Men who were abused as boys often experience problems with sleep. These problems can take many forms, including:

• Nightmares about the abuse.
• Waking up in a panic.
• Not being able to get off to sleep.
• Finding that the slightest noise or disturbance wakes you.
• Finding that having sex triggers memories of the abuse.

Its easy to see why problems might arise at night. You may be feeling almost permanently tensed up and unable to rest. Night time may carry particular memories of abuse. Instead of bedtime being a relaxing ritual, as a child, it may have been the time when you were violated by someone who should have been looking after you. Simply going to bed may be a trigger for bad memories.

Here's some general hints about sleep, rest, and bedtime, before we look in more detail at the distressing areas of nightmares, and waking in a panic:

• Make sure the place you're going to rest is physically comfortable.
• Use whatever relaxation works for you to decrease tension prior to bedtime.
• Establish some regular habits. This may be difficult. Bedtime may have been spoiled for you as a child by the abuser. Try to establish a new 'going to bed' ritual which will break the pattern of fear. This may involve : what time you go, whether you read in bed, whether you sleep alone or with a partner, whether you have the light on or off.... Experiment and see what you can come up with.
• Try to get into the habit of taking exercise during the day.
• Avoid coffee and tea in the evening - its a stimulant and keeps you awake.
• Avoid literature on Survivors issues just before bedtime
• If you're with a partner see what help they're prepared to offer. Will they read to you before bedtime, or give you a massage? They have their own need for sleep too, but it is worth asking what they can do to help you.
• Avoid alcohol and non-prescribed drugs. If you're not sleeping its tempting to 'knock yourself out' just to get through the night. But it rarely works. As well as carrying dangers of addiction, alcohol usually makes you wake up to go to the loo in any case.

You may be wondering whether to take sleeping pills. Its certainly worth talking to your C.P., as well as any other professionals you're involved with. Problems with sleep can also be a symptom of depression, and if you're depressed your doctor may prescribe you an anti-depressant to help you sleep and lift your mood. Doctors claim anti-depressants are very successful in treating depression. Other types of sleeping pill can be addictive and are usually only prescribed on a short-term basis. Its worth talking to your C.P. seeing what advice they offer, then weighing up whether any of it seems useful to you. Remember that pills alone are not the answer for dealing with abuse and are not a substitute for a good ho Support Team. The mental health charity publishes independent fact sheets on medication which are well worth consulting when making your decision. Find the address at the back of this pack in the 'Resources for Recovery' section.

Men who have been abused as boys often experience distressing nightmares. The nightmares can include:

• direct re-creations of the abuse
• children being harmed or killed
• scenes of death and violence
• being chased or otherwise assaulted
• being humiliated or put in a powerless position

The emotion attached to the nightmare is often one of absolute terror.

Nightmares are like flashbacks and sudden unpleasant memories in that they represent the abuse suddenly breaking through into awareness. They are very distressing and hard to get rid of. Here are some suggestions:

• Make sure you've got some 'talking' help with the issue of the abuse. Being able to talk about the way sexual abuse has affected you with a trusted counsellor therapist, or friend should reduce the amount and intensity of nightmares over time. Being able to share it seems to reduce the need for the abuse to 'break through' in the form of a nightmare.
• Whilst they are terrifying, nightmares are also a painful part of healing. It is like the mind is remembering what happened and trying to make some sense of it.
• Some people suggest that you can 'take charge' of your nightmare. In other words, turn the tables on whoever is attacking or abusing you during the nightmare. Whilst this may be possible in some cases its certainly not true for everyone. Don't give yourself a hard time if this isn't true for you.

Waking up panicking after a nightmare is a terrifying experience, so,

• Be kind to yourself immediately afterwards. Make yourself comfortable. Take whatever relaxation measures work for you.
• Try to remember that having the nightmare, as painful as it is, is part of remembering and healing.
• Decide whether you need to be on your own right now.
• It can be good to talk about how you are feeling. If you're with a partner who is willing to be woken then tell them what is happening and how you feel. Ask them for what support you need whether its a cuddle or a hug.
• If you're on your own, is there anyone you can ring to talk it through? Consider using the Samaritans if you're feeling desperate. Try to tell a supportive person as soon as practical afterwards. Sharing the nightmare is a way of breaking the isolation and getting support with the terror of it
• If you're with a partner see what help they're prepared to offer. Will they read to you before bedtime, or give you a massage? They have their own need for sleep too, but it is worth asking what they can do to help you.
• Avoid alcohol and non-prescribed drugs. If you're not sleeping its tempting to 'knock yourself out' just to get through the night. But it rarely works. As well as carrying dangers of addiction, alcohol usually makes you wake up to go to the loo in any case.