Ashwin Lewis
Sleep dysfunction is a common symptom of a concussion, which is a type of mild traumatic brain injury. It is estimated that 30% to 80% of people who experience a concussion will develop some kind of sleep problem. These sleep disturbances can include insomnia, hypersomnia, circadian rhythm disturbances, and sleep apnea. While it is generally safe for both adults and children to sleep after a concussion, certain sleep aids and medications can worsen recovery due to their effects on brain plasticity and cognition. So, can you take sleeping pills with a concussion?
| Characteristics | Values |
|---|---|
| Sleep after a concussion | Safe, but difficult to assess symptoms |
| Sleep problems after a concussion | Very common, including insomnia and hypersomnia |
| Sleep aids | Avoid drugs with anti-cholinergic effects, e.g. benzodiazepines |
| Sleep and recovery | Important to get restful sleep during all stages of recovery |
| Treatment | Discuss with a doctor for recommendations and a treatment plan |
| First 24 hours | Avoid medications that increase bleeding risk, e.g. aspirin, ibuprofen |
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What You'll Learn
Sleep is important for recovery
Sleep is extremely important for recovery from a concussion. A concussion is a type of mild traumatic brain injury (TBI) that can affect your sleep. Sleep dysfunction, ranging from insomnia to hypersomnia, is very common after a TBI. In fact, around 30% to 80% of people develop some kind of sleep problem after a concussion.
Post-concussion sleep problems can take the form of insomnia, where you have difficulty falling or staying asleep, or hypersomnia, where you sleep far more than normal and feel extra drowsy. These two issues are related to the same brain system but are opposite expressions of the same problem. Other less common sleep disorders that can occur after a concussion include circadian rhythm disturbances, sleep apnea, and transient impairment of the brain's neural networks.
Getting enough sleep is critical for healing and recovery from a concussion, especially for older patients. Adequate sleep helps the glymphatic system remove abnormal protein waste products, including amyloid, which is associated with Alzheimer's disease and other cognitive problems. Therefore, it is important to address any sleep problems that arise after a concussion. If you are having trouble sleeping, talk to your doctor for further recommendations. Sleep behaviour techniques or certain medications may be helpful.
However, it is important to note that some common sleep aids can actually worsen recovery due to their effects on brain plasticity and cognition. For example, it is recommended to avoid benzodiazepines and drugs with anti-cholinergic effects. Instead, focus on getting enough rest, staying hydrated, and gradually increasing your level of physical and mental activity over time.
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Sleep disturbances are common
The presence of pre-existing sleep disorders, such as insomnia or obstructive sleep apnea (OSA), may increase the risk of sustaining a concussion or athletic injury. Therefore, understanding a patient's sleep patterns before their injury is crucial. Sleep plays a vital role in brain healing and recovery, especially for older patients, as it aids in removing abnormal protein waste products associated with cognitive issues.
During the recovery phase, it is essential to identify and address factors causing symptoms, including sleep difficulties. While sleep problems may resolve as the concussion improves, intervention may be required in some cases. Healthcare professionals might recommend sleep behaviour techniques or specific medications to aid sleep. However, it is important to note that certain common sleep aids, such as benzodiazepines and drugs with anti-cholinergic effects, should be avoided as they can negatively impact brain plasticity and cognition.
To promote sleep and aid in concussion recovery, it is recommended to stay hydrated, maintain a normal eating schedule, and gradually increase cognitive and physical activity. While it is generally safe for adults and children to sleep after a concussion, it is advisable to seek medical attention and have a family member monitor for any unusual behaviours or worsening symptoms during sleep.
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Hypersomnia and insomnia
A concussion is a type of traumatic brain injury (TBI) that occurs when a forceful movement causes the brain to suddenly bang against the inside of the skull. This can result in physical injuries such as bruising, bleeding, and swelling, as well as disruptions to the natural balance of neurotransmitters, affecting brain function. Sleep disturbances are common after a concussion, with insomnia being one of the most prevalent symptoms.
The occurrence of hypersomnia and insomnia after a concussion is attributed to disruptions in the brain's sleep regulation systems. These disturbances can affect the natural sleep cycle, causing difficulties in falling asleep (insomnia) or failing to progress through the sleep stages necessary for restoration (hypersomnia).
Treating insomnia and hypersomnia after a concussion primarily focuses on aiding the brain's recovery and promoting adequate rest. Treatment options include medication, sleep devices, and lifestyle modifications. Doctors may initially recommend sleep hygiene practices, such as improving sleep habits and routines, before considering medication. Cognitive-behavioural therapy for insomnia (CBT-I) is also an effective treatment option, combining sleep hygiene with behavioural strategies to improve sleep. In some cases, doctors may prescribe sleep medications, but it is crucial to carefully assess the risks associated with TBI before introducing any medication or sleep aid.
