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. In fact, sleeping difficulties have been one of the most common health complaints since the attack, according to local hospital physicians.
Sleep specialists say that insomnia and nightmares are normal within the first several days after such a traumatic event, and many people may be making problems worse by self-medicating with 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 from Tufts Medical Center. Those with previous bouts of insomnia due to depression or an anxiety disorder may be more susceptible to lingering problems, as well as those directly affected by the attacks, who are at risk of developing post traumatic stress disorder.
Dr. James Mojica, director of Massachusetts General Hospital’s Spaulding Sleep Center, fielded calls from three patients since Monday who said their previous sleep issues had returned since the bombings. He’s counseled them to try relaxation techniques and cognitive behavioral therapies to manage anxious thoughts that enter their minds in the quiet stillness just before sleep. “I prescribe sleep medications as a last resort,” he said.
Hospital workers who witnessed the grisly wounds and copious amounts of blood up close are finding themselves seeing those images again and again when they close their eyes. Dr. Leana Wen, an emergency medicine physician working at Massachusetts General Hospital 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 about her frequent nightmares, “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 sleep difficulties should practice smart sleep habits by going to bed at the same time each night, skipping the nightly news with updates on the bombing, and avoiding napping during the day and caffeine after noon.
Downing several beers in the local bar may be tempting to drown sorrows and induce drowsiness, but it will likely lead to poor quality sleep. “Alcohol is an absolute destroyer of sleep,” said Dr. David Gitlin, a psychiatrist at Brigham and Women’s Hospital.
Customers packed into Local 149, a bar in South Boston, within the first few hours after Monday’s explosion and have been staying well past midnight on every evening since.
Bar sales have risen by $1,000 to $2,000 each of the past few nights, according to bar manager Bobby Shah, who himself has been having nightmares and difficulty falling asleep. “Regulars sit for hours crying and talking quietly,” he said.
Gitlin has met with most of the 35 patients treated at the Brigham and their families, 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 a small 15-minute bout of exercise 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 tramautic events repeatedly, because 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 a few studies suggest that they could be increasing their chances of suffering from post traumatic stress disorder.
Children having sleep issues may benefit from a little extra cuddling for a few days. “This is a good time for nightlights,” said Dr. Stuart Goldman, a psychiatrist at Boston Children’s Hospital. Parents can also lie down in their young children’s beds to help them fall asleep for a few nights, Goldman said, but he would not advise the practice for more than a week. “At that point, it may be time to call the pediatrician.”
After being blown off her feet during 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 slept at her boyfriend’s apartment for two nights but has since 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.