A concussion is a mild traumatic brain injury from a bump, blow, or jolt to the head, or a hit to the body causing rapid head and brain movement. This sudden movement can cause the brain to bounce or twist within the skull, leading to chemical changes and sometimes damaging brain cells. These effects are often short-term, causing symptoms like headaches, dizziness, and problems with concentration, memory, balance, mood, and sleep.
The “Stay Awake” Myth
The idea that someone with a concussion must be kept awake is a common misconception. This outdated belief stemmed from concern about monitoring for severe brain bleeds, as a loss of consciousness could signal a serious complication. However, internal bleeding in the brain is rarely associated with concussions; if cleared by a medical professional, sleeping is safe.
Sleep is beneficial for brain healing after a concussion. Rest, including sleep, is a powerful tool for recovery. Only about 10% of concussions involve a loss of consciousness, meaning most people can safely rest after such an injury.
Why Rest is Essential
Rest is the primary recommendation for concussion recovery, allowing the brain to heal. This means avoiding strenuous physical activity, which can divert the brain’s energy away from the healing process. While complete rest in a dark room is not recommended, light physical activity like walking can be started within the first 24 to 48 hours if it does not worsen symptoms.
Rest also involves cognitive rest, which means limiting mentally demanding tasks. Activities such as extensive screen time, reading, schoolwork, or video games can overwork the injured brain, potentially prolonging recovery and exacerbating symptoms like headaches and fatigue. Reducing screen time in the first 48 hours has been shown to shorten recovery times.
Sleep is an important component of this recovery process, allowing the brain to repair and regenerate damaged cells. During deep sleep, the brain actively clears out metabolic waste products and releases growth hormones that stimulate cell repair. It also plays a role in consolidating memories, which can be affected by a concussion, and helps regulate inflammatory responses in the brain.
Recognizing Serious Symptoms
While many concussions resolve with rest, certain “red flag” symptoms indicate a more severe brain injury that requires immediate medical attention. These signs suggest a potential complication like bleeding or swelling in the skull. Some serious symptoms may not appear immediately but could develop hours or even days after the injury.
Seek immediate care if you observe any of the following:
- A headache that is worsening
- Repeated vomiting
- Signs of seizures or convulsions
- Slurred speech
- Significant confusion or disorientation
- Difficulty waking up or excessive drowsiness
- Weakness or numbness in the arms or legs
- Changes in pupil size (one larger than the other)
- Clear fluid draining from the nose or ears