All over Boston, people are sleep-deprived this week. With nerves jangled and brutal images of Monday’s bombing replaying in their minds, many are having trouble falling or staying asleep, according to local physicians, who said that sleeping difficulties have been one of the most common health complaints since the attack.
Sleep specialists say insomnia and nightmares are normal in the first several days after such a traumatic event, and many people may be making problems worse by use of alcohol, cigarettes, and caffeine.
About 90 percent of people will experience sleep problems at some point from a traumatic life event. “It usually lasts for a few days and less commonly for a few weeks,” said Dr. Khalid Ismail, a sleep medicine specialist at Tufts Medical Center. Those with previous bouts of insomnia due to depression or an anxiety disorder may be more susceptible to lingering problems, he said.
Dr. James Mojica, director of Massachusetts General Hospital’s Spaulding Sleep Center, fielded calls from three patients who said previous problems had returned since the bombings. He ha counseled them to try relaxation techniques and cognitive behavioral therapies to manage anxious thoughts in the quiet stillness just before sleep. “I prescribe sleep medications as a last resort,” he said.
Even hospital workers can find themselves seeing grisly images again and again when they close their eyes.
Dr. Leana Wen, an emergency medicine physician working at Mass. General at the time of the bombing, knew her husband was near the Marathon finish line at the time of the bombing, but did not know he was safe until hours later.
“That’s the moment I relive in my sleep,” she said, “resuscitating a patient devastated by the attacks who then turns out to be my husband.”
While time can help ease painful memories, Mojica said, those with difficulties should practice smart sleep habits: going to bed at the same time each night, skipping the nightly news with bombing updates, avoiding napping during the day and caffeine after noon.
Having several beers may be a tempting way to get drowsy, but it may lead to poor sleep. “Alcohol is an absolute destroyer of sleep,” said Dr. David Gitlin, psychiatrist at Brigham and Women’s Hospital.
Gitlin has met with most of the 35 bombing victims treated at Brigham, as well as their relatives, many of whom are having trouble sleeping. “I’ve been telling families to get out and take a walk,” he said.
Research has shown that even a15-minute exercise session can lower anxiety levels and improve sleep quality.
What may not be so helpful, Gitlin added, is for those who witnessed the bombings to endlessly discuss what occurred with family and friends — or the news media. Many mental health experts no longer believe that it’s therapeutic to discuss traumatic events repeatedly, based on findings that the brain continues to strengthen the memories each time.
“I’ve seen the same people interviewed on five different news stations, and I’m worried for them,” Gitlin said, since they could be increasing chances of post-traumatic stress disorder.
Children may benefit from a little extra cuddling for a few days. “This is a good time for night lights,” said Dr. Stuart Goldman, a psychiatrist at Boston Children’s Hospital.
Parents can also lie down with young children to help them fall asleep for a few nights, he said, but after a week, “it may be time to call the pediatrician.”
After being blown off her feet by the second explosion, Chelsea Turner, a senior at Northeastern University who was standing across the street from the bomb, said she had multiple nightmares and little sleep early in the week. She stayed at her boyfriend’s apartment for two nights, but has returned to her own studio.
“My sleep is still interrupted,” she said, “but it’s getting a little easier every night.”Deborah Kotz can be reached at firstname.lastname@example.org. Follow her on Twitter @debkotz2.