It is important to note that sleep plays a crucial role in brain recovery after a concussion. During sleep, the brain clears out metabolic waste proteins, and insufficient sleep can interfere with this process. Therefore, addressing sleep disturbances, such as insomnia and hypersomnia, is an essential aspect of managing and recovering from a concussion.
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Natural remedies and good habits
Sleep dysfunction is a common occurrence after a traumatic brain injury (TBI) or concussion. While sleep dysfunction usually resolves as the concussion heals, intervention may be required in some cases. It is important to address sleep problems during concussion management as they can make it more difficult for patients to overcome other symptoms such as headaches. While certain medications can be used to aid sleep, some common sleep aids can actually worsen recovery due to their effects on brain plasticity and cognition.
Multidisciplinary Therapy
A multidisciplinary therapy approach is one of the best ways to speed up recovery and care for your brain in the long term. This involves multiple therapies in a short time span, such as physical and vestibular therapy, rather than just one type of therapy.
Diet
An anti-inflammatory diet rich in nutrients that your brain and nervous system need to function is recommended. Consuming flavonoids, which are found in brightly coloured foods such as blueberries, cranberries, red kale, and strawberries, can help to reduce inflammation in the brain. Saffron is another natural remedy that can be used to combat inflammation and swelling.
Meditation
Meditation, when performed correctly, encourages more alpha and theta brain waves, which allow the brain to rest and recover from stress. An alternative is to use a Brainwaves app to induce alpha waves.
Acupuncture
Acupuncture is a low-risk treatment that can be used to relieve symptoms such as migraines and dizziness, as well as boost the production of new brain cells.
Fish Oil
Fish oil is another remedy that has been clinically proven to help with post-concussion syndrome.
Sleep Behaviour Techniques
Sleep behaviour techniques can be helpful during recovery. Staying hydrated (60-80 ounces of water or non-caffeinated beverages per day) and eating normally are also recommended.
Exercise
While rest is important during the acute symptomatic phase, new studies suggest that limited exercise during the recovery phase can aid quicker recovery. Return to physical activity and exercise should be gradual and determined by a doctor.
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Medication to help sleep
Sleep dysfunction is a common occurrence after a concussion, with 30% to 80% of people experiencing sleep problems. These sleep disturbances can manifest as insomnia, where one has difficulty falling or staying asleep, or hypersomnia, where one sleeps far more than normal and experiences excessive drowsiness. In some cases, post-concussion sleep issues may persist, leading to what is known as Post-Concussion Syndrome (PCS).
While adequate sleep is crucial for brain healing and recovery after a concussion, certain sleep aids should be avoided as they can hinder recovery due to their effects on brain plasticity and cognition. For instance, it is recommended to steer clear of benzodiazepines and drugs with anti-cholinergic effects. Instead, it is advisable to consult a doctor for guidance on sleep behaviour techniques and suitable medications.
During the acute symptomatic phase of concussion recovery, it is important to avoid medications that increase the risk of bleeding, such as aspirin, ibuprofen, and naproxen sodium, for the first 24 hours. However, acetaminophen can be used for pain relief during this initial period. After the first 24 hours, ibuprofen and naproxen sodium are generally safe and more effective for pain management.
In cases of severe nausea associated with concussion, prescription medications can help alleviate the symptom. Additionally, staying hydrated and maintaining a normal eating routine are important considerations during the recovery process. While screen time and exposure to bright lights, loud sounds, and movement can worsen symptoms, certain natural remedies, rituals, and good habits can provide relief.
It is important to note that recovery from a concussion is a complex and dynamic process that should be managed by a healthcare provider with expertise in concussion care. An individualized recovery plan, including prescription exercise and referrals, can optimize recovery and address factors causing symptoms, such as neck injury, dizziness, lightheadedness, vision problems, and mood changes, in addition to sleep difficulties.
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Frequently asked questions
It is best to consult a doctor before taking any medication, including sleeping pills, after a concussion. Sleep dysfunction is common after a concussion, and while sleep is important for recovery, some common sleep aids can worsen recovery due to their effects on brain plasticity and cognition.
Some sleeping pills may have anti-cholinergic effects that can contribute to cognitive symptoms. It is also important to avoid medications that can increase the risk of bleeding during the first 24 hours after a concussion.
Yes, there are alternatives to sleeping pills for people with a concussion. Sleep behavior techniques may be helpful, and it is important to stay hydrated and eat normally throughout the recovery process.
Sleep dysfunction after a concussion can manifest as insomnia or hypersomnia. Insomnia is difficulty falling asleep or staying asleep, while hypersomnia involves sleeping much more than normal and feeling extra drowsy. If you are experiencing either of these symptoms after a concussion, it is important to discuss this with your doctor.
