Sleep Terror Disorder occurs with the repeated abrupt awakenings from sleep, usually beginning with a panicky scream or cry. During an episode, the individual is going through behavioral manifestations of intense fear and is difficult to awaken or comfort. After finally waking, the individual has no recollection of the event except perhaps a single image.

• During a sleep terror, the individual may actively resist being held or touched or even demonstrate more elaborate activity (swinging, punching, fleeing).
  • These behaviors appear to represent self-protection from a threat and may result in physical injury.
• Sleep Terror Disorder may occur with an increased frequency in individuals with PTSD and Generalized Anxiety Disorder.
• Many individuals suffer from isolated episodes of sleep terrors at some time in their lives. The distinction between individual episodes and Sleep Terror Disorder lies in the repeated occurrence and potential for self-injury.

Eating well, exercising, and getting help for sleep disorders can be useful in treating them. An increased mood stability, and a general better sense of well being will provide a greater sense of ease, and will make nighttime sleep a safe space once again.

^Endnotes

^{Diagnostic and Statistical Manual of Mental Disorders. American Psychiatric Association. 2000.
http://www.psych.org/MainMenu/Research/DSMIV.aspx}

^{Sleepnet.com. 2009. http://www.sleepnet.com}

^{This product was supported by grant number 2009-D1-BX-KO23 awarded by the Office for Victims of Crime, Office of Justice Programs, U.S. Department of Justice. The opinions, findings, and conclusions or recommendations expressed in this product are those of the contributors and do not necessarily represent the official position or policies of the U.S. Department of Justice.}

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