Chronic Stress, Trauma, and Insomnia: Why Your Nervous System Can’t Sleep and How Trauma-Informed CBT-I and ACT Can Help

When you live with chronic stress or a history of trauma, bedtime is rarely just “bedtime.”

You might be exhausted, desperate to sleep, yet the moment you lie down your body flips into high alert. Your chest tightens. Your mind starts scanning for something wrong. The world is quiet, but inside you it feels like sirens.

If that sounds familiar, you are not alone. I meet a lot of people in British Columbia whose insomnia did not appear out of nowhere. It grew out of years of stress, difficult experiences, or outright trauma. Their nervous systems did exactly what they needed to do to survive. The problem is that pattern does not automatically switch off just because life is “technically” safer now.

In this article, I want to walk you through how chronic stress and trauma interact with insomnia, and then talk about what trauma-informed treatment can look like. The first two thirds of this piece are about understanding. The last third is about what we can actually do.

My hope is that as you read, something shifts from “what is wrong with me” toward “oh… that actually makes sense.”

When Your Nervous System Learns The World Is Not Safe

Before we talk about sleep, we need to talk about the body.

Chronic stress

Chronic stress is what happens when your demands stay high and your chances to recover stay low. It can come from:

• A demanding job where you never fully switch off

• Caregiving for children, partners, or parents

• Financial uncertainty

• Ongoing health issues

• Relationship conflict or separation

None of these are “trauma” in the classic sense, but they keep your stress response switched on. Over time, your baseline arousal creeps upward. You start to live closer and closer to the edge.

Trauma

Trauma can be:

• A single overwhelming event, like an accident, assault, or natural disaster

• Repeated events, like emotional neglect, abuse, or ongoing bullying

• The absence of safety and care when you really needed it

Sometimes this meets criteria for PTSD. Sometimes it does not. Either way, your nervous system learns something very important: the world is not reliably safe and you cannot fully relax.

Your body internalizes this lesson. Long after the event is over, the response system continues to fire. Your system keeps acting as if threat is just around the corner.

Hyperarousal in plain language

Biologically, all of this shows up as hyperarousal.

Your threat system (fight, flight, freeze, fawn) is switched on more often than not. Hormones like adrenaline and cortisol are meant for quick spurts of danger. With chronic activation, they become a background hum. You may notice:

• Feeling “keyed up” even when nothing is happening

• Startling easily

• Having a hard time relaxing or doing “nothing”

• Irritability or impatience

• A feeling of being “tired but wired”

This is crucial for understanding insomnia. Sleep is the opposite of a threat response. To sleep, the brain has to feel safe enough to temporarily go offline.

If your system does not trust safety, sleep becomes very complicated.

Sleep In A Nervous System That Does Not Trust Safety

We sometimes talk about sleep as if it is a simple switch. Lights off, brain off. Anyone who has had insomnia knows this is not how it works.

Sleep is a vulnerable state. When you fall asleep, you surrender awareness of your surroundings. Your body will only do that if it is convinced conditions are “safe enough.”

Hypervigilance at night

If you have lived through trauma or chronic stress, your system may not let you fully drop your guard at night.

Hypervigilance can look like:

• Lying in bed, scanning every sound

• Feeling like something is going to happen, even if you cannot name what

• Being “on guard” in your own home

• Mentally rehearsing worst case scenarios

From a nervous system perspective, this is not irrational. Your body learned that being relaxed is dangerous. It is trying to protect you.

Nightmares and trauma memories

For many trauma survivors, the night is not just about falling asleep. It is about what happens once you do:

• Vivid nightmares

• Replays of traumatic events

• Waking in a panic with your heart racing

• Confusion about whether what you dreamed “really happened” just now

After a while, your brain starts to pair “sleep” with “bad things happen.”
Of course you start to dread bedtime.

The Insomnia–Stress Feedback Loop

It is helpful to think in cycles.

1. Chronic stress and trauma activate your nervous system.

2. Activation makes it hard to fall asleep or stay asleep.

3. Poor sleep weakens your ability to regulate emotions and stress the next day.

4. You feel more on edge, more sensitive, more overwhelmed.

5. That evening, your system is even more activated.

6. Sleep gets worse.

Round and round it goes.

Insomnia is not just “I sleep badly.” It is “my system no longer remembers how to power down, and every rough night makes tomorrow even harder.”

When Nighttime Itself Becomes a Trigger

People often say to me, “The moment I start getting ready for bed, my anxiety spikes.” That makes sense when you consider how learning works.

