My 12 year-old daughter had a mild traumatic brain injury during a soccer match about seven months ago. She’s gotten a lot better but she is tired ALL the time. The irony, too, is that she can’t sleep more than 2-3 hours without waking up and then not being able to go back to sleep. How can we help her with her sleep/fatigue problems … they seem like a vicious circle?
Severe persistent fatigue following mild traumatic brain injury is not common. So the first step is to rule out other issues before deciding that the fatigue is directly due to the brain injury itself. Given that your daughter’s injury was seven months ago, her fatigue is most likely a consequence of inadequate sleep; the deeper stages of sleep, which she doesn’t seem to be reaching, are the most restorative to brain function.
She could be experiencing problems getting regular and restorative sleep for a variety of reasons, including persistent pain, depression, anxiety, changes in breathing control, or physical inactivity. You can help by making sure these strategies are in place:
- Getting up at the same time each day and going to sleep at the same time at night
- Not napping for more than 20 minutes during the day
- Avoiding eating or drinking caffeinated beverages several hours before bedtime
- Getting regular exercise and eating a healthful diet
- Creating a restful atmosphere in the bedroom
That said, to get to the bottom of your daughter’s sleep/fatigue problems, find a specialist with a background in TBI who can give her a full evaluation. Depending upon the results of the work-up, further diagnostic testing such as a polysomnogram might be helpful.
Nathan Zasler, MD is CEO and medical director for Concussion Care Centre of Virginia, Ltd. as well as CEO and medical director for Tree of Life Services, Inc. He is board certified in physical medicine and rehabilitation and fellowship trained in brain injury.