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Post-Dramatic Stress Disorder: A Hidden Cause of Sleeplessness

TV's not the opiate but the amphetamine of the masses.

We live in a world where drama is so ubiquitous that we have largely habituated to its insidious impact on our lives. Beyond the personal dramas that may visit, so many of us are overexposed to a much broader range of dramatic experiences through the media -especially news reports, television dramas and print media.

Most of us are keenly aware of the concept of PTSD, or post-traumatic stress disorder. And, of the fact that a common symptom of PTSD is sleeplessness. I've come to believe there is generally overlooked, subtler condition that negatively impacts the sleep of millions more on a nightly basis -- what I think of as post-dramatic stress disorder. Most of us are not so much traumatized as we are dramatized.

The National Sleep Foundation's 2005 Sleep in America Poll explored what Americans did in the hour before bed. It found that 87% of respondents reported regularly watching television, 51% reported reading and 28% cruised the Internet. Most of the warnings about such "sleep stealing culprits" are based on concerns about the effects of overexposure to light at night.

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The blue wavelength of light, present in all clear or white light, is a potent melatonin suppressive agent. The suppression of melatonin, the key neurohormone that mediates sleep and dreams, can disrupt sleep as well as damage our circadian rhythms. Computer and television screens emit particularly high levels of tsuch blue light, making them especially harmful to sleep. But as damaging as light at night can be to sleep, it's not the only culprit at play here.

Radio, television and newspapers routinely feed us drama-spiked renditions of reality. What we call the news is typically a terribly biased presentation of death, devastation and danger. Still, millions of Americans partake of the news in one form or another in the hour before bed, and too frequently from bed. Millions more consume dramatic material from books or television shows. Fully half of the top ten prime time television shows today are dramas. We can easily witness more betrayals, assaults, rapes and murders in an evening of "must-see TV" than most of us would ever personally experience in a lifetime. The extensive portrayal of crime on television has led to what George Gerbner calls the Mean World Syndrome, a sense that crime rates are significantly higher than they actually are. Of course, feeling safe is essential to good sleep, but so much more challenging when we believe the world we live in is dangerous.

One could argue that bad news and other portrayals of life's dramas are simply a part of reality that we should not deny. But are they really? Some years ago the chief of homicide at the San Diego Police Department was a guest speaker in a psychology course I was teaching. At the time, the TV police drama, Hill Street Blues, was the rage. A student asked if that show accurately depicted life in the precinct. "No," replied the chief, "Its much more like the sit com, Barney Miller."

Who hasn't felt their heart pound hard and fast while riveted to a compelling drama?  I believe that excessive exposure to drama results in symptoms of post-dramatic stress. These might include a sense of helplessness, agitation, worry and, of course, sleeplessness. Provocative, suspenseful, anxious and violent images are not as easy to digest as we might believe. Like acid reflux after a large, spicy meal, our systems will regurgitate undigested negative emotions and images, disrupting the quality of our sleep.

I believe that our excessive attraction to drama is related to our excessive sleepiness. In Healing Night I suggest that we are unconsciously drawn to drama because it provides us with a fix of adrenaline that momentarily counters our exhaustion. But being dramatized then further compromises our sleep, resulting in an unfortunate vicious cycle.

When it comes to post-dramatic stress, there is no question that prevention is the best medicine. I'm certainly not suggesting we avoid dramatic programs or news, just that we be judicious about the extent and timing of our exposure to them. Consider experimenting with drama free evenings and, in its place, cultivating peace and lightheartedness before bed. Relaxing rituals including yoga, breathing exercises and meditation are excellent alternatives. Enjoy the company of loved ones, a soak in a warm tub, or perhaps, a re-run of Barney Miller, one of my personal favorites.

Although most of my colleagues would advise against watching television before bed (and even against having a TV in the bedroom to avoid temptation), I believe this is a bit heavy handed. The problem is not television, per se, but the specific programs we watch and the melatonin suppressive effects of light. The solution is to use blue light screening devices such as special low blue light amber tinted glasses and, of course, to watch something undramatic, soothing or lighthearted.

There is now compelling evidence supporting many health benefits associated with laughter and lightheartedness. Laughter is a most effective antidote to post-dramatic stress as well as a potent natural sleep elixir. Think: post-ecstatic rest.

 

Rubin Naiman, Ph.D., is a Clinical Assistant Professor of Medicine at the Arizona Center for Integrative Medicine, University of Arizona.

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