What is The Role of Sleep in Trauma Recovery?
Sleep is essential for healing and wellbeing. During your sleep your body gets to regenerate, heal, detox, recover from the day. Cell regeneration, promoted by the so-called “growth hormone” mostly happens during the REM phase of your sleep, which is the deepest sleep and the time you are dreaming. It takes a little while until your sleep is deep enough - usually it takes 1-2 hours of sleep until you reach REM sleep. This is exactly why it's so important to go to bed early enough to be have enough time to sleep before the sun rises and either your alarm clock or your body's cortisol release (basically a wake-up-and-get-things-done-function) wake you up.
Under normal circumstances, your brain processes your day and everything that happened during your sleep. It makes new connections and transforms negative thoughts and sensations into lessons learned during the deep sleep phase (called REM).
But why is sleep an issue when you’ve made traumatic experiences? And what is the role of sleep in trauma recovery?
Traumatic memories are stored in fragments. And this fragmented storage of trauma hinders your brain from processing memories, affecting your mind, brain, emotions, and body. That’s why common symptoms of trauma include insomnia, difficulty falling asleep, nightmares, inability to sleep through the night and inability to get up in the morning, exhaustion and fatigue.
How is that?
The human brain has evolved over centuries of human evolution. At its core is the brain stem, also referred to as the reptilian brain. The next layer is the limbic system, which, together with the brain stem, forms what is called the emotional brain. The brain stem is in in control of your basic needs to sustain your life in balance (homeostasis). This includes the rhythmical management of hunger and satiation, breathing, your sleep and wakefulness, all chemical balancing, arousal. The emotional part of your brain reacts faster than the logical part and any of these areas might be impacted when your nervous system is overreactive. Consequently, your body’s trauma response can disrupt any of the basic needs (sleep, wakefulness, appetite, hunger and satiation, digestion, touch, energy management and more) and the rhythmical management of them. This makes a holistic approach to healing so vital!
The circadian rhythm
The rhythm of life - the 24-hour cycle of human functioning, your ‘internal clock’ or circadian rhythm - works by coordinating your bodily processes and is disrupted by trauma just like your innate sense of time is.
Normally, the circadian rhythm functions in alignment with the light transmission through your eyes and is closely connected to the daily rhythms in nature – the rising sun and the setting sun marking the beginning and the ending of the day, providing structure. The rhythm is connected with hormone and neurotransmitter release. Serotonin is the neurotransmitter known to contribute to well-being and happiness and melatonin is the neurotransmitter essential for good and regenerative sleep at night.
Every morning to help you awaken, the production of sleep hormone (melatonin) stops. With sunlight, your brain sends signals to your body to increase your body temperature and produce a stress hormone (cortisol) and serotonin which promote alertness, getting up and moving, and hunger.
In the evening, you experience your highest levels of the sleep hormone (melatonin) known as the ‘darkness hormone’ since it is secreted during periods of darkness to promote sleepiness. Its levels are highest between 1 and 4 am. The relationship of this cycle of sleeping and being awake is inverse: when you produce high amounts of cortisol, your melatonin levels sink and when you produce high amounts of melatonin, your cortisol levels decrease.
While daylight exposure is required for both melatonin and serotonin production, an exposure to bright light during the evening or at night, as well as exposure to Electromagnetic Fields of a range of 60hz decrease melatonin levels and impact the quality of sleep, as well as your wakefulness and your mood.
Both melatonin and serotonin production are compromised, when trauma is not healed. Low serotonin levels may make you hyperactive, depressed, or have difficulties to cope socially. Low melatonin levels go hand in hand with insomnia or difficulties sleeping[i].
This may be due to being out of tune with your circadian rhythm: when the rhythm is disrupted by trauma and chronic stress, your body may release cortisol in the evening. This ultimately means, you’re physically not able to produce melatonin, relax and become sleepy, which is why insomnia or sleeping problems are a common symptom of trauma[ii].
The high cortisol levels also do something else: they are promoting blood sugar peaks. Every elevation in your blood sugar levels will trigger an insulin release. Insulin is like a transporter that carries the sugar from you blood to your cells, where it attaches to the cell receptors, to provide the cells with the energy of sugar. This is insulin’s job and it’s good when that dynamic works well. However, with regards to sleep, it’s not good to have high levels of sugar in your blood or in turn high levels of insulin, because insulin is the antagonist to growth hormone. If insulin levels are high, growth hormone won’t be released and vice versa.
So, high insulin levels at night can block the release of growth hormone. The consequence being that you stay alert due to high cortisol levels and cannot experience a regenerative, deep, restorative sleep, because your insulin levels are high.
