Sleeping Problems

Sleep disturbances are one of the most common symptoms following a brain injury. Not getting good, regular sleep can impact your whole world. In fact, studies and surveys have shown that sleep disorders are three times more common in people with brain injury than that of the general population and that nearly 60 percent of people with traumatic brain injury experience long-term difficulties with sleep. Women are more likely to be affected than men, and issues with sleep are more likely to develop as a person gets older.

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Good Sleep Is Vital for Recovery

Good Sleep Is Vital for Recovery
Finding out a way to get them to sleep is vital, before anything else. Even before headaches, but usually we treat those things together or at the same visit, because then the patient will do that much better next time. And, very briefly, the keys to sleeping are not necessarily medications. There are some, and there are commercials with butterflies, and there is always wonderful commercials out there about medications. They're okay, but if they were going to work, they probably would have already worked. Almost any physician can write a prescription for a sleep medication. They're not a bad thing, but without what we call good sleep hygiene, or preparing for sleep, you're not going to sleep. And sleep hygiene consists of everything as simple as not drinking coffee or a lot of liquids 4 hours before you're going to sleep, so you don't have to get up to go to the bathroom or you're not on a stimulant, such as caffeine. Making sure that you're trying to do something physical during the day, typically aerobic-type exercise, so that you are not just laying around on the couch or napping throughout the day. It's hard to sleep if you haven't been physically active during the day beforehand. Making sure that you're eating a balanced diet and not overeating at dinner, because a body that's digesting and is full doesn't tend to sleep well Even if you go to sleep, you're going to tend to wake up or not have a restful sleep. And then the last couple things are 30 minutes before you sleep, not watching television; not playing video games; not having bright lights on; and--you know-- it's a quiet room. It's--if you're reading--a very dim light. Listening to relaxing music. Talking to someone. Listening to the radio, etc. That's key. And, obviously, making sure that you're in an environment where what you do is sleep there. So you shouldn't be laying on a couch trying to get to sleep. You know--your bedroom should be for sleeping and having sexual activities. It should not be for--you know--eating. It shouldn't be for playing with your kids on the floor, and the reason that's important is behaviorally you want to associate that bedroom as a place for restfulness, a place of pleasure. Something where you want to go to-- kind of, settling down, not all these other activities. Vital. If you do that, that--in addition, if you learn some relaxation breathing techniques, very often, that alone will begin them on the process. Americans like medications, so very often you'll offer them a medication. Typically they'll refuse it the first visit, because they haven't had good success with it. But if you combine the right medication with the things we've just talked about, people sleep.

Getting to the Root of Fatigue Post-TBI

Getting to the Root of Fatigue Post-TBI
If a veteran or service member comes in complaining of significant fatigue after their concussion, and that's been going on for quite some time one of the things that I like to start with is a review of their sleep patterns. So, when they're going to bed at night, when they're waking up if they're waking up during the night and then how they're dealing with that fatigue during the day. Are they drinking an enormous amount of caffeine in the morning and afternoon. And in the afternoon, are they even doing that at night to get through their work day so that at night they're really, really stimulated and not able to get to sleep. Some of those behavioral things that they're doing may be a real clue to somebody that there are ways that they can intervene and educate them about some of the things that they can do to improve their sleep in order to improve daytime fatigue. Let's say the service member tells you that they have a lot of difficulty going to sleep at night. That may not necessarily be because of brain injury so what you want to find out is what they're doing prior to going to sleep. Are they watching a lot of TV that may be really overstimulating? Are they playing really intense video games? Are they chatting with friends until 2:00 o'clock in the morning? Some of those things may actually stimulate them to the point where they have difficulty going to sleep.

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