Is It True That You Should Keep Someone Awake Who Has Sustained a TBI?

Is It True That You Should Keep Someone Awake Who Has Sustained a TBI?
Question: 

I always learned that if someone got “dinged” that he should be kept awake.

How long should someone be observed after receiving a mild brain injury and is there a time frame for the person to stay awake?

Answer: 

There is no benefit to keeping someone awake after a concussion, and it is no longer recommended. In fact, people with a concussion need to sleep to recover. In the days before head CT scanning was widely available, the only way to know if someone had life-threatening brain bleeding (which occurs in less than 0.1 percent of those with concussion) was to observe him for a decrease in his level of alertness that resulted from the blood pressing on vital brain structures. This usually happened within six hours of injury. It was thought that if you could keep someone awake you could prevent him from lapsing into coma, which of course did not work.

Anyone getting very sleepy within six hours of a brain injury should be brought immediately to an emergency department for a head CT scan.

Posted on BrainLine July 12, 2012. Reviewed July 25, 2018.

Comments (60)

Please remember, we are not able to give medical or legal advice. If you have medical concerns, please consult your doctor. All posted comments are the views and opinions of the poster only.

I am almost certain I have a concussion right now and was told until very recently not to sleep, and so was everyone else. But all I really want to know now is if I should elevate my head or not. My bed is not even or ergonomic in any way so it's usually best for me to do so but could it make things worse, better, what?

So my friend was just head butted by his care taker… he has a pretty deep laceration to his forehead bleeding has stopped but this happened when he would still be sleeping, he wants to fall back asleep , is it ok to let him sleep for 10-15 min intervals?? We are going to call police but my friend wants to rest a little , and knows he will probably be made to go to hospital and he just wants to rest at home. Anyone, advice??

Im a 29yr old female. I was hit multiple times in the head I have a goose egg on my forehead and the right side of my head was hit and is painful to touch. I iced everything right away. I used some bruise gel and a ice pack. I was swaying some about 2hrs ago walking I've had a horrible headache and for the past hr I've been fighting going to sleep I don't know if I have a concussion or what or if I should go to sleep or not.

Ivr gotten into a fight and was hit in the head multiple times with a metal baseball bat now i have knots all throughout my head what should i do

Massive head injury 2002, skull fracture in a coma (induced) for almost three weeks. Literally saved me my life and made my recovery that much quicker. Had friends that were non as lucky?

I am 78 years old and a week ago I took a bad fall, hitting my head on blacktop in a parking lot. I am mediately had a hematoma on the upper right corner of my face and I still have it over a week later. Is that normal? I did have a CT scan that day and there was no brain hemorrhaging. I’m just concerned why this is not going down.

My dad had a TBI and us home from rehab but sooooo exhausted what can we do to keep him awake during the day so he can sleep at night

I was skateboarding today with my friends and the board slipped from under my feet, due to my lack of balance while pushing off. I fell backwards and hit the back of my head pretty hard on the concrete, and was in a lot of pain. I had scratched my elbows/arms through my hoodie, and my bare finger pads on the concrete.

But after about two minutes of walking home, I couldn't feel my elbows or my hands, and the pain in them was replaced with a cold burning sensation. My severe headache had turned to light throbbing, and I started to get dizzy as I went to sit on the couch when I got home. It's been about four hours since I hit my head, and I feel fine and not dizzy at all. But why can't I fall asleep?

I banged my head on the wall last thursday night and I got a headache. Now it's monday It still not dissappear

I hit my head but it was late at night anyway so I was tired anyway. Is there any other way to know if I’d need to go to the ER? Aside for that, “you should always go to a doctor when sustaining a head injury”. No one can afford that I just want to know if I’m dying.

Same thing is happening to me currently and I'm afraid of going to sleep

In case anyone is curious, I survived the 75 foot tree falling and hitting me in the head. :D

Stay safe and God be with u.

Thank God you made it through! Wow! So Scary!

Hi
Did you temporarily lose memory? Please tell me details about it my 16 year old son had car accident hit to a tree

I’m sorry to hear

Hi I just recently yesterday had received a concussion. I'm confused, seemingly dazed, and am having memory problems. My doctor says this is normal, and that with plenty of rest, and eating well my body will recover and I should get at least get all of my memories before the incident back.
I apologize for any typos I'm still a little out of it.

I had a head injury in 2015 and I’m still suffering things like severe memory problems,sudden fits of rage,speech problems,and keep feeling confused and disoriented,and have visual problems and recurring severe migraines,and all this after a CT scan apparently shows there’s no issues,so sadly the problems can continue much longer than claimed,I really hope in your case it’s stopped though and wish you the best of luck and health.

I deal with exactly the same problem.
I had a swamp cooler dropped on my head at work in 2014.
It took several years, but in 2018 i was diagnosed with trigaminual neuralgia and occipital neuralgia. Neither will show up on x ray, ct scan or mri. The diagnosis is based on evaluation in a doctors office.
I have lvl 8-9 pain in my head and face. It damaged nerves in my head. The accident has also left me permanently disabled and unable to even walk on my own.
I'd recommend mentioning this to your doctor. But be warned, most doctors wont use that diagnosis as they refuse to even acknowledge either. But there are doctors who do.

