5.10 Sleeping Disorders In almost all of the cases that HBF works with, victims of trafficking suffer lack of sleep or disturbed sleep patterns. Sleeping disorders, insomnia and nightmares are common among victims of all forms of trafficking and are often a component of PTSD, Complex Trauma and depression. A Central African woman trafficked for sexual exploitation “I can’t sleep at night – that’s when the men came.” Habits are also formed from trafficking and exploitation experiences which seriously disturb long term sleeping patterns. For example, victims may have been forced to stay awake for 18 hour days in exploitative work and been plied with caffeinated drinks for that purpose. Some describe being brutally punished by traffickers for being found asleep or resting, which forces them into a state of hyper-arousal and fear of not being awake. A West African man trafficked for sexual exploitation George frequently feels overwhelmed “like I’m trying to solve 1000 problems at one time”. His sleep has become very disturbed, he has intermittent severe headaches and frequent nightmares. A West African woman trafficked for sexual exploitation Rebecca sometimes has two or three nightmares a night. For example she dreams that her trafficker is trying to kill her or that she is being raped. These dreams cause her to wake up with a start and afterwards she has pains all over her body. She has to sleep with the light on and is too frightened to leave her room to use the bathroom in the night. She cannot sleep in a bed and prefers a mattress on the floor. This is because sleeping on a bed reminds her of enforced sex work. 83