It was hardly surprising that children exposed to the trauma we were would develop abnormal sleep patterns: night terrors, sleep walking, etc.   With no adult willing to step in and provide us with the care, support and psychological counselling we needed we came up with our own coping mechanisms.  Some were more successful than others.

My brother sleep walked.  When he did he often got himself into dangerous situations so I was in the habit (we slept in the same room when we were together) of tying his foot when he was asleep to mine so that I’d be woken if he wandered off in his sleep.  Initially this worked but I must have become tired and grumpy which is why I yanked back on the tether which had him flying face first into the wall.  My bad.

Brian here.  One of the other areas this rears its head is bed wetting.  Grown adults have been known to start wetting the bed again.  Its been written about, and I believe the idea was that theres so much physical stress during the day associated with the mental stress, that all the organs and tissues are overworked; hence at night they let go.

One of the things about his sleeping was just how deeply comatose he would become.  In Ireland my mother managed to set fire to her bed whilst the toxic parental unit were out, the house was filled with acid smoke, an electric blanket had caused it and I figured out pretty quickly that I couldn’t put it out by myself.  Having been trained to put the call in the moment the danger was identified I went into fully automated responses, no bravery there just a trained response from early childhood.  Dialled 999.  Made my report in clear perfectly pronounced sentences.  Hung up.  My sister had moved to Florida by this point, only my brother and I remained to survive what was left of our childhood together.  I kicked my brother’s door open (we were teenagers at this point), his room was solid with eye biting smoke, I couldn’t breathe but managed to find his foot and started pulling, yelling at him to get up.  I couldn’t get him up.  He was a good foot taller than me at this point and there was no way for me to physically get him out of bed.  The house was in the Irish countryside, it would be a good 20 minutes before the fire department made it there so I did what I had to do and beat my way into my mother’s room, found the source of the flames and sprayed it with whatever I could lay my hands on trying to stop oxygen feeding the fire.  It wasn’t all that successful, if anything I just bought more time.  Fire fighters arrived, brother was hauled out of bed and the fire successfully put out.  As I heaved my guts into the oxygen mask they’d placed on me my brother was yelling at me, screaming and lashing out.  Physically trying to punch and kick me.  It didn’t surprise me that he was quite so manic as I knew better than to wake any of the four other members of my toxic family unit and expect to live.  If you’ve never experienced waking somebody who suffers from parasomnia you won’t understand just how dangerous it can be.

 

I’m not a big user of medicine for PTSD.  For me, most medicines did more harm than good and often needed a new medicine to counter their effects.  But for sleep, I’m a believer.  I need sleep meds most nights.  And therapists of all kinds can only do so much for you if you aren’t getting any sleep.  I’ve known guys to go to the therapist and sleep on the couch because that was more what was needed at the time.  Night terrors and sleep apnea are not the same thing at all but they do share some symptoms over time.  They both can stress the body intensely, and when stressed our bodies produce chemicals, particularly adrenalin.  Adrenalin has its strengths of course, and the immediate effect has the guy trying to sleep suddenly wired and doing anything but sleep.  Long term though, theres lots of organ damage thats associated with frequent large dumps of adrenalin.  Not good for kidneys and liver and others.  So if there are ways to address a sleeping issue, take them.  For me, its meds and cannabis oil.

When needing to wake my father, for example, I did it through a closed door, ready to run for it and body off to the side and away from the door itself.  If that didn’t work the most I would venture to do was slightly crack the door and yell, but ready to run for it.  Same with mother.  Same with sister.

But they were slower and less capable to go to rage from a prone position.

Ah, how on earth I survived them I do not know.

My own sleep issues were that of a cat: I could sleep anywhere, anytime for brief at most 40 minute slots of time.  I was known to lean against a wall and be fast asleep.  On a 20 minute taxi ride.  Boom.  Out.  So long as I was comfortable that my surroundings were safe, I slept.  By the time I made it to Singapore where I met my neurologist who finally gave me answers I had no ability to sleep as a normal human should.  He put me on a two year drug regimen to “train my brain to sleep”, it was a rocky first year of feeling numb, unable to function and then when he thought that a nuclear dose of caffeine to counteract the nuclear doses of put me to sleep meds  (in pill form – it was the latest thing used to treat chronic migraines like mine which at that point hadn’t been identified as hemiplegic) I bounced off the walls for 72 hours straight unable to sit still: literally.  It was successful and until I came to Canada my sleep patterns were somewhat normalized.