My daughter had a few concussions during sports when she was younger, when she was in college out of the clear blue she had a grand mal seizure. She’s now 30 years old but still needs anti seizure meds otherwise she will have a seizure. Her brain scans however were always normal.

I just got knocked down by my dog and knocked my head really hard. And messed my back and knee up. Starting to get tired but it is also my normal time to go to bed. Should I stay awake.

Same thing happened to me, my dad hit me with something mildly sharp (he was saying goodbye and I was right under his hand. I didn't know he was right behind me)

I’m having the same issue I hit the top of my head on the wall while doing push-ups and it’s my bed time should I stay awake?

i hit the top of my head against the wall when i feii , i'm putting ice on a goose egg

i was at my track meet and me and a couple friends were racing and we accidentally bumped into each other fast forward i hit my head and it went pitch black then i woke up saying what am i running again

Hi Heavyn,
Please seek medical attention ASAP. "Blacking out" or losing consciousness (even if only briefly) is a symptom of concussion that should prompt an immediate trip to the hospital or emergency room. You can read more here: https://www.brainline.org/qa/when-go-hospital

One of my friends kicked a soccer ball into my face, on accident, straight into the eye from about 10-15 feet away really hard and my vision went completely black for a few seconds. It’s been like 7 hours and I still have a bad headache from it and am a little worried even thought that’s the only symptom I’ve had so far.

I hit my head hard one time when I fell and hit my head against concrete, I woke up and felt dizzy, and I was in pain for a while, and I stayed away for 6 hours or so, I’m doing good now, but I’m still wondering

While closing the car trunk I wasn’t paying attention and my car trunk hit my head. Later on in the day I became really tired (unsure whether it’s the injury or my going to bed late). I have a bump on my upper right temple and cannot sleep on my side because it hurts. Should I go to the ER?

Josephine, you could give your doctor's office a call and see what they advise.

I am 13 years old and this boy accidentally threw the ball at my head and now I'm scared to go to sleep because I don't know if it is serious and my mom tells me to not annoy her and I got really sleepy when I came back home

I’d be worried sick if that happened to one of my children, I’d probably do the most and look online for answers and what steps to take then follow up with a visit to the emergency room

How ya going now

my little sister (7months) hit her head on the floor while she was sitting. i can't identify if she is sleepy or not. I already applied ice on her head. The redness is gone. I dont think she hurt her head that hard.

You're awesome for paying attention. Continue being a great older brother or sister. Hope all is well.

Let your parents know what happened.

In 2008 I hit my head on the top
Of my car door. I didn’t notice it until 2 weeks after when someone at work asked what happened to your head? I looked in the mirror and noticed a large bump. I left it alone thinking it would go away on its own. I put ice and did all that. Then a few months passed and I started getting headaches. Went to the dr and told him everything that has happened to me. I did a CT and MRI. He said nothing was on there that worried him so he just told me to take 600 mg ibuprofen. I was getting headaches everyday so I start taking ibuprofen everyday.
About a year later my headaches got worse and ibuprofen wasn’t helping. So, I went to the dr and told him ibuprofen wasn’t working anymore maybe my body has become immune to it. I wasn’t sure? He then referred me to a brain and spine specialist. I did the MRI and CT scan. They told me that it seemed like a benign tumor that couldn’t have been from a blunt trauma like hitting my head on the car. Later after 2 or 3 visits or headaches, finally decided with the dr that we should remove the tumor/ I had craniectomy to remove the benign tumor which then thought might have cancer underneath but they couldn’t see it through the MRI or CT scans. After surgery they sent the tumor to pathology and they said it looked to have been formed because of a blunt trauma to the head. Which is exactly what caused it and what I told the dr was the only reason I thought that bump appeared.

Simply AMAZING! Thanx for sharing that story!!

How has your progress been? What did they find? Hope you’re doing ok!

I fell hard last night. Did not hit head as hard as hip and shoulder. slept mostly for14 hours. Hard to stay awake

"very sleepy" is incredibly vague and subjective. What if the person worked long hours the day they bumped their head? Didn't sleep enough the night before...

This is currently my situation. Been fighting to stay asleep after hitting my head after being at work from7:01-9:12

I want to know if a child hit there head and fell asleep half hour after? What does that mean and what do I do.? My child is deaf so waking him up is hard and I don’t want to shake him. Can someone help me.

If you’re still looking for an answer... it may very possibly be a concussion. The easiest way to check that on your own is to flip off the lights in the room and move a flashlight by their eyes. If the pupils still dilate ( get large and then small) they are ok. If there is no dilation, you probably want to get that checked out

I hit my head and I have a knot on my head is it ok for me to lay down after I hit my head

If a 2year old fall off a bench, hitting the back of her head, should she be taken to the doctor are ER?

If you're asking whether or not you should go to the ER, you should probably go to the ER

I believe that the child should because I did that as a kid and it was very painful but it was a good thing that they took me because I could have died.

My 16 mo old just fell out of bed onto hard wood floors at 2 am. he cried inconsolably in my arms for few minutes then drank his milk and fell asleep in my arms .. he was very scared and this may explain his crying more than pain. I checked his hands and arms and legs for reflexes and they are present. He is a deep sleep now and I am so so worried that he sustained a brain injury.

Yes

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