A concussion is a brain injury that occurs from a sudden bump, blow, or jolt to the head or body, causing the brain to move rapidly inside the skull. This rapid movement can lead to chemical changes in the brain and sometimes stretch or damage brain cells, affecting how the brain functions. Contrary to a long-held belief, sleeping after a concussion is generally considered safe and beneficial for recovery. The outdated advice to keep someone awake stemmed from fears of slipping into a coma or not being able to monitor worsening symptoms, but this is largely a myth.
What a Concussion Is and Why Rest Matters
A concussion is categorized as a mild traumatic brain injury (mTBI), impacting brain function rather than causing visible structural damage on standard imaging like CT or MRI scans. This means the injury primarily affects the brain’s ability to function properly due to temporary disruptions in neural networks and chemical processes, even if no major bleeding or swelling is apparent. The symptoms experienced, such as headaches, dizziness, or confusion, are the brain’s way of signaling that it needs to heal.
Rest, both physical and cognitive, is a foundational element in concussion recovery. Physical rest involves avoiding strenuous activities, while cognitive rest means limiting mentally demanding tasks like reading, screen time, or schoolwork. The injured brain requires a significant amount of energy to repair damaged cells and restore normal function. Engaging in too much activity too soon can divert this energy away from the healing process, potentially prolonging symptoms or even worsening the injury.
How Sleep Aids Concussion Recovery
Sleep is not only safe after a concussion but is also a crucial part of the healing process. During sleep, the brain undergoes restorative processes that are essential for recovery from injury. These processes include the removal of metabolic waste products that accumulate during wakefulness, facilitated by the brain’s glymphatic system.
Sleep also plays a significant role in energy restoration and neural repair. The brain can allocate more resources to healing damaged cells and rebalancing its systems when it is at rest. Furthermore, sleep contributes to neuroplasticity, which is the brain’s ability to reorganize and form new connections, helping it adapt and recover from the injury. Adequate and uninterrupted sleep supports memory consolidation, emotional regulation, and overall brain health, all of which can be disrupted by a concussion.
Monitoring and Safe Sleep After a Concussion
While sleeping is generally encouraged, it is advisable to have someone monitor the individual, especially within the first 24 to 48 hours following a concussion. Frequent waking, however, is typically not necessary and can be counterproductive to the healing process. Instead, caregivers should observe the concussed person for specific signs that might indicate a worsening condition without disturbing their rest.
Monitoring involves quietly checking for changes in breathing patterns or any unusual movements. Creating an optimal sleep environment can also support recovery; this includes ensuring the room is dark, quiet, and comfortable. The goal is to allow the brain to rest and repair itself effectively, while still being aware of any potential red flags that would necessitate immediate medical attention.
Urgent Symptoms Requiring Medical Attention
Certain symptoms following a head injury indicate a more serious condition that requires immediate medical evaluation. These “red flag” symptoms include:
- A severe headache that progressively worsens
- Repeated vomiting
- Increasing confusion
- Seizures
- Loss of consciousness lasting longer than 30 seconds
- Severe dizziness and loss of balance that makes walking difficult
- Clear fluid or blood draining from the nose or ears
- Changes in vision, such as unequal pupil sizes
- Weakness or numbness in the arms or legs
- Slurred speech