A concussion is a type of mild traumatic brain injury (mTBI) resulting from a bump, blow, or jolt to the head or body that causes the brain to move rapidly within the skull. This sudden movement can stretch and damage brain cells, leading to temporary changes in brain function. Common symptoms often include headaches, confusion, dizziness, sensitivity to light or sound, and problems with concentration or memory. These effects are generally short-term, but their severity and duration can vary greatly among individuals.
Concussions frequently cause sleep disturbances, including insomnia. It is a common symptom following a head injury, with studies indicating that 40-65% of concussion patients experience insomnia symptoms. Sleep problems are among the most prevalent complaints after a concussion, often second only to headaches.
While many people recover from a mild concussion within weeks, insomnia can sometimes persist for months or even years. The association between traumatic brain injury and sleep disorders appears to be stronger for mild traumatic brain injuries compared to more severe cases.
How Concussions Disrupt Sleep
Concussions can disrupt the brain’s delicate balance, leading to sleep difficulties through several mechanisms. The forceful impact can cause physical injury to brain tissue and alter the natural balance of neurotransmitters, which are chemical messengers essential for regulating sleep. For instance, the production or signaling of neurotransmitters like melatonin and serotonin, which play key roles in the sleep-wake cycle, can be affected.
Beyond neurotransmitter imbalances, concussions may also cause inflammation within the brain, further interfering with its normal functioning and sleep regulation. Brain regions responsible for controlling sleep and wakefulness, such as the hypothalamus and brainstem, can be impacted by the injury. This disruption can lead to problems with the body’s internal biological clock, known as the circadian rhythm, which manages the 24-hour sleep-wake cycle. These physiological changes collectively make it harder for the brain to transition into and maintain a restful sleep state.
Recognizing Post-Concussion Insomnia
Identifying post-concussion insomnia involves observing specific changes in sleep patterns. Individuals may find it hard to fall asleep, a condition known as sleep onset insomnia. Others might struggle to stay asleep throughout the night or wake up much earlier than intended, experiencing sleep maintenance insomnia. Non-restorative sleep is another common complaint, where individuals sleep for an adequate duration but still feel unrefreshed and tired upon waking.
Excessive daytime sleepiness can also be a sign, even if the person feels they have slept enough at night. Sleep disturbances often appear in the days or weeks following a concussion.
Strategies for Sleep Recovery
Improving sleep after a concussion often involves adopting consistent sleep habits. Establishing a regular sleep schedule, going to bed and waking up at the same time daily, including weekends, helps regulate the body’s natural sleep-wake cycle. Creating a conducive sleep environment is also beneficial, which means keeping the bedroom dark, quiet, and cool. Removing electronics from the bedroom and avoiding screens for at least an hour before bedtime can reduce brain stimulation and promote relaxation.
Limiting stimulants like caffeine and alcohol, especially in the afternoon and evening, can prevent interference with sleep. Incorporating relaxation techniques into a bedtime routine can also prepare the mind and body for sleep; examples include warm baths, reading, listening to soft music, or practicing deep breathing exercises. If sleep difficulties persist or are severe, seeking medical consultation is advisable. A doctor might recommend specific therapies, such as Cognitive Behavioral Therapy for Insomnia (CBT-I), which is highly effective in addressing sleep problems by targeting thoughts and behaviors that hinder sleep. In some cases, short-term medication may be considered under medical supervision, though non-pharmacological approaches are typically prioritized.