How To Stop PTSD Nightmares

Understanding Why PTSD Nightmares Happen

PTSD nightmares are linked to your brain’s attempt to process trauma when you are asleep. Unlike regular nightmares, which are often nonsensical, PTSD nightmares are extremely vivid and realistic replays of past traumatic events.

There are many causes for these nightmares, but each of the following could contribute to vivid, distressing dreams if you have PTSD:

Overactive fear centers

Scientists have found that people with PTSD have changes in the fear-processing centers of the brain (the amygdala and the hippocampus) compared to people without PTSD. These structural changes cause the fear centers to be more active than usual and harder to turn off. This creates a vicious cycle where these brain centers are overactive at night and trigger nightmares, making it even harder for people with PTSD to get restful sleep.

Disrupted REM cycles

Sleep occurs in cycles of “REM” (rapid eye movement), during which dreams and nightmares occur, followed by deeper, more restful cycles. Researchers have found that people living with PTSD have increased numbers of REM cycles and fewer cycles of restful sleep. This creates more opportunities for the overactive fear centers in the brain to cause nightmares.

Hyperarousal

Researchers have found that in the brains of PTSD patients, the structures of the brain involved in emotions, memory, and motivation are hyperaroused or constantly in “fight-or-flight” mode. Specifically, these areas of the brain turn on during REM sleep in PTSD patients and have a hard time turning off. When this happens, it can cause fearful memories to be played in a loop, which can make nightmares appear extremely vivid.

Immediate Coping Strategies for PTSD Nightmares

PTSD nightmares can feel overwhelming, especially when they start to impact your daily life. While long-term treatment is important, having immediate ways to cope with PTSD can make nights feel more manageable and less frightening. 

Prioritizing good sleep hygiene

Practicing good sleep hygiene can help sleep feel more restful and less stressful. There are several things you can do to create an environment where you can get consistent and uninterrupted sleep:

• Maintain a consistent sleep schedule: A consistent sleep cycle, even on weekends, can help regulate your circadian rhythm and make it easier to fall asleep and wake up naturally.

• Establish a relaxing bedtime ritual: Do things you find calming — read a book, take a warm bath, play a cozy game, listen to soothing music — 30 to 60 minutes before you go to bed each night. Try to avoid scrolling on your phone!

• Use your bed for sleep only: Avoid watching TV, working, eating, or scrolling social media after you get in bed. These activities can distract you from a good night’s sleep.

• Limit stimulants: Stay away from caffeine, nicotine, and alcohol, especially in the several hours before you go to bed. Alcohol can be sneaky. It can help you fall asleep faster, but it disrupts sleep quality, ultimately harming your sleep experience.

• Incorporate physical activity: Regular exercise can improve sleep quality and reduce PTSD symptoms (specifically, it helps with hyperarousal). Try to add more physical activity to your day, but don’t exercise too close to bedtime as it can keep you awake.

• Manage wakefulness: If, after 20 minutes, you are still unable to fall asleep, get out of bed and go to another room. Do calming activities until you feel sleepy and can try to fall asleep again. Don’t stay in bed all night tossing and turning.

Creating a safe sleeping environment

Creating a safe and cozy sleeping environment can make a big difference in your sleep quality and help stop PTSD nightmares. Try to make your bedroom a restful retreat where you can get your best sleep. Creating a cool, dark, and quiet space will help encourage better quality sleep. 

It could also be beneficial to include blackout curtains, a white noise machine, or a fan to help reduce light and noise distractions. Some individuals find that weighted blankets provide a sense of safety and comfort. Research also shows that pleasant smells may encourage restful sleep, so try to keep your room clean, cool, and smelling fresh for a comfortable night of sleep.

Relaxing or grounding techniques before bed

There are various grounding techniques for PTSD that you can use to help calm your mind before bed to help stop recurring PTSD nightmares.

