Improving Sleep After Traumatic Brain Injury

Why TBI causes sleep problems 

Having a TBI may cause a sleep problem for many reasons. These include:

• Direct injury to the sleep areas in the brain

• Changes in melatonin, a brain hormone that helps regulate sleep

• Other injury types

Other problems and some common TBI symptoms can also make it harder to sleep. These include:

• Abuse of drugs and alcohol

• Mental health problems, such as depression and anxiety

• Daytime sleepiness (because you may end up napping during the day)

• Headache and other types of pain

Types of sleep problems with TBI

If you are recovering from TBI, you may:

• Have trouble falling asleep or staying asleep (insomnia)

• Wake up often and easily (you’re a “light sleeper”)

• Not be able to fall back asleep

• Have trouble getting enough oxygen while sleeping (called sleep apnea)

• Fall asleep suddenly without any control (narcolepsy)

• Walk or move while asleep with no awareness of this (sleepwalking) 

Why sleep is important for TBI recovery 

Your brain needs sleep to heal from a TBI. Not getting enough sleep can make many other TBI symptoms worse. These symptoms include:

• Severe tiredness (fatigue)

• Confusion

• Pain

• Depression

• Anxiety

• Mood swings

• Memory problems 

Help for TBI sleep problems

Insomnia after TBI can last a while. It may occur with depression. You may also have trouble doing daily activities. If your symptoms get worse or last for more than a few weeks, contact your healthcare provider. They may advise:

• A kind of talk therapy called behavioral therapy

• Antidepressants

• Medicines to keep you awake during the day

In most people, medicines that help you sleep don't work for sleep problems from a TBI. Many sleep medicines, including over-the-counter ones, can make TBI worse. Don’t take any sleep medicines or aids until you talk with your provider.

The best way to treat sleep problems from a TBI is with healthy sleep habits. That means:

• Going to bed and getting up at the same time every day, including weekends

• Not having caffeine, alcohol, and nicotine

• Getting some exercise and sunshine each day. This helps reset your internal clock.

• Resting during the day. But not napping for more than 20 minutes.

• Not exercising or eating a large meal in the hours before bedtime

• Keeping your bedroom quiet, dark, and at a comfortable temperature

• Not using electronic devices like your TV or computer at least 30 minutes before bedtime

• Not lying awake in bed if you have trouble falling asleep. Instead, get up and do a relaxing activity for a short time.

Sleep problems are common after a TBI. If healthy sleep habits are not helping, talk with your provider. They may advise relaxation methods. Or you can try talk therapy if you have a mental health problem like depression or anxiety.  

Sleeping well can help your brain recover. Your provider can help you get the rest you need.