Sleep
Why Veterans Can't Sleep — and What Actually Helps
Medically reviewed · Updated 2026
Sleep problems are among the most common complaints after military service — and among the most treatable, once you understand what's actually happening. This is not a willpower problem. It's a nervous system that was trained for vigilance and never got the stand-down order.
Why service breaks sleep
- Trained hypervigilance. Deployment conditions the brain to treat sleep as vulnerability. That conditioning doesn't discharge with you.
- PTSD-related nightmares keep sleep shallow — and teach the brain to dread going to bed at all.
- Chronic pain fragments sleep, and fragmented sleep amplifies pain the next day. The loop feeds itself.
- Years of shift work and irregular ops leave circadian rhythms without an anchor.
What actually works
CBT-I — the first-line treatment
Cognitive behavioral therapy for insomnia is the gold standard — more durable than sleep medication, and it's what treatment guidelines recommend first. It retrains the bed-sleep association, corrects the schedule, and dismantles the anxious math ("if I fall asleep now I'll get five hours...") that keeps you staring at the ceiling.
Treating the nightmares directly
Trauma-related nightmares have their own treatments — Imagery Rehearsal Therapy (rescripting the nightmare while awake) and the medication prazosin are both used for post-trauma nightmares. If nightmares are the engine of the problem, treating "insomnia" alone misses the target.
Down-shifting before bed
Paced breathing — particularly 4-7-8 with its long exhale — gives the nervous system a physiological signal that it's safe to stand down. It's not a cure, but it's a lever you control tonight.
Start with the sleep pathway
Service & Recover includes a dedicated sleep pathway alongside PTSD, depression, and chronic pain — plus built-in paced breathing for tonight and appointment prep for raising it with your provider. Free, private, no account.
Free companion app
Service & Recover puts these pathways, a personal safety plan, and appointment prep in your pocket — free, no account, nothing collected. Get it on the App Store →
Educational companion, not therapy or medical advice. This does not replace professional care and is not a crisis service. In immediate danger, call 911. Veterans Crisis Line: call 988 then press 1, or text 838255.