Trauma, Insomnia, and Circadian Rhythms

Lately I’ve been trying to figure out why my body has such a hard time going to sleep at a reasonable hour, and how to work towards an earlier bedtime–even if that means I’m falling asleep at one or two in the morning instead of three or four.

I’m familiar with the basics of sleep hygiene: go to bed and wake up at the same time each day; avoid naps if possible, or at least avoid late naps; keep your room dark and quiet; try to limit screen time and eating before bed.

The thing is, I’ve tried all of these in concert for extended periods of time, with little success, and I’ve had sleep difficulties since I was a little kid.

When I was a teenager, I could get by on just a few hours of sleep a night without too much difficulty. I saw a doctor who diagnosed me with idiopathic insomnia, stressing that I shouldn’t worry too much about it if I just couldn’t sleep but otherwise felt fine; some people just need less sleep. He was making the best diagnosis with the information he had at the time, but now I know better. I need sleep.

I also know, now, that often I can sleep enough, as long as I’m allowed to sleep in. The problem is that I just can’t fall asleep until well into the night–even when I’m waking up early in the morning each day.

I’m not a doctor, and I can’t diagnose myself. If I were to see a doctor, though, I’d suggest that I might have Delayed Sleep Phase Syndrome, perhaps with elements of Non-24-Hour Sleep-Wake Disorder (sometimes, it seems as though my body thinks there are too many or too few hours in a day, and cycles through sleep wake patterns out of sync with the clock).

Which brings us to bright light and melatonin.

We know that we need light to help regulate our sleep cycles, so I won’t belabor the point. But yes, light–especially sunlight–helps us recognize day, and darkness helps our brain recognize night. Ideally, our brains recognize day and night at the right times, and then dispenses melatonin (the sleepy hormone) accordingly.

The connection between sunlight and melatonin, however, isn’t automatic. There are at least three working parts: the right environment, the right sensory processing, and the right neurological response. We need the sun, our eyes, and our brain.

Any of these three parts can interfere with the connection.

In the case of having not enough sunlight or too much night time light, there is an environmental barrier. This can happen because of where you live (such as if there are two many or few daylight hours), night-time screen time, or work environment. It might even happen if you are stuck inside all day, such as if, say, you are in the middle of a global pandemic and there are limited safe outdoor opportunities available to you.

Often, there are things you can do about environmental barriers, like:

• Use a darkscreen app on your electronic devices at night (and reduce screen use at night if possible)
• Go outside during the day OR open your windows and camp out in the natural light
• Use bright screens during the day
• In some cases, obtain artificial bright lights, such as those used to treat Seasonal Affective Disorder
• Basically, leverage your environment to get more light in the day and less at night

However, it doesn’t matter what your environment is like if your eyes aren’t receiving the waves of light. In this case, you have a sensory barrier.

Most people who have Non-24-Hour Sleep Wake Disorder are totally blind. If you are blind, you may be getting plenty of vitamin D from sun exposure, but your eyes are not registering sunlight, and as such they aren’t telling your brain when to make melatonin. In this case, taking artificial melatonin may help, though if not, most schools and workplaces are required to accommodate an alternative schedule for those with Non-24 Hour Sleep-Wake Disorder (as protected by the ADA).

But suppose you have a good environment and your eyes are able to detect day and night signals around you. Even if you get a lot of bright light in the morning, and even if your eyes are sending those signals to your brain, you STILL might not have a regular sleep-wake rhythm if your brain just doesn’t produce melatonin at the right time. In this case, you have a processing error.

I certainly don’t know all of the reasons why brains are prone to short-circuiting this way, but a few vulnerable populations include those on the autism spectrum and those with depression or anxiety. I’m also partial to the idea that there are genetic night owls. I think I might be one (but then again, when it comes to delayed-sleep-phase people, don’t we all feel like this?).

But of course, one REALLY BIG reason why our brains just don’t make melatonin is trauma.

Scientists way smarter than me have found that those with PTSD have fewer melatonin secretions than those without PTSD. And it’s a two-way street: PTSD and insomnia or other sleep disorders can perpetuate each other in a vicious cycle.

Right now, most if not all of us are experiencing at least a minor trauma. Some of us are experiencing a lot of trauma.

Likewise, most of us are experiencing a disruption to our routine. We’re being asked to stay home as much as possible, and for many, that equates to largely staying indoors. So we’re being hit with environmental changes and brain processing changes. Then, if our sleep is affected enough, we may be experiencing even more trauma than we otherwise would be, which then makes it harder to sleep again.

Hopefully there’s more then one take-away from all this, but the most important part, as I see it, is that taking care of your sleep is a basic but foundational need right now.

If you can manage healthy sleep with regular “sleep hygiene,” then prioritize that.

If you need more bright lights, a later (but consistent, if possible) wake up time, melatonin supplements, or even other sleep aids, then go for it. You may not be able to have a normal persons sleep schedule, but you *might* be able to improve what you would have otherwise had.

And if you are worried that you aren’t doing enough to get good sleep, try to cut yourself some slack. There’s only so much you can do, and there’s a lot out of your control.

I am still going to let myself sleep later (Michael is a hero, yes), but I’m at least a little bit hopeful that taking melatonin and using bright lights a half hour before I naturally get up will help me shift my schedule, even if just by a little bit. If I can get myself to fall asleep an hour or two in the morning most nights, I’ll take that improvement gladly.