In terms of nightmares, obviously I suffered from them just as I did constant flashbacks and suicide ideation, I was so used to them though that I barely acknowledged them. That might sound odd for somebody who has only had these things since adulthood, but if all you’ve ever known is that, then it is truly normal and I found a way to simply exist with them.  That is until EMDR.  With EMDR came nightmares with a punch.  Nightmares that I got severely bruised in.  Nightmares that left me with scars, scratch marks and on more than one occasion a black eye.  I became for about a year during the EMDR treatment terrified of sleep.  I’d do pretty much anything to avoid it.  Fortunately I had lots of first responder friends at that point and could happily chit chat with whoever was working nights, tell myself I was doing it for “them”, whilst all the while using them to avoid what lay in wait for me if I slept.

One of the worst things that was done to me as a child was the creation of a victim.

I was trained to put a call in, to radio in the attack and then to go and hide.  I was trained to be silent no matter what.  I was trained to accept pain as my normal.  I was literally groomed to be the most accomplished victim.  As an adult this has developed into an extreme stress response: I skip all the stages of alert, fight, flight and go straight to comatose.  I am a human fainting goat.

I joke with my cop friends that the only way I could stop a bad guy is if he accidentally tripped over my prone unmoving body on the floor.

In terms of sleep what that means is during a nightmare I don’t move.  I barely breath.  Much of my nightmares revolves around the horror I witnessed but the worst of it for me is my inability to move, act or cry out.  This isn’t unusual.  Brian has exactly the same responses.  I know he is in a nightmare because I am fully aware of his breathing, his perspiration and his heart rate (a gift of growing up as a small child being hunted, there are some skills that are animalistic that I retain to this day).  His service dog, Sasha, no longer wakes Brian up from his nightmares but stands up stretches, which is enough to wake me up and if I don’t fix the problem, she will wander over to my side of the bed lay her head on it and make that condescending “get a move on with it woman” growl she has developed.  She loves me in that I exist and am occasionally useful.  Smile.

I do not try to wake Brian as waking him from that would cause an enormous amount of pressure on his heart, it’s one of the blessings of having had such a dedicated neurologist in my life before Brian, he spent hours explaining to me how my brain didn’t function as a normal brain does, and the impact it has on the various systems from nervous to heart, to gut etc.   I first ensure that my legs are over his body, the heaviness of them grounds his brain and I place my hand on his heart.   That’s step one.  I give it a good 5 minutes before I move to step 2 which is to pat him gently and say, “hey I’m here.”   Usually enough to tell his brain he isn’t in Kabul but here in B.C.  If that’s not working and her ladyship is giving me the evil eye and get on with it growl, then I will shake him awake but that’s a last measure because he will wake up confused and dazed, his guts will bleed and he will be unable to sleep for the rest of the night.

 

Kate gets chatty when she’s asleep.  The words can come out in english, or african dialects depending what she’s dreaming about.  I generally haven’t a clue what she’s going on about , and as a man, I’ve learned that you need an ability to tune stuff out.  Sorry ladies, but we have to. One can only listen to so much.  But it’s the tone I can use to tell if she’s stressed, and hands protecting her face means it’s a problem. I gently wake her up from those.  The others, I leave alone and just touch more.  Normally sorts her out.

Most of the time Brian is unaware that he has slept badly or that he had nightmares because we’ve got to a point now where I can do step 1 and 2 without him ever being aware of it consciously.  It impacts him the next day because it isn’t a good sleep, so I tell him in the morning when he wakes what kind of night he had.  There are weeks when I’m bagged, just bagged because the stresses in his daytime life always translate to terrible nightmares at night.  It’s one of the reasons I’ve worked double time over the last few months to remove stressors from his life, our life and to remain aloof from it or to simply not engage.

For me, going to bed and getting to sleep has been harder than staying asleep.  During the day, I can keep my mind busy.  And at night, it goes where it goes.  But that period of trying to relax and sleep is where my mind takes a wander and its not often pleasant.  So I don’t put off sleep meds anymore.  If I need em, i take em as soon as I feel I should.  Not when I’m exhausted and frustrated but ages earlier.  If they aren’t working, I don’t stare at the roof.  I get up and make my brain busy.  Experts tell you no tv or screens.  I go watch tv.

It being us and we opened the can of worms a while back, I am going to bring up sex at this point.

