Sleep, startle and anxiety after a disaster
Jumping when a door slams, lying awake all night, feeling a tremor that isn't there — none of this is a fault. It is a body still on watch after danger. This guide separates what is ordinary from what needs support.
Booklet 9 min read Print-ready CC BY-NC 4.0
This page does not diagnose. What follows is general information and does not replace an assessment of you or someone close to you. If you are having thoughts of harming yourself, do not wait: call 112 or go to the emergency department of the nearest hospital.
What is happening
The alarm went off; it takes time to quieten
In danger the body triggers an alarm system within seconds: the heart speeds up, muscles tighten, the senses sharpen, digestion stops. That system exists to protect you and it works extremely well. The problem is that once the danger has passed, the alarm takes time to switch itself off.
That is why the body is still on watch weeks after the earthquake ended. A slamming door, a passing lorry, a spinning washing machine trip the same circuit. This is called hyperarousal and it is the most common reaction after a disaster.
Feeling a tremor that is not there — the "phantom shake" — is another face of the same mechanism: your balance system has started expecting movement again. It does not mean you are losing your mind. It is very common and it fades.
Ordinary reactions
All four are expected in the first weeks
Everything below is an ordinary response to an extraordinary event. In most people it eases markedly over a few weeks.
In the body
- Palpitations, tightness in the chest
- Muscle ache, clenched jaw
- Nausea, changes in appetite
- Headache, exhaustion
- Trembling, feeling cold
In feeling
- Sudden anger and irritability
- Guilt — "I survived"
- Numbness, distance
- Crying for no clear reason
- Being permanently on alert
In thinking
- Poor concentration, forgetfulness
- The scene replaying itself
- Not being able to decide
- The "if only I had" loop
- A distorted sense of time
In behaviour
- Trouble falling asleep, waking often
- Avoiding crowds and enclosed spaces
- Sleeping dressed, keeping the bag close
- Not being able to stop scrolling
- Drinking and smoking more
Sleep
Eight things that help with sleep
Most sleeplessness after a disaster comes from a body that has not yet confirmed it is safe. These make that confirmation easier. Do not try all of them; start with two.
1 · The same hour, every day
Fix the hour you get up rather than the hour you go to bed. Rising at the same time even after a bad night restores the rhythm within days.
2 · Keep the bed for sleeping
If you are still awake after twenty minutes, get up, do something dull in low light and return when sleep comes. Turning over for hours teaches the bed to mean wakefulness.
3 · Confirm safety with your eyes
Before bed, check the door, the bag and your shoes once. Once. This reduces the urge to keep checking through the night.
4 · An evening news fast
Two hours before bed, disaster footage and group chats close. Anything you need to know will still be there in the morning.
5 · Long out-breath
In through the nose for four, out through the mouth for six. Making the out-breath longer than the in-breath is the simplest way to slow the nervous system. Five minutes is enough.
6 · Muscle release
Starting at the feet and working up, tense each muscle group for five seconds and let go. When the body has forgotten how to release, it has to be reminded.
7 · Limit caffeine and alcohol
Alcohol makes falling asleep easier but breaks up the second half of the night and worsens nightmares. Stop caffeine after midday.
8 · Daylight and movement
Morning daylight and walking during the day repair night-time sleep more reliably than medication does.
Sleep medication is useful in some situations and for short periods — but that is a doctor's decision. Using someone else's prescription is a common post-disaster mistake with serious consequences.
In the moment
When you startle: grounding
When anxiety rises, attention slides to the past or to what might happen. Grounding pulls it back to this moment and this room. Practise both while you are calm, so they are easy to remember when you are not.
Method A
5–4–3–2–1
Out loud or silently, count:
- Five things you can see
- Four sounds you can hear
- Three surfaces you can touch
- Two things you can smell
- One taste in your mouth
Method B
Pressing into the ground
Put both feet flat on the floor and press down through your heels. Notice that the ground beneath you is solid. Rest your hands on your knees and feel their warmth. Say aloud where you are, the day and the hour: "I am in Nicosia, it is Tuesday, it is eleven o'clock. There is no shaking right now."
Avoidance brings relief in the short term and grows the fear in the long term. If you avoid lifts, enclosed rooms or buildings altogether, the body concludes "so it really was dangerous". Returning gradually, with support, heals more than staying away.
When to seek help
Past a month, and stopping your life
The test is not whether a symptom is present but how long it lasts and how much it costs you. If any of the following applies, there is no reason to wait longer before making an appointment.
- Symptoms have lasted more than a month and are not easing, or are worsening
- You cannot keep up with work, school or running the household
- Sleep is regularly under four hours
- Flashbacks are cutting into your day
- You systematically avoid people, places and conversations
- Alcohol, tobacco or medication use has clearly increased
- You are having thoughts of not wanting to live — do not wait on this one
None of this indicates weakness. It indicates a load heavier than can be carried alone. Early support keeps things from dragging on.
Related guide
After a loss: on grief
If there is a death as well, part of what you feel belongs to grief and follows its own course.
Related guide
Talking to your child
If there are children at home, their sleep and startle reactions look different.
Related guide
Secondary trauma for field workers
If you are the one helping, similar symptoms arrive by a different route.
References
Where the information on this page comes from
The list of ordinary reactions, the grounding techniques and the thresholds for support are adapted from the guides below. The examples were adapted to the Cyprus context by TAKDER.
- Psychological first aid
- World Health Organization, War Trauma Foundation & World Vision International (2011). Psychological First Aid: Guide for Field Workers. Geneva: WHO. who.int
- Ordinary reactions and thresholds
- National Child Traumatic Stress Network & National Center for PTSD (2006). Psychological First Aid: Field Operations Guide, 2nd edition. nctsn.org
- Stress management skills
- World Health Organization (2020). Doing What Matters in Times of Stress: An Illustrated Guide. Geneva: WHO. who.int
- Mental health services in emergencies
- Inter-Agency Standing Committee (2007). IASC Guidelines on Mental Health and Psychosocial Support in Emergency Settings. interagencystandingcommittee.org
Links go to the publisher; last accessed 11 September 2026. If you spot an error in a citation, tell us and we will correct it.