9 Ways to Improve Sleep After a Concussion

By: Cristin Beazley, PT, DPT, CBIS and Cait Larkins, PT DPT, CBIS

After a concussion, there are a lot of common misconceptions about sleep. Mainly, is it safe to sleep following this mild traumatic brain injury? The answer is yes – it is okay to sleep after a concussion! This misconception stems from an out-of-date recommendation to wake the person up every hour to check on them; however, that is only if there is concern about the risk for a brain hemorrhage or bleed that wasn’t immediately apparent. If the person has been screened by a medical professional and he or she doesn’t have any red flags (i.e., a dramatic increase in headache, change in cognition, loss of balance, speech changes, etc.), then let them sleep!

Following a concussion, it’s critical that the brain gets rest to recover and help with symptom management. Normal sleep patterns are important for cognitive rest, but oftentimes after a concussion, it’s common for sleep habits to change. Some of these changes may include difficulty falling asleep or staying asleep, sleeping more than usual or sleeping less than usual. In order to help the brain re-regulate its sleep patterns, it is important to use good strategies to encourage healthy sleep habits.

That’s where sleep hygiene tips come in. Here are some suggestions to help improve your sleep:

  1. Avoid electronics and technology for at least 1 hour before bedtime
    The glow from screens and the input to your brain increases your brain’s stimulation and tricks the brain into thinking it’s daytime instead of nighttime. Instead of watching TV or scrolling through your phone, try listening to soft music, reading a book, coloring, or any other relaxing activity that you enjoy and doesn’t increase symptoms.
  2. Get into a bedtime routine
    Start winding down your day and get into a rhythm that signals your brain that it’s time to go to sleep. Drink a cup of caffeine-free tea (Celestial Seasonings has a Sleepytime tea that promotes relaxation), wash your face/brush your teeth, read in bed, etc. until it’s time to go to sleep.
  3. Keep your room dark and cool
    Again, you want to create an environment that promotes restful sleep. Any light, even ambient light coming from an alarm clock or from a streetlight can confuse the brain into thinking it’s day, not night. Cover electronics, chargers, etc. and make sure your curtains block out light. Room temperature should be lower than 72 degrees Fahrenheit in order to promote the natural decrease in body temperature that happens when you go to sleep. Having a ceiling fan on can help, not only to help keep the room cool, but also to provide white noise.
  4. Check your alignment
    Make sure you are keeping yourself positioned as close to neutral as possible. This means keeping your head aligned with your spine, regardless if you’re lying on your side or on your back. If you’re lying on your side, you may need to use two pillows to keep your head elevated to the correct height. Also make sure your shoulders are not on the pillow, this creates a rounded-shoulders posture, which can contribute to increased muscle tension.
  5. Medications/herbals/supplements can help
    Before adding a sleeping agent (even a natural one), ALWAYS consult your physician, especially if you’re taking other medications. Some natural remedies include non-caffeinated herbal teas (like the Sleepytime tea mentioned above), melatonin, and valerian root. Melatonin and valerian can be found in the supplement section of health food stores. If natural remedies are not enough, you may want to talk to your physician about adding over-the-counter sleep aids and/or prescription medication.
  6. Keep a journal by your bed
    If you are having a difficult time getting your brain to “turn off” while you’re lying in bed trying to fall asleep, try jotting down some notes. Getting your thoughts out of your head and onto paper can help quiet your mind enough to fall asleep.
  7. Use relaxation strategies
    Using techniques such as diaphragmatic (belly) breathing or progressive muscle relaxation can help promote restful sleep. Meditation while paying attention to your breathing can be helpful as well. For further information on this topic, it may be helpful to see a medical psychologist.
  8. Don’t look at the clock
    If you are stressed about going to sleep and getting enough sleep, watching the clock will likely contribute to increased anxiety. If you wake up in the middle of the night, try not to look at the time; instead, focus on taking deep breaths and falling back asleep.
  9. Be consistent
    Try to get 8-9 hours of sleep every night, making sure to go to bed and wake up at the same time daily, even on the weekends! Your brain likes routine, so going to bed and waking up at the same time every day will help reset the circadian rhythm that naturally keeps your sleep/wake cycles consistent.

If you or a loved one need help recovering from a concussion, ask your physician for a referral to our Total Concussion Care program or contact us directly at www.shelteringarmsinstitute.com/contact-us or by calling (804) 764-1000.

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