PTSD and Night Terrors: When Your Loved One Suffers in Their Sleep

Post-traumatic stress disorder is a serious mental illness triggered by experiences that are terrifying, life-threatening, or perceived as life-threatening. Potential causes of PTSD include being a victim of assault, witnessing violence, being in a terrible accident, or seeing combat in the military.

Not everyone develops PTSD after a traumatic experience, but those who do struggle with disruptive, frightening, and difficult symptoms including:

• Intrusive and scary memories
• Nightmares and night terrors
• Avoidance and social isolation
• Negative thoughts and hopelessness
• Difficulty with memory
• Detachment and lack of interest
• Strong startle response
• Self-destructive behaviors
• Irritability and angry outbursts
• Difficulty concentrating

Because this mental illness is so disruptive to a normal, satisfying life, professional treatment is essential. Therapy is the foundation of treatment, which teaches patients to change their negative thoughts, cope with difficult memories, and relate better to other people. There are several types of therapy with a trauma focus that can be very helpful for managing and reducing symptoms.

Some people with PTSD experience night terrors, also known as sleep terrors. Night terrors are fairly common in children but not in adults, but trauma can cause them. During a night terror, a person appears to awaken and scream or shout in terror. Most of the time, they are not actually awake.

Night terrors may be accompanied by sleepwalking. They can cause a racing pulse, flushed skin, dilated pupils, sweating, and kicking and thrashing in bed. Someone in a night terror will be difficult to awaken. They may not have any memory of it the next day.

Night Terrors vs. Nightmares

PTSD can also cause nightmares, but these are different from night terrors. When you have a nightmare, you usually wake up with vivid memories of it. After a night terror, you may have a flash of an image, but you generally will not remember the experience. You may not even wake up at all during the night terror.

The most important treatment for night terrors is addressing the underlying condition. For someone with PTSD, this means regular therapy, trauma-focused therapy, and in some cases medications. Because PTSD is so serious, and symptoms like night terrors can be so disruptive, a residential mental health facility is often a good idea. It gives the individual the chance to benefit from intensive treatment, round-the-clock safety, and the ability to focus on their wellness.

Successful treatment of PTSD should reduce and ultimately eliminate night terrors. In the meantime, strategies such as managing stress, meditation, good sleep hygiene, and anticipatory waking can help. Anticipatory waking means setting an alarm to wake up about 15 minutes before the terrors usually begin.

If your partner struggles with PTSD night terrors, it’s disruptive, damaging, and frightening for both of you. The best thing you can do for them is to get them into treatment. PTSD does not go away without professional support. If you can get your partner good treatment, night terrors will eventually subside, along with other symptoms.

As your partner goes through treatment, there are several other things you can help them with to manage night terrors and reduce their frequency:

• Speak calmly but avoid waking them. A person may behave irrationally and violently during a night terror. Trying to wake them up can be dangerous but also futile. Many people in night terrors never wake up during the episode. What you can do is speak to them in a calm and soothing voice to offer comfort. If they get up but are not too agitated, gently guide them back to bed.
• Make the bedroom safer. Because people with night terrors tend to move and thrash, or even get up from the bed, it’s important to remove items that could hurt them or you. Take everything off nightstands and remove any sharp objects or weapons from the bedroom.
• Keep a sleep journal. Information is power when it comes to managing night terrors. Keep a journal of when the terrors begin and end and with details of each episode. This is very helpful because your partner won’t remember most of the incidents.
• Wake them before the terrors begin. Once you have a pattern established, you can begin to wake your partner before the usual onset of night terrors. This disruption can break the cycle. Set an alarm for yourself and wake your partner about 15 minutes before the time the night terrors usually start. Stay awake for a few minutes before going back to sleep.
• Try a smartwatch app. The U.S. Food and Drug Administration recently approved an app that aims to reduce sleep disturbances in adults. The creator of the app dreamed it up as a solution for his father, a veteran with PTSD and terrible nightmares. It uses information from the watch, like heart rate, to wake up the wearer before the nightmare sets in. While the app was designed for nightmares, it could work with night terrors too. The Veterans Administration is expected to offer it soon as a prescription.
• Manage stress and sleep. The risk of having night terrors increases with stress, sleep deprivation or disruptions, and fatigue. Help your partner manage stress in their daily lives and develop a healthy sleep routine. Keep a regular schedule of going to bed and waking up, even on the weekend, and aim for seven to nine hours of sleep each night.
• Talk about it in the morning. Your partner may be embarrassed and not want to talk about what happened in the night. This will only add to their stress. Be open about the incidents and assure your partner that you are not mad at them, that you understand it is out of their control, and that there is no shame in having night terrors as a response to trauma.