A concussion is a mild traumatic brain injury resulting from a bump, blow, or jolt to the head, or a hit to the body that causes the brain to move rapidly inside the skull, leading to temporary changes in brain function. While concussions are generally not life-threatening, their effects can last for days or weeks, causing symptoms like headaches, dizziness, and confusion. A common misconception exists that sleeping after a concussion is dangerous.
The Role of Sleep in Concussion Recovery
Sleep is not only safe but also highly beneficial for concussion recovery. The brain undergoes restorative processes during sleep. During deep sleep, the brain activates its glymphatic system, a specialized waste removal system. This system flushes out metabolic waste products that accumulate during wakefulness.
Sleep supports cellular repair by releasing growth hormones for mending damaged brain tissue. It also plays a role in neuroplasticity, the brain’s ability to reorganize and form new neural connections, important for recovery. Sleep is important for memory consolidation, transferring short-term memories to long-term storage. Adequate sleep helps regulate inflammatory responses, reducing inflammation that can worsen concussion symptoms. The belief that someone with a concussion must be kept awake to prevent a coma is outdated; rest is necessary for the brain to repair itself.
Monitoring During Sleep
While sleeping is encouraged, caregivers should still monitor individuals with a concussion, especially within the first 24 to 48 hours following the injury. It is not necessary to forcibly wake someone every few hours, as this can disrupt the healing processes of sleep. However, it is important to check on the person periodically to ensure they are breathing normally and not showing concerning signs.
Signs that warrant waking the person include difficulty waking up, extreme confusion, or restless tossing and turning. Other indicators are a headache that worsens or does not go away, repeated vomiting, or unusual changes in behavior or personality. If any of these signs are present, seek medical attention or advice.
When to Seek Immediate Medical Attention
Red-flag symptoms indicate a more severe injury requiring immediate medical attention, regardless of whether the person is awake or asleep. These signs suggest a potentially serious brain injury beyond a typical concussion. Call emergency services immediately if the concussed individual exhibits any of these symptoms.
These symptoms include loss of consciousness for more than a brief moment, increasing confusion or difficulty staying awake, or repetitive vomiting (three or more times). Other signs include severe or worsening headache, slurred speech, weakness or numbness on one side of the body, seizures or convulsions, or unequal pupils. Any fluid leaking from the ears or nose, or new bruising around the eyes or behind the ears, also require immediate medical evaluation.
Concussion Recovery and Management
Concussion recovery extends beyond sleep and involves a comprehensive approach for healing. Initial physical and cognitive rest is beneficial for the first 24 to 48 hours, to limit symptom aggravation. However, prolonged or complete bed rest is not recommended as it may delay recovery.
Gradual return to daily activities, including light physical and mental tasks, should begin as tolerated without worsening symptoms. Activities that pose a risk of re-injury, especially those with high impact, should be avoided during the initial recovery phase. Patience is important throughout the recovery process, as healing rates vary among individuals. Follow-up with a healthcare professional experienced in concussion care is advisable for personalized guidance and to ensure a safe, effective recovery plan.