Bed as a conditioned cue

In behavioural terms, the bed can become a trigger for distress.

If you have spent many nights:

• Lying awake worrying

• Fighting off panic

• Reliving arguments or traumatic events

• Feeling intensely alone or unsafe

Then your brain does not just see a bed. It sees a place where suffering happens.

The same is true of certain times of night. If bad things happened around a specific time, it is common to wake near that hour, even years later.

Common trauma-linked sleep patterns

Some patterns I see often:

• Long, anxious delays before falling asleep because your mind will not stop

• Falling asleep, then waking at almost the same time every night with anxiety

• Feeling numb at first, then suddenly jolted awake by fear or a nightmare

• Staying up very late scrolling or watching something, just to avoid being alone with your thoughts

None of this means you are weak. It means your nervous system is doing the best it can with what it has learned.

The Emotional Weight Of Trauma-Linked Insomnia

Insomnia in the context of trauma is not just a sleep problem. It is also an emotional one.

Common experiences include:

• Shame: “Why can’t I just sleep like everyone else?”

• Self-blame: “If I had dealt with things differently, I wouldn’t be like this.”

• Fear: “What if I never sleep normally again?”

• Hopelessness: “I’ve tried everything. Nothing works.”

• Grief: Missing the version of you who could just fall asleep without thinking about it

Over time, people do not only see themselves as “someone who struggles with sleep.” They begin to see themselves as “a broken person.”

One of the first goals of therapy is to gently challenge that story. You are not broken. You are adapted. And adaptations can change.

Why Standard Sleep Advice Often Falls Flat

If you have tried basic sleep tips and felt worse, there is a reason.

Sleep hygiene is not designed for trauma

Most articles and quick tips focus on:

• No caffeine after a certain hour

• Keep your bedroom cool and dark

• Turn off screens before bed

• Have a consistent routine

These are not bad ideas. They are just incomplete.

They do not speak to:

• Waking from nightmares

• Feeling unsafe in your own bed

• A body that goes into panic when you close your eyes

• Memories that flood in when your distractions are gone

Telling somebody with trauma to “just relax and dim the lights” is like telling someone in a burning building to “focus on their breathing.” It misses what is actually happening in their world.

When strict CBT-I can feel too harsh

CBT-I, the gold standard treatment for insomnia, is powerful. It uses techniques like sleep restriction and stimulus control to recalibrate your sleep system.

Used without sensitivity to trauma, though, it can feel punishing:

• Being told to get out of bed every time you wake, no matter how tired you are

• Being asked to keep a very tight sleep window when your days are already stressful

• Being encouraged to wake up at the same time even after a night of nightmares

For some trauma survivors, this can add a layer of pressure and self-criticism. “If I cannot do this exactly right, I will never get better.” That is the opposite of what we want.

The good news is that CBT-I does not need to be rigid. It can be adapted in a trauma-informed way.

Trauma-Informed Principles For Treating Insomnia

Now that we have spent some time naming what is happening, let’s turn to what can help. The goal is not to erase your history. The goal is to help your body learn that, in the present, more moments are safe than not, and sleep can become possible again.

1. Safety First: Stabilizing the Nervous System

Before we push your sleep system very hard, we need to build some basic safety and regulation skills.

That often starts with:

• A therapeutic relationship where you feel respected and not judged

• Clear education about what insomnia is and how trauma affects sleep

• Gentle grounding skills you can use day and night

Some simple grounding tools include:

• Naming five things you can see, four you can feel, three you can hear, two you can smell, one you can taste

• Using your breath as an anchor rather than a “fix,” noticing the flow in and out

• Looking around the room and letting your eyes land on objects that remind you “this is now, that was then”

These are not magic tricks. They are small signals to your nervous system that the present moment is different from the past.

2. Adapting CBT-I With Compassion

We still want to use the power of CBT-I, because it is very effective. But we use it in a way that respects the realities of trauma and chronic stress.

This can look like:

• Collaboratively setting a sleep window that challenges insomnia but does not feel brutal

• Allowing some flexibility on especially hard nights, then gently returning to the plan

• Practising stimulus control (leaving the bed when you are wide awake) while ensuring the “alternative space” feels emotionally safe and comforting

For nightmares or trauma dreams, we sometimes bring in additional tools like imagery rehearsal therapy, which involves rewriting the dream and practising the new version while awake. In some cases, I will recommend parallel trauma therapy alongside insomnia treatment, such as EMDR or trauma-focused CBT, so that we are not asking you to carry everything alone.

