A common question after a head injury is how long someone should stay awake following a concussion. Concussions are a type of mild traumatic brain injury resulting from a bump, blow, or jolt to the head, or a hit to the body that causes the head and brain to move rapidly. Proper care after these injuries is important for recovery.
The Myth of Staying Awake
The advice to keep someone awake after a concussion stems from older medical practices. This recommendation originated from concerns about severe complications like intracranial bleeding, which could lead to a coma. The idea was to monitor for a decline in consciousness indicating a serious underlying brain injury. However, this advice is now considered outdated and potentially harmful.
Modern medical understanding emphasizes that forcing someone to stay awake is not necessary and can interfere with the brain’s healing process. Sleeping does not cause serious problems after a concussion. The primary concern was detecting more severe brain injuries, not preventing sleep for the concussion itself.
Modern Concussion Management
Current evidence-based recommendations for concussion care focus on rest. For the first 24 to 48 hours after a concussion, relative physical and cognitive rest is advised. This means limiting activities that demand significant brain energy or could worsen symptoms. Such activities include excessive screen time, strenuous physical exertion, or mentally demanding tasks like studying or complex work.
After this initial period, a gradual return to normal activities is encouraged as tolerated. Light physical activity, such as walking, can begin within the first 24-48 hours if it does not worsen symptoms. This approach allows the brain to heal while preventing negative effects from prolonged, strict rest.
Recognizing Serious Complications
While concussions are generally mild, it is important to recognize signs that might indicate a more serious brain injury. These symptoms warrant immediate medical attention. Specific red flags include a severe headache that worsens, repeated vomiting, or seizures. Other concerning signs are slurred speech, weakness or numbness on one side of the body, or difficulty waking up.
Changes in pupil size, such as one pupil appearing larger than the other, or clear fluid draining from the nose or ears also signal a serious issue. Any unusual behavior, increasing confusion, or significant memory problems following a head injury should prompt urgent evaluation. Symptoms may not appear immediately and can develop hours or even days after the injury.
Seeking Urgent Medical Care
If any serious symptoms appear or worsen after a head injury, seek immediate medical attention. Calling emergency services is appropriate for severe symptoms like loss of consciousness, difficulty staying awake, or seizures. For other serious warning signs, going to the nearest emergency room is recommended.
A medical professional can evaluate the injury and determine if more severe damage, such as bleeding or swelling in the brain, is present. While rest is a key component of concussion recovery, monitoring for these signs and acting swiftly is important for patient safety.