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Sleep and Brain Injury

The University of Washington TBI Model System and the University of Washington Medical Center

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Sleep and Brain Injury

Why is sleep important?

During sleep, your brain and body recharge. Proper sleep follows regular and predictable rhythm cycles. When you sleep, your brain sets down memories and refreshes various connections that allow your brain to work. Quality sleep helps you think more clearly, be more alert, and function at your best in all areas: mental, physical, and emotional.

What is a sleep problem?

Sleep problems are related to the amount and quality of sleep you get each day. You may have a sleep problem if you:

  • Are sleeping a lot more or less than 8 hours each day.
  • Feel drowsy no matter how much you sleep.
  • Are not able to fall asleep at night.
  • Wake up often during the night.
  • Wake up extra early and can’t get back to sleep.
  • Have nightmares.
  • Have problems with breathing or snoring.
  • Have unusual body movements during sleep.

Why does a brain injury affect sleep?

You may need extra sleep while your brain is trying to heal from the brain injury. Even if you had a mild brain injury, you might have sleep problems. Your brain might also be having a hard time making or using the natural chemicals that help you fall and stay asleep. It is also possible, especially after a serious injury, that the brain’s electrical rhythms have been disrupted.

A brain injury may also affect control of breathing, dreaming or leg movements. Or, if you have other physical injuries that are causing pain, this pain may affect your ability to sleep.

As your brain and body heal from your injuries, your sleep patterns may become more normal. You may need to take medicines to help you sleep normally, but there are ways to treat some sleep problems without medicines.

Other things may cause sleep problems. Some people have sleep apnea and are not aware of it. Signs of sleep apnea are heavy snoring or gasping for breath during periods of sleep. It can make a person feel tired all the time.

Sleep problems can also be a side effect of some medicines. Ask your doctor if your sleep problems could be related to medicines you are taking.

What are some effects of sleep problems?

If you are having sleep problems, you may:

  • Feel tired even if you think you are getting a lot of sleep.
  • Feel irritable and cranky because you are so tired.
  • Have frequent headaches.
  • Feel depressed or anxious.
  • Develop body aches and pains.
  • Have problems remembering things or thinking clearly.
  • Not do things you would normally do because you are too tired or because you sleep through them.

What can make sleep problems worse?

  • Drinking caffeine, alcohol, or exercising too much late in the evening.
  • Sleeping in a room that is too hot, too cold, or not dark enough.
  • Watching TV while in bed.
  • Irregular sleep patterns.
  • Taking naps during the day, or sleeping longer than 20 minutes when
  • you nap.
  • Physical problems that interfere with sleep such as pain or sleep apnea.

When should I ask for help with sleep?

Talk with your health care provider if:

  • Your sleep problems are getting worse or do not seem to be getting better.
  • Practicing good sleep habits is not working.
  • Pain interferes with your sleep.
  • You think your sleep problems are related to a medicine side effect.

What can I do about sleep problems?

Follow recommendations from medical professionals:

If your doctor has prescribed a sleep medicine, take it as prescribed. When taking sleep medicine, talk with your doctor if:

  • The medicine doesn’t seem to be working.
  • You feel you are sleeping too much.
  • You think you may be having side effects from the medicine.

You may need to have a sleep evaluation so doctors can check you brain’s sleep rhythms. This can help identify why you are having sleep problems.

Evaluate your sleep problems:

Keep a journal of your sleep habits that includes:

  • What time you go to bed at night.
  • What you usually do right before bedtime.
  • What you eat during the day, and when.
  • What you drink during the day, and when.
  • What wakes you up during the night, such as the need to go to the bathroom.
  • What your sleep problems are like, and if you wake up at the same times during the night.
  • If you feel anxious at night.
  • If you have nightmares or bad dreams.

If you have a sleep partner, ask if they notice any unusual behavior during the night. Add this information to your sleep journal.

Practice good sleep habits:

  • Make your bedroom a comfortable place to rest.
  • Make your sleep environment as quiet as possible. Play soothing music or turn on a fan at night if these help you to sleep.
  • Sleep in a dark room that is not too hot or too cold.
  • Do not drink caffeinated beverages in the afternoon or evening.
  • This includes soda, coffee, or tea with caffeine.
  • Do not eat, drink any beverages, or smoke for at least 2 hours before bed.
  • Do not exercise strenuously in the evening.
  • Go to the bathroom before you go to bed.
  • Follow a relaxing, calming bedtime routine.
  • Go to bed at the same time every night, even on weekends.
  • Wake up and get up at the same time every morning.
  • Spend non-sleep time out of bed and out of your bedroom.
  • If you are tired during the day, try going for a walk or doing some gentle exercising instead of taking a nap.
  • Do not sleep or nap for more than 20 minutes during the day.

Where can I learn more about sleep problems?

Ask a professional:

  • Talk with your doctor or psychologist about your sleep problems.
  • Talk with any of your therapists about sleep concerns, so they can help direct you to good resources for help.
  • You may benefit from a sleep study in a sleep laboratory. Discuss this with your doctor.

Check out these resources:

Brain Injury Association of America
www.biausa.org/
8201 Greensboro Drive, Suite 611, McLean, VA 22102
703-761-0750
Brain Injury Information Hotline: 800-444-6443

From the University of Washington TBI Model System and the University of Washington Medical Center. Used with permission. http://uwmedicine.washington.edu.

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