Yes sex helps him.  If he has had a decent supply (snicker) during the day, he will sleep better that night EVEN if shitty things have happened during the day that would normally see him back in Kabul at bedtime.  Breasts didn’t exist in Kabul either*.  So using them, shoved in his face if all else fails at Step 2 before I have to go to Step 3, works a treat.  (* for him, in fact, most would tell you that war is a very hard, cold, metal place with nothing soft.)

Smells also work but less effective than body contact from me.  One of the smells that snaps him back is the smell of cedar, so I always snaffle fresh cuts whenever I find them or have an opportunity.  I put them in ziplock bags in his truck and I keep them in the house.  Some of my girlfriends are aroma specialists (one in Townsville Australia married to an Aussie Vet and another in the US who’s son is a US vet), both can give you advice on smells and are members of the Kate Gillie Art Life After PTSD group.  There is an amazing doctor who works tirelessly with the #PTSDChat team who is also an expert and can coach better life skills, Dr Debra Lindh.

Smell does work.  Girly hair stuff that smells like woman is actually nice to sleep next too.  Whatever hellhole you’re from, when it was hell it probably didn’t smell like peaches and lavender.

The physical price paid for nightmares can’t be ignored.  Without sounding the alarm bells too badly, I think it worthwhile outlining the impact they have on the sufferer.

I think of nightmares and night terrors as a psychotic episode in our sleep.  Sound a bit dramatic?  I don’t think it is.  Think about my experience of those affected by this phenomena.  Those who suffer from these episodes are exponentially more likely to suffer anxiety, depression and suicidal thoughts.  It isn’t healthy REM, and has been linked to obesity, heart disease and other physical ailments, including auto-immune issues.  Here is what we know.

Typically these episodes will hit in the first hours of 3-4 non-rapid eye movement sleep (NREM).  The generally occur during periods of arousal from delta sleep (also known as slow-wave sleep): this is the sleep we have during the first half of a sleep-cycle (sleep cycles are measured at 40minutes).  The difference between nightmares and nigh terrors is diagnosed through sleep studies using tools that measure rapid eye movement.  All of which tells me absolutely Sweet F*** All, let’s be honest.

Sleep and our need for it is not entirely understood, many fantastic theories abound but what little we do states that it is a fundamental requirement for life.

“Sleep is a vital aspect of human life that has appears to have both physiological and psychological purpose, and is essentially universal in the animal kingdom. All you need to do is observe a cat for more than five minutes to see that we aren’t the only animal species that both needs and seemingly enjoys sleep. In fact, if you could talk to a nematode, it would likely go on for hours about how much it enjoys sleeping in on Sundays. Humans spend roughly a third of their lives asleep, but the percentage of each day devoted to sleep is significantly higher during infancy and early childhood.

We don’t know why the need to sleep became part of the blueprint for life so early on in our evolutionary history, and researchers certainly haven’t worked out all of the nuances of why humans and other animal species continue to be so dependent on it throughout the lifespan. It is likely that its purpose has broadened over time as species branched out into new environments. There are a number of leading hypotheses, however. And barring some amazing technological or medical advance, we appear to be stuck with sleep.”  from the link I have given below by Clay Jones, who’s focus is paediatrics but has many useful titbits and information on sleep, nightmares, etc.

If we do not sleep we will die.  It’s that simple.

“How do you truly boost your immune system? Sleep is probably a better means than any supplement or bogus healing modality and considerably cheaper. Sleep also may play a role in clearing out the cobwebs so to speak, by weeding out weak neuronal connections, allowing memory and learning to function optimally and supporting cognition. There are numerous studies detailing the effects of poor sleep on these processes.”  Again, from Dr Jones but google is your friend.  Research the effects of sleep and sleep deprivation, it will shock you.

Heart disease and nightmares? If you fail to reach the nirvana of restful non-psychotic episode sleep there are certain chemicals activated that keep the body from achieving extended periods in which heart rate and blood pressure are lowered.   Now and again?  Not a big issue but if this is who you are, this is what happens all the time then your blood pressure will be higher, and you will have a greater chance of cardiovascular problems: one study I found stated that over an 8 year period men who suffer from disturbed sleep or sleep apnea were 58% more likely to develop congestive heart failure.

I’m sorry that made for pretty crappy reading but PTSD and all her gifts sucks.  She truly does.  Yes, I have made her female.   You can’t fix all things at once but if you are going to focus in one area to begin with start with sleep.  You have zero chance as my neurologist in Singapore pointed out so long ago of fixing anything else if you aren’t sleeping.  Zero.

 

Nightmares, Night Terrors and Potential Implications for Pediatric Mental Health…..

 

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