3. Using ACT To Change Your Relationship With Nighttime

Acceptance and Commitment Therapy (ACT) gives us a language for how to be with difficult internal experiences without being swallowed by them.

Some of the ACT-based skills that help with trauma-linked insomnia are:

• Acceptance: Making gentle space for anxiety, memories, sensations, and fatigue, rather than fighting them. This might sound like, “I really do not like this feeling in my chest, but I can allow it to be here while I sit in this chair and breathe.”

• Defusion: Noticing traumatic or hopeless thoughts as thoughts, rather than as facts. For example, “There is the ‘I will never be normal again’ story,” instead of “I will never be normal again.”

• Present-moment awareness: Building a “nighttime protocol” for wakeful periods that includes grounding, gentle activities, and a clear plan, so you are not left alone with rumination and fear.

• Self-compassion: Practising a kinder inner voice at 3 AM. Instead of “What is wrong with you?” something like “Of course you feel this way after everything you have been through. And you are here, learning a different way.”

ACT does not try to erase your history. It helps you create a bit of space inside it, so you can choose how to respond in the present.

4. Integrating Trauma Work And Sleep Work

Sometimes treatment focuses first on stabilizing sleep because you are barely functioning. Sometimes it focuses first on trauma processing while we make small, gentle shifts in sleep habits.

Most often, we do some of both:

• Building regulation and grounding skills

• Gradually introducing CBT-I strategies

• Addressing trauma memories and beliefs at a pace that feels tolerable

There is no single correct order. A trauma-informed approach means we decide together what to prioritize, based on your history, your current life, and your capacity.

5. Values: Letting Life Become Bigger Than Insomnia

One of the most powerful questions we can ask is:

If sleep improved, what kind of life would you want it to support?

Values might include:

• Being more present with your kids

• Having the energy to move your body again

• Showing up for your relationships with more patience

• Reengaging with hobbies or creativity

We do not wait until sleep is perfect to move toward those values. We start with tiny steps now, which ironically can also support sleep by giving your days more meaning and structure.

What This Can Look Like In Real Life

To bring this down out of theory, here is a composite example.

“Sam” (not a real person, but a blend of many clients) grew up in a household where nights were unpredictable. Arguments, drinking, and sudden outbursts were common. As an adult in British Columbia, Sam had a stable job and a safe apartment, yet could not sleep.

They would fall asleep for an hour or two, then wake at 2 or 3 in the morning with their heart racing. Most nights they stayed in bed frozen, replaying memories and blaming themselves for “not getting over it by now.”

When we began therapy, we did not start with strict sleep rules. We started with:

• Understanding how their childhood nights shaped their current nervous system

• Practising grounding when they felt activated

• Creating a “middle of the night plan” that involved getting out of bed, making tea, sitting in a comfortable chair with a blanket, and doing a simple sensory exercise

Once those pieces were in place, we added:

• A gentle sleep window tailored to their actual sleep time

• Stimulus control (leaving the bed when wide awake) in a way that felt safe

• ACT skills for responding to the “I am broken” and “I will never sleep like a normal person” stories

Over several weeks, their sleep became more consolidated. They still had occasional rough nights, especially around meaningful dates, but their relationship with those nights changed. They began to see them as understandable flares in a sensitive system, not personal failures.

Most importantly, as they slept a bit better and felt safer in their body, they started doing small things that mattered to them again: morning walks, lunch with a friend, picking up a creative project they had dropped years ago.

Life became bigger than the insomnia.

When To Reach Out For Help

You might consider trauma-informed insomnia treatment if:

• Nighttime feels unsafe or overwhelming

• You dread going to bed, even when you are exhausted

• You often wake from nightmares or panic

• Insomnia has lasted more than three months and is affecting your mood, work, or relationships

• You have tried basic sleep tips and nothing has shifted in a meaningful way

If this describes you, it does not mean you are failing. It means your nervous system has been carrying a heavy load for a long time, and you should not have to figure it out alone.

I work with clients across British Columbia using CBT-I and ACT through a trauma-informed lens. If you are curious about what working together might look like, you are welcome to book a brief consultation and we can talk about your specific situation and your goals.

Your history matters. So does your nervous system. And even if sleep has felt like a battleground for years, it is possible to teach your body, gently and patiently, that more nights are safe than your system currently believes.