Further down the line, this whole interplay can promote blood sugar imbalances, chronic inflammation, weight gain and it may also intensify or worsen any emotional and psychological symptoms you experience due to the trauma you are healing from. So, it’s very important to take the measures you can to improve your sleep for both your physical and mental health on this healing journey.
A solution for improved sleep and trauma recovery
What you do before going to bed also determines a big part of the quality of your night's sleep; your evening routine can influence your sleep quality. When holding traumatic stress in your body, you might find it especially difficult to (fall a-) sleep. Insomnia and sleep disturbances as well as nightmares are common symptoms of trauma, demanding an evening routine that soothes and heals.
Your evening routine will be as unique as you are. As with all healing tools and suggestions, choose what works for you and suits your schedule. Be kind yet conscious and disciplined when creating your evening routine. In the following, I have listed an overview of elements that can all contribute to a healing evening routine.
Habits that contribute to an improved sleep
The Essentials
1. Eat dinner at least 2h before going to bed
Eating right before going to bed means you your body will be triggered to produce insulin, so this can block growth hormone production, as mentioned before.
2. No screen time 2 hours before going to bed
Avoid the use of your cell phone, computer, tablet or TV
Blue light blocks melatonin (the sleep hormone) production which is necessary for being sleepy and entering the REM (deep) sleep phase
3. Spend time in nature during the day to reestablish the circadian rhythm
Daylight exposure during the day and exposure to warm, dimmed light during the evening and night can reestablish the healthy functioning of the circadian rhythm and with it, balance the production of melatonin and serotonin.
The most healing light wavelength is found in the green-blue spectrum of light during the day, such as the ocean, nature, the woods, trees or the sky.
4. Don’t watch anything that scares you or makes you feel tense before going to bed
The brain and your body do not differentiate between an actual threat or a perceived one. Whatever scares you will trigger a fight or flight stress response with the aim of keeping you safe. While you are still healing from trauma, your nervous system responds more sensitively to your environment. A release of stress hormones (i.e. cortisol) and sugar into your blood stream is part of this response. The consequence is again a blockage of growth hormone release and most probably sleeping problems.
5. Your bedroom should be dark
Use dark curtains or shatters or a mask to cover your eyes, if you cannot completely darken your room. Again, light, especially blue light, blocks the release of melatonin
6. Sleep in a safe and quiet space
If there is noise from your partner, housemates, friends, kids, how can you turn your bedroom into a quieter space? Use earplugs, for example.
When your nervous system is sensitized or you are hypervigilant, every sound and movement in the room can become a trigger and either prevent you from falling asleep or easily startle you and wake you up. Every interruption during the night impairs the quality of your sleep.
7. Go to the bathroom right before going to bed
Trauma can lead to a chronic stress response. Physically, this affects the adrenals and kidneys. The adrenals are where stress hormones are produced (just like sex hormones) and your kidneys are essential for the storage and balance of minerals. They also ensure that you are able to hold onto enough water to be well-hydrated. When the kidneys and adrenals work well, they hold onto water throughout the night and prevent you from waking up just to pee. However, because of the stress response in the context of trauma, your kidneys and adrenals are weakened which can also impair their ability to hold onto water. The result then is an increased frequency of urinating – peeing. To prevent waking up at night to pee, use the bathroom before going to bed and do not drink huge quantities before sleeping.
Your Personal Choice
1. Journal about the day
2. Read a book
3. Listen to calm music
4. Drink herbal tea
i.e. like lavender, passion flower, valerian & avoid caffeine
5. Practice a gentle yoga flow
Avoid stimulating exercises like running in the evening – gentle or restorative yoga is okay, however running or the gym, dancing, anything that gets you to sweat and speeds your heart beat up, stimulates you and makes you awake
6. Meditate
7. EFT / Tapping
8. Light candles
Warm light like candle light, salt lamps or the light of a fireplace are like watching a sunset a soothing reminder for the body that the day comes to an end and help attune your circadian rhythm (inner clock) to its natural rhythm.
9. Take a bath or foot bath
Add Epsom salts (a form of magnesium that can be absorbed via your skin and lead to increased relaxation) or lavender and light some candles.
10. Practice breathing exercises
11. Diffuse calming, grounding essential oils
Ylang ylang, lavender, or pine are grounding and calming
12. Take herbs or supplements in the evening to promote relaxation
i.e. magnesium, lavender tea, chamomile etc.
13. Lie down on the right side of your body
Lying on the right side of your body stimulates an increased airflow through your left nostril which is associated with relaxation and can support your body in calming down.