Colin Snow
Sleep is an important part of recovering from a concussion, and it is a common myth that you shouldn't sleep after a concussion or that you should be woken up every few hours. However, it is recommended that you consult a doctor before taking any medication, as certain painkillers such as aspirin, ibuprofen, or naproxen can increase the risk of brain bleeding. In some cases, acetaminophen may be recommended as a safer alternative. Sleep disturbances following a concussion are common and can manifest as insomnia, hypersomnia, circadian rhythm disorders, or sleep apnea. If you are experiencing sleep issues, it is important to address them as they can interfere with your recovery.
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What You'll Learn
- Sleep medication may be necessary to treat post-concussion insomnia
- However, acetaminophen may be a safer alternative to aspirin, ibuprofen, or naproxen
- Sleep is crucial for recovery, but 30% to 80% of concussed people develop sleep problems
- These sleep issues may be due to damage to neurons controlling the sleep-wake cycle
- Natural remedies, rituals, and good habits can also help improve post-concussion sleep
Sleep medication may be necessary to treat post-concussion insomnia
Sleep is an extremely important part of recovering from a concussion. It is a common myth that you shouldn't let someone with a concussion fall asleep. In fact, rest is considered essential for recovery from mild head injuries, especially during the first three to five days. However, sleep issues are common after a concussion and can last for several weeks.
Post-concussion insomnia is a recognised issue, with 30% to 80% of people experiencing some kind of sleep problem after a concussion. Insomnia may last for more than a year, especially if the person does not give themselves time to heal before returning to work or school. Being unable to sleep deeply can interfere with recovery, so it is important to address sleep problems during this time.
If you are experiencing post-concussion insomnia, you should talk to your doctor about treatment options. Sleep behaviour techniques may be helpful, as is the use of certain medications. Your doctor may recommend sleep medication to help you recover.
It is important to note that you should not take any over-the-counter (OTC) pain medications if you think you have a concussion before you see a healthcare provider. Many of these medications thin your blood, which can be dangerous if you have a brain bleed. Your provider will tell you which medications are safe to take while you recover.
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However, acetaminophen may be a safer alternative to aspirin, ibuprofen, or naproxen
Sleep is an important part of recovering from a concussion. However, many patients experience post-concussion sleep problems such as insomnia and hypersomnia. Sleep disturbances following a concussion may directly result from damage to the neurons that control the sleep-wake cycle.
If you are experiencing sleep issues a few weeks after a concussion, talk to your healthcare provider. They may recommend sleep behaviour techniques or the use of certain medications. It is important to note that you should not take any over-the-counter (OTC) pain medications before seeing a healthcare provider, as many of these medications thin your blood, which can be dangerous if you have a brain bleed.
Medications containing aspirin, ibuprofen, or naproxen could increase your risk of brain bleeding if you have a more severe concussion. In these cases, acetaminophen may be a safer alternative. Acetaminophen (Tylenol) can be used for pain relief during the first 24 hours after a concussion. After the first 24 hours, ibuprofen and naproxen are generally more effective for pain relief and are safe to take. However, you should always consult your healthcare provider before taking any medication to ensure it is safe for you.
It is also important to maintain a regular sleep schedule and practice good sleep hygiene during your recovery. This includes going to bed and waking up at the same time each day, avoiding naps (especially in the afternoon), and keeping your bedroom dark, quiet, and cool. You should also avoid using electronics or bright lights for at least an hour before going to sleep.
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Sleep is crucial for recovery, but 30% to 80% of concussed people develop sleep problems
Sleep is essential for recovery from a concussion. However, 30% to 80% of concussed people develop sleep problems. This is because concussions can cause sleep disturbances, with symptoms such as insomnia and hypersomnia being common. Sleep issues can also be caused by disruptions to the 24-hour circadian system, which affects daytime and nighttime sleepiness.
It is a common misconception that people with concussions should not be allowed to sleep. Historically, healthcare providers were concerned that a person's condition could worsen while asleep, leading to severe complications. However, there is no evidence to support this claim. In fact, medical experts now agree that sleep is safe and recommended for those with concussions, provided they meet certain requirements. These include being alert, able to walk without balance issues, having equally sized pupils, and lacking severe symptoms.
To aid recovery, it is important to adopt good sleep hygiene practices. This includes maintaining a regular sleep schedule, getting at least the recommended amount of sleep, and keeping the bedroom quiet, dark, and at a comfortable temperature. Avoiding naps, especially in the afternoon, and limiting exposure to bright lights and electronic devices before bed can also help promote restful sleep.
