Concussion Care: Stay Awake, Be Alert

Sleep is an important part of healing from a concussion, but it can be difficult to assess a person's symptoms when they are asleep. Historically, people with concussions were advised to stay awake to prevent slipping into a coma, but we now know that sleeping after a concussion won't lead to a coma. However, it can make it difficult to monitor symptoms of a more serious head injury, such as seizures or weakness on one side of the body.

If you or someone you know has a concussion, it is generally safe to sleep, but only once you have visited your doctor or an emergency room.

Medical professionals now advise that it is safe for someone with a concussion to sleep

It's Safe to Sleep with a Concussion

The change in advice is due to the recognition that rest is crucial for recovery from a concussion. Waking someone up or preventing them from sleeping can disrupt the healing process. Getting a full night's sleep is more beneficial for the person's recovery than constantly checking on them.

It is generally safe for both adults and children to sleep after a concussion, provided they have visited a doctor or an emergency room. It is important to get checked out by a medical professional first, as it can be more difficult to assess a person's symptoms when they are asleep.

Concussions can cause sleep disturbances, with 30-80% of people developing some kind of sleep problem after a concussion. It is common to feel very sleepy and take extra naps the first week after a concussion and then have trouble sleeping in the following weeks. People may continue to feel tired during the day if they are having trouble falling asleep at night or are waking up early.

Tips for Sleeping with a Concussion

• Avoid caffeine, nicotine, and alcohol.
• Stay on a regular sleep-wake schedule.
• Incorporate relaxing activities into your bedtime routine.
• Keep the bedroom cool, dark, and quiet.
• Store electronics and other distractions outside the bedroom.
• Avoid looking at bright screens before bedtime.
• If you can't fall asleep, get out of bed and do a calming activity until you feel sleepy.
• Frequent napping may be appropriate in the weeks after a concussion, as long as it doesn't interfere with nighttime sleep.

Previously, it was believed that sleeping with a concussion could lead to a coma or death

Previously, it was believed that sleeping after a concussion could lead to a coma or even death. Medical professionals advised people to stay awake after a concussion to prevent slipping into a coma. However, this advice has since been disproven by research and expert advice.

The belief that sleep after a concussion could lead to a coma or death stemmed from the idea that sleeping could cause serious brain damage, such as internal bleeding. It was also thought that if a person fell asleep, their family or doctors would not notice symptoms of serious brain damage, such as seizures or weakness on one side of the body.

While it is now known that sleep after a concussion does not lead to a coma or death, it is still important to monitor the person for any worrying symptoms. For example, healthcare professionals may advise family members to wake the person up every few hours to ask them simple questions, check their behaviour, and shine a light in their eyes to see if their pupils are the same size and responsive to light. These tests can help alert caregivers of any concerning developments.

Additionally, it is important to note that a person with a concussion should only sleep if they can hold a conversation, walk without difficulty, and do not have dilated pupils. If a person is exhibiting any concerning symptoms, they should see a healthcare provider right away.

It is important to monitor a person with a concussion while they sleep, checking for unusual behaviour and unusual pupil size and responsiveness to light

It is important to monitor a person with a concussion while they sleep, checking for unusual behaviour, unusual pupil size, and responsiveness to light. This is because it can be difficult to assess a person's symptoms when they are asleep, and there is a risk that they could develop serious brain damage, such as a seizure or weakness on one side of the body.

Healthcare professionals may advise family members to wake the person with a concussion every few hours to conduct simple tests. These tests can include asking the person questions, watching for unusual behaviour, and shining a light into their eyes to check pupil size and responsiveness. These tests are designed to alert caregivers of any worrying developments. However, waking someone up every few hours can disrupt sleep, which is crucial for the recovery process. Therefore, depending on the severity of the concussion, a doctor may advise an adult family member to stay with the person while they sleep, without waking them, to monitor their breathing and rest patterns.

It is generally safe for people with a concussion to sleep, as long as they have visited their doctor or an emergency room first. Other criteria that indicate it is safe for a person with a concussion to sleep include being able to hold a conversation, walk without difficulty, and having pupils that are not dilated.

Sleep is a crucial part of recovery from a concussion

However, it can be more difficult to assess a person's symptoms when they are asleep, and there is a risk that signs of serious brain damage, such as seizures or weakness on one side of the body, may be missed. For this reason, it is recommended that someone sleeping with a concussion is regularly woken to monitor their symptoms. In the case of children, medical professionals advise that parents wake their child up a few times during the night to ensure they can be aroused.

Concussions can also cause sleep disturbances, with many people experiencing insomnia symptoms that can last from a few weeks to three years. In the first week after a concussion, it is common to feel very sleepy and take extra naps, before then having trouble sleeping in the following weeks. Other sleep issues related to concussions include trouble falling asleep, trouble staying asleep, and feeling tired during the day. These issues can be addressed by adopting good sleep hygiene practices, such as maintaining a regular sleep schedule, keeping the bedroom dark and quiet, and avoiding caffeine, nicotine, and alcohol.

If you are experiencing certain symptoms, it is best to avoid sleeping until you can see a healthcare provider

It is generally safe for a person to sleep after a concussion. However, if you are experiencing certain symptoms, it is best to avoid sleeping and seek immediate medical attention.

Symptoms in adults

If you are an adult and are experiencing any of the following symptoms, it is best to avoid sleeping and seek immediate medical attention:

• Seizures or loss of consciousness for more than 30 seconds at any point
• Confusion, disorientation, or mood changes
• Slurred speech or trouble speaking
• Extreme tiredness or difficulty staying awake in the first six hours
• Severe headache that is worsening
• Repeated vomiting
• Problems with movement or weakness
• Neck injury
• Dizziness, clumsiness, or difficulty moving normally
• Fluids leaking from the nose or ears

Symptoms in children

If a child is displaying any of the following symptoms after a head injury, seek immediate medical attention:

• Crying more than usual
• Refusing to eat or nurse
• Vomiting right after the injury without another cause
• Appearing dazed or confused
• Clumsiness or unsteadiness on their feet
• Behaviour changes, such as more temper tantrums or irritability
• Wanting to be held or comforted more than usual

When to wake a sleeping person with a concussion

If you are concerned about waking a sleeping person with a concussion, it is important to note that doing so will not help them recover faster. However, it is perfectly fine to check on the person to ensure that their breathing is normal.

If you notice any unusual behaviour or symptoms, you can conduct simple tests by asking them easy questions, shining a light to check if their pupils are the same size and responsive to light, and monitoring their breathing.

When in doubt, seek medical attention

If you are unsure whether you or someone else has suffered a concussion or serious brain injury, it is always best to err on the side of caution and seek medical attention.

Frequently asked questions