• 5-senses grounding: Use your 5 senses to help ground you in your environment before going to sleep. Use your sight to find meaningful items in your bedroom so you know you are safe. Take note of the sounds of familiar things, such as traffic outside. Use touch to feel the comforting weight of your blankets on your body. Keep a glass of water near your bed so you can engage taste. Use a relaxing essential oil or an unlit candle to engage your sense of smell before going to sleep.
• Progressive muscle relaxation: Focus on individual areas of your body and relax those areas one at a time. Start from your toes and envision the relaxation of each muscle in your body until you reach the top of your head.
• Diaphragmatic breathing exercises: Practicing breathing techniques to fall asleep like the 4–7–8 technique (inhale for 4 counts, hold for 7 counts, exhale for 8 counts) or box breathing (inhale for 4 counts, hold for 4 counts, exhale for 4 counts, hold for 4 counts). These can stimulate your parasympathetic nervous system, enabling a “rest and digest” response instead of “fight or flight” response, and help you feel more relaxed before bed.

Journaling or imagery rehearsal

Journaling can be an excellent way to help identify triggers and recurring traumas or patterns that keep coming up in your nightmares. This technique is particularly helpful in identifying real-life issues like unresolved emotions and lifestyle habits that can be addressed and may make a difference in stopping your PTSD nightmares.

Try to keep a journal near your bed, so you can take notes on your nightmares right after they happen. The memories of dreams can fade quickly after you wake up. And if writing isn’t your thing, don’t worry about it. You can always record your dreams as a collection of words, drawings, or feelings that you experienced, as this is a helpful record for you, too.

Long-Term Strategies To Reduce Nightmares

If you’re feeling overwhelmed by PTSD nightmares, remember: you’re not alone. There are long-term options available to help you reduce the occurrence and severity of your nightmares. 

Long-term coping strategies for PTSD nightmares focus on reducing the frequency and intensity of distressing dreams by addressing their underlying causes. These strategies utilize evidence-based treatments to help rewire the brain’s processing of traumatic memories during sleep. With the right combination of PTSD therapy and healthy habits, many people experience meaningful improvement in their sleep and overall quality of life.

Cognitive behavioral therapy for insomnia (CBT-I)

Cognitive behavioral therapy for insomnia (CBT-I) is one of the most effective long-term treatments for PTSD nightmares. CBT-I teaches you to identify and modify the beliefs that impact your sleep. Through this technique, you can learn how to control or eliminate negative thoughts and worries that trigger nightmares.

The behavioral component of CBT-I helps guide you in developing good sleep habits using many of the immediate coping strategies for stopping PTSD nightmares, such as improving your sleep area, learning relaxation techniques, and setting a consistent sleep schedule. Licensed therapists can help guide you through this process and provide personalized recommendations tailored to your specific needs.

Explore medication options with a professional

Medications can be prescribed by a healthcare professional to help accompany other techniques aimed at stopping PTSD nightmares. Medications for PTSD act on the chemicals in the brain that trigger fear and anxiety. The medications are used to balance the levels of chemicals like serotonin, dopamine, and gamma-aminobutyric acid (GABA) and help your brain turn off pathways that are causing fear and anxiety. These can be extremely helpful when used in combination with other therapies.

Imagery rehearsal therapy

Imagery rehearsal therapy is a specific type of cognitive behavioral therapy that can help guide you through rewriting and mentally rehearsing a new and less distressing ending to your recurring nightmares. This type of therapy involves writing down the original nightmare, altering the story to have a neutral or positive outcome, and then mentally rehearsing the new version for a few minutes each day. This can help replace the nightmare in your mind with a dream with a happier ending. Research shows that this technique can be effective in reducing the frequency of nightmares and the intensity of fear that they cause in people with PTSD.

Overcome Nightmares With Online PTSD Treatment

Learning how to stop PTSD dreams takes time, care, and the right support. With consistent treatment, it’s possible to retrain your brain, reclaim restful sleep, and reduce the power that traumatic events from your past hold over you.

If you’re ready to begin your healing journey, Talkspace offers flexible online treatment for PTSD and online therapy for veterans, providing you with the effective coping skills and support you need to manage your PTSD.