If sleep problems persist, it is important to consult a healthcare provider. They may recommend sleep behaviour techniques or suggest certain medications to aid sleep. Additionally, they can advise on any necessary precautions, such as having someone monitor the concussed person while they sleep or periodically waking them up for evaluations.
Overall, while sleep is crucial for recovery, it is important to be vigilant about potential sleep disturbances and seek appropriate medical advice if needed.
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These sleep issues may be due to damage to neurons controlling the sleep-wake cycle
Sleep is considered an essential part of recovering from a mild head injury, especially during the first three to five days. However, sleep issues are common after a concussion, and these may be due to damage to neurons controlling the sleep-wake cycle.
In a population-based study of 346 patients with mild TBI (concussion), 40% experienced sleep difficulties one year after the injury—more than three times the incidence in the general population. In patients with moderate to severe TBI, 66% had sleep-wake disturbances at one month post-injury. Sleep-wake disturbances have also been observed in the acute, sub-acute, and chronic stages following TBI.
Several factors may contribute to these disturbances. One study found that 41% of TBI patients had neuropathological abnormalities of the hypothalamus, specifically a loss of wake-promoting histaminergic neurons. Other research has identified structural brain injuries in patients with severe traumatic injuries, including injuries to the suprachiasmatic nucleus, optic chiasm, hypothalamus, amygdala, and brain stem. However, the majority of cases do not show obvious structural abnormalities contributing to sleep-wake dysfunction.
The pathophysiological cascade of events following a concussion, including microglia activation, ionic imbalance, and release of excitatory neurotransmitters, may also play a role in disrupting the sleep-wake cycle. Ionic concentrations, in particular, have been observed to be similar in both the neurometabolic cascade and the sleep-wake cycle, which may offer a partial explanation for why sleep is disrupted following a concussion.
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Natural remedies, rituals, and good habits can also help improve post-concussion sleep
While medication may be necessary for treating post-concussion syndrome, natural remedies, rituals, and good habits can also help improve post-concussion sleep. Firstly, it is important to understand that rest is crucial for brain recovery and symptom management after a concussion. Contrary to outdated beliefs, it is generally safe to sleep after a concussion, and sleep can aid in the healing process.
Maintain a Regular Sleep Schedule
Keeping a consistent sleep schedule is essential for regulating your body's natural sleep/wake cycles, also known as the circadian rhythm. Try to go to bed and wake up at the same time each day. This routine can help your brain reset and recover.
Create a Relaxing Sleep Environment
Make sure your bedroom is dark, quiet, and cool. Light, even from alarm clocks or streetlights, can confuse your brain into thinking it's daytime. Cover electronics, use light-blocking curtains, and consider using a ceiling fan or air conditioning to maintain a comfortable temperature.
Avoid Electronics Before Bed
The blue light emitted by electronic devices can stimulate your brain and disrupt your sleep. Avoid screens for at least an hour before bedtime. Instead, engage in relaxing activities such as listening to soft music, reading a book, or colouring.
Practice Relaxation Techniques
Herbal teas, aromatherapy, and meditation can help calm your mind and body, improve sleep quality, and reduce inflammation. Certain herbal teas, such as chamomile, are known for their soothing and anti-inflammatory properties. Always consult with a healthcare professional to ensure these remedies do not interfere with any medications you may be taking.
Seek Multidisciplinary Therapy
Consider cognitive and physical therapies that leverage the natural healing abilities of your brain. Vision therapy, occupational therapy, and vestibular therapy are just a few examples. Combining multiple therapies in a short time span can be highly effective in treating post-concussion symptoms.
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Frequently asked questions
It is best to consult a doctor before taking any medication for sleep difficulties while post-concussed. Peer-reviewed research shows that 77% of patients treated at Cognitive FX experienced significant improvement in their post-concussion symptoms.
Some alternatives to medication include self-awareness, natural remedies, rituals, and other good habits. Identifying what is interfering with your sleep each night can help you adjust your routine.
Sleep disturbances following a concussion differ from person to person and do not always indicate the severity of the injury. Some common issues include insomnia, hypersomnia, circadian rhythm disorders, and sleep apnea.
It is recommended to get at least the usual amount of sleep, and you might need more while recovering. It is important to keep a regular sleep schedule by maintaining a consistent bedtime and wake-up time.
Avoid using electronics or bright lights at least an hour before bedtime. Keep your bedroom dark, quiet, and cool to promote restful sleep. Relax before bed with quiet activities such as taking a bath or listening to soothing music.
