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Sleep and Traumatic Brain Injury Recovery

Sleep is an important function that keeps your body healthy, recharges your mind, and helps you feel more refreshed and alert when you wake up. It’s recommended that adults get about 7-9 hours of sleep per day. However, many individuals with traumatic brain injuries experience sleep disturbance, which can affect their mood, health, activity level and daily functioning.

One common sleep disorder and syndrome that individuals with traumatic brain injuries may experience is insomnia.

Insomnia is difficulty falling asleep or staying asleep persistently.

Symptoms of insomnia include:  

  • Excessive daytime sleepiness 
  • Fatigue 
  • Irritability or mood disturbances 
  • Impairments in academic performance, work performance, or social performance 
  • Increased risk for making errors or accidents 
  • Hyperactivity, aggression, or other behavioral problems 
  • Delayed sleep phase syndrome: Sleep is delayed by two or more hours than the acceptable or conventional bedtime  
  • Narcolepsy: Falling asleep suddenly and excessively during the daytime  
  • Restless leg syndrome: Uncomfortable urge to move your legs, especially at night 
  • Bruxism: Excessive grinding or clenching of the teeth 
  • Sleep Apnea: Characterized by brief pauses in breathing during sleep, loud snoring, and feeling tired after a full night’s sleep 
  • Periodic limb movement disorder: Involuntary and repetitive movements of limbs during sleep 
  • Sleepwalking 

 There may be various factors that can cause sleeping difficulties:  

Potential Causes of Sleeping Problems  Description 
Physical and Chemical Changes  Traumatic brain injuries can disrupt the “internal clock” in the brain that regulates when your body falls asleep or wakes up. TBI can also change the way sleeping chemicals, or hormones, affect your body. 
Sleep Apnea  Traumatic brain injuries can affect the brain’s ability to control breathing during sleep. Brief pauses during sleep, or sleep apnea, can cause disruptions in sleep. 
Medications  Some medications can cause insomnia, such as prescription drugs for asthma or depression. Stimulants that treat daytime sleepiness can also cause sleeping difficulties if taken near bedtime. Other medications may also have drowsiness side effects. 
Napping  Napping during the day may cause difficulty sleeping at night. 
Inactivity or Lack of Exercise  Inactivity or lack of exercise may contribute to poor quality sleep.  
Pain  Pain in other parts of the body from a traumatic brain injury may provide discomfort that can disrupt sleep. 
Alcohol  Drinking alcohol can interfere with normal sleep. 
Caffeine and Nicotine  Caffeine and Nicotine can disrupt sleep, especially if caffeine is consumed in the afternoon or evening. 

General strategies that individuals with traumatic brain injuries can utilize to improve sleep are:  

  • Setting your alarm to wake up at the same time every day 
  • Go to bed at the same time every night 
  • Exercise daily 
  • Get sunlight exposure outdoors 
  • Avoid napping more than 20 minutes a day 
  • Avoid caffeine, nicotine, alcohol, or sugar intake 5 hours before bedtime 
  • Avoid eating right before bedtime but also avoid going to bed hungry 
  • Limit screen time (i.e., watching TV or looking at your phone) before bedtime 
  • Reduce or remove any distractions, noise, extreme temperatures, or bright light in the bedroom 
  • Keep stress out of the bedroom (i.e., do not work or pay your bills there) 


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