A concussion is a mild traumatic brain injury resulting from a jolt or blow to the head, or a hit to the body that causes the head and brain to move rapidly. This sudden movement can temporarily alter brain function, leading to various symptoms such as headaches, confusion, and difficulty with concentration, memory, balance, or sleep. The common concern about sleeping immediately after a concussion arises from the need to monitor the individual for any worsening symptoms that could indicate a more serious injury.
Immediate Risks of Unsupervised Sleep
Sleeping immediately after a concussion carries risks because it can mask worsening symptoms. These “red flag” symptoms include severe or worsening headaches, repeated vomiting, increasing confusion, slurred speech, seizures, difficulty waking up, or weakness or numbness on one side of the body. If a more severe brain injury, such as a hematoma (blood clot), is developing, these signs might be missed while the person is asleep, delaying prompt medical intervention. Medical professionals may recommend having someone stay with the concussed individual and check on them for at least 24 hours to ensure symptoms are not worsening. This observation period helps identify any emergent issues requiring immediate attention.
How Concussions Affect Brain Function
Following a concussion, the brain undergoes complex physiological changes known as the neurometabolic cascade. This cascade begins with an abrupt neuronal depolarization and the release of excitatory neurotransmitters, such as glutamate, which triggers a massive efflux of potassium ions and influx of calcium and sodium ions, creating an ionic imbalance within the brain cells. To restore this balance, the brain’s energy demands significantly increase, leading to a period of “hypermetabolism” where it works harder to produce adenosine triphosphate (ATP), the cell’s energy currency. However, this increased demand often occurs alongside reduced cerebral blood flow, creating an energy crisis where the supply of glucose (the brain’s primary fuel) cannot meet the heightened demand. This energy deficit can persist, making the brain vulnerable and less able to respond to further stress.
Guiding Rest and Recovery
Rest is generally considered an important part of recovery once serious symptoms are assessed and ruled out. Current medical advice supports getting rest and sleep after a concussion as long as the person can carry on a conversation, walk without difficulty, and their pupils are not dilated. After the initial 24 to 48 hours of relative rest, a gradual return to cognitive and physical activities is encouraged, as prolonged strict rest, often called “cocoon therapy,” is not beneficial and may even prolong recovery. Creating a quiet environment, limiting screen time, and avoiding strenuous activity can support the brain’s healing process.