In the night's dream: suffering from nightmares since the seventh of October? Read it

Thousands of Israelis suffer from various degrees of post-traumatic stress disorder since the fighting in Gaza. Among them are the survivors of the massacre, soldiers and those who were displaced from their homes. One of the prominent symptoms of post-traumatic stress disorder is impaired sleep quality, among other things due to nightmares. New guidelines determine how these symptoms should be treated, thereby significantly helping the normal functioning of the victims.

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Sleep disturbances are essential hallmarks of an acute stress reaction and post-traumatic syndrome. They cause a decrease in mood, concentration, cognitive ability and physical health. About 35% of trauma victims report nightmares, and about 58% about difficulty sleeping within a day of the trauma. Fast and correct treatment of sleep disorders can be useful in the immediate period, and probably in preventing the development of post-trauma.

In the medical literature, there are no uniform and unequivocal guidelines regarding drug treatment, and the new guidelines authored by Dr. Daniel Warsman Berkovich and Dr. Yoel Reiter from the Israeli Sleep Research Society detail the recommendations for drug treatment. According to the experts, the treatment is multidisciplinary and focuses first and foremost on behavioral psychological therapy, which includes training on sedation methods, an explanation of sleep hygiene that includes sleeping in a dark, quiet room at a temperature conducive to sleep, avoiding physical activity, drinking caffeine and screens before bed, and avoiding naps that may interfere with activity the biological clock.

The experts point out that in the drug treatment, antidepressants and anti-anxiety drugs from the SSRI and SNRI groups, which are considered the first line in the treatment of post-trauma, must be avoided, but they have significant side effects in terms of sleep and can cause an increase in awakenings, increased mobility and disturbances in the REM phase, and therefore are not effective For the treatment of immediate sleep disorders. In this case, the experts recommend to doctors specific drugs that deepen certain stages of sleep, such as antipsychotic drugs.

The experts also emphasize that beta-blocker drugs used for hypertension and arrhythmias such as propranolol may worsen insomnia, causing nightmares and dreams at the time. Treatment with drugs from the benzodiazepine family is also not recommended, and may worsen post-traumatic symptoms and impair sleep stages.

"Nightmares are a disturbing and significant phenomenon that harms the quality of life of post-trauma sufferers," explains Dr. Yoel Reiter, a sleep medicine expert from the Hadassah Medical Center and chairman of the Israel Sleep Research Society. "Those who suffer from nightmares wake up from their dreams, suffer from sleep disorders and also have difficulty functioning on a daily basis."

Reiter further explains: "Some sufferers even develop a fear of sleeping at night, which causes the sleep problems to worsen. The treatment of nightmares is very important, and it should be an integral part of the treatment of trauma victims. Those who suffer from the problem should contact their family doctor and through this continue treatment with sleep specialists. The treatments today are effective, and may lead to a very significant improvement in function and quality of life."