Veterans With Insomnia Face Uphill Battle

04/12/2011 12:00 pm ET | Updated Nov 17, 2011

It's hard enough for most single mothers to squeeze in eight hours of sleep every night, but Nehemie Almonor, a 26-year-old Iraq war veteran, is having an especially difficult time with it. In addition to raising a 5-year-old on her own, she has been extremely stressed out since she returned from her tour in February.

"I usually get maybe five hours," she said. "It''ll be like 11, 12, one in the morning and I'm still awake in front of the TV, knowing I have to get up at six and take care of my daughter and send her to school."

Almonor says the lack of sleep is starting to leak into other aspects of her life. She's tired and irritable all day, she's struggling to keep up with the homework for her online associate's degree program at Colorado Tech and she can't find a job, which makes it difficult for her to keep up with her bills.

"I used to pay the internet bill, but I really can't support the internet bill, cable bill, phone bill and childcare," said Almonor, who now has to walk to the library every day to use their computers for job searching. "I'm basically forcing myself to stay awake all the time, because I have to do my homework, and evening time is devoted to my kid. I can't get any of it done during the daytime because I'm up searching for employment."

Sleeping was never a problem in Iraq, Almonor said, because she was so exhausted all the time. But she can't figure out why she is having trouble getting her eight hours in now that she's back home in Wyomissing, Pa. At the insistence of her friends, she recently made an appointment at the local Veterans Affairs center to get tested for post-traumatic stress disorder, a type of anxiety disorder that occurs after a person has seen or experienced a traumatic event.

"At first I would've said it was the time zone difference that was keeping me up, but I don't think so anymore," she said. "My friends tell me I'm a little bit angry."

Sleep disorders are an extremely common problem among veterans, according to the National Pain Foundation, and many of the symptoms they suffer -- including nightmares, chronic insomnia, sleep apnea, severe snoring, restless leg syndrome and sleep cycle disturbances -- are thought to be caused by PTSD. One out of five veterans who served in Iraq or Afghanistan suffers from PTSD, the National Veterans Foundation reports, and only half of them ever seek treatment.

Since Congress pushed for greater awareness of sleep disorders among veterans in 2007, the number of veterans receiving disability benefits for them has increased by 61 percent, according to Veterans Affairs data.

"Sleep disorders are huge with any veteran in any war," said Floyd Meshad, a psychiatric social worker and trained traumatologist who founded the National Veterans Foundation. "So many of them are calling and saying they can't sleep, and they're angry and irritable all the time, and they have ADHD, and all these symptoms are rolling out. I tell them it's a normal reaction to an abnormal situation -- you've been in war."

Meshad, who counsels veterans on a daily basis, said one of the most difficult adjustments to cope with upon returning home from deployment, ironically enough, is the quiet. "Often with this population, they come home and they're used to explosions," he said. "They live in a state of anxiety, and they can get anxious because it's too quiet when they sleep. It's very loud in a war zone, and the one thing that takes years to get comfortable with is quietness."

Alex Munoz, 24, has been suffering from insomnia since he returned home to Inglewood, Calif., from his 13-month Iraq tour in November 2009.

"It's the silence," he said. "I have to sleep with music or some kind of noise on, and on top of that, I toss and turn."

Like Almonor, Munoz is having trouble landing a job, and he said the lack of sleep is exacerbating the problem. He said he applies to three or four jobs a day, everything from engineering positions to jobs flipping burgers at local fast food restaurants, but he is having trouble getting a career together on only four hours of sleep a night.

"I'm irritable and tired all day," he said. "It makes it harder to concentrate."

One of the most problematic aspects of sleep disorders among veterans, Meshad has noticed, is that it can lead them to self-medicate, behavior which can then snowball into an array of other problems.

"It's a domino effect," he said. "Lack of sleep makes anybody irritable, and veterans coming back from war are already irritable, so now you're double irritable. Drinking and numbing yourself will quiet it down, so you try to self-medicate with alcohol or sleep pills and you get into other problems -- no job, no money, no place, you can't afford anything. You eventually hit depression."

The National Pain Foundation recommends that veterans suffering from sleep disorders avoid alcohol and adopt general healthy sleep habits, such as avoiding caffeine and exercise in the evenings, setting sleep schedules, and using the bedroom solely for sleep. If that doesn't work, veterans should seek cognitive behavioral therapy to address the underlying issues.

"Most of this is emotional," Meshad said. "As a therapist, you gotta find the hub of this sleep disorder, and with this population, it goes pretty quick to all the intrusive thoughts. You're gonna need therapy to get to the bottom of those."

Munoz said he tried taking Ambien to help himself sleep, but he stopped after a few months because it didn't help. "It would put me to sleep, but it wouldn't keep me asleep," he said. He is now talking to a psychologist he found through the National Veterans Foundation.

"There are a lot of little things that amount to the big picture of trying to get used to normal life again. It's like you have to learn everything over," he said. "Even how to sleep."

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