Sleep disturbances with mild, moderate and severe brain injuries are one of the most disturbing symptoms following brain injury and are three times greater than the general population. Are sleep problems taken seriously? Inability to sleep is a severe untreated condition in this population that lasts from months to years. Sleep problems cause an impairment in daytime functioning and may impede all attempts to return to normal daytime activities.
It’s always easy to blame depression as the cause. If you can’t sleep there is a hypersensitivity to pain and depression. It’s likely that the lack of sleep causes depression. Who wouldn’t be depressed when the brain is injured and can’t rest or sleep regardless at every attempt to promote sleep?
Wouldn’t it be great to solve this problem with sleep? With proper sleep lives may return to some sense of normalcy. Again returning to become a contributing member of society. That is the goal of TBI survivors. There is NO secondary gain to having a brain injury.
- Severe problem
- Chronic issue and last from months to years
- Impairs ability to partake in normal activities
- Impedes daytime functioning
Patients do not overestimate the severity of their sleep disturbances. Subjective complaints by the patient are more reliable observations of sleep deficits than objective EEGs and other research tools currently being evaluated. The objective data does not measure significant problems with sleep. Are patients ever asked what works and what does not that would appear in studies or literature so others can be helped?
Without the proper sleep these patients cannot function with even the simplest tasks on a daily basis. When they have a good night sleep they have a false sense of feeling good, then the bottom drops out with the next night that sleep does not occur. The one good day, always offers hope. TBI survivors depend on sleep to think or have any energy during daytime hours.
Without sleep, survivors cognitive performance is impaired. The degree of sleep problems is most likely related to neuropsychological functioning. Unfortunately, the blame is on the personality of a mild traumatic brain injury instead of the neuropsychological functioning. In severe brain injury survivors seem to be considered unreliable sources.
Consequences of sleep disturbances
- Neurophysiologic and/or Neuropsychologic
- Nonpharmacologic and pharmacologic treatment
- Impedes ability to return to work
- Exacerbates other symptoms
- Impairs cognitive (thinking) and physical recovery process, fluctuates daily
If severe brain injury survivors are not taken seriously, how do we know that sleep disturbances are more prominent in mild TBI? Who is reporting for these patients? I dispute the fact that severe brain injury survivors are not reliable sources. These patients know what is happening, they just have slow processors.
It’s time scientists move away from the psychological factors of sleep disturbances, and move into the physiological damages that occur with brain injury. What is the correlation between endocrine and neurological systems that may resolve the sleep disturbance issues? Is there hypothalamic damage that cannot be visualized on MRI or CAT scans, hence remain undiagnosed and untreated?
Does treatment for endocrine related problems improve sleep in the TBI population?
Problems with Sleep Disturbances
- Difficulty thinking – Cognitive difficulties
- Neurobehavioral impairments
- Increased pain
Sleep disturbances persists for months and even years. It is not just immediately following injury. This is a major health problem. Our TBI survivors deserve to have a successful treatment for sleep disturbances. With a resolution of this problem millions will be able to function on a daily basis.
Is mTBI versus severe TBI sleep disturbances really worse? Is it a misdiagnosis of an injury to the brain that remains unidentified, hence the patient is consider to have a mild traumatic brain injury. Ultimately, sleep disturbances are a major health concern. Sleep promotes the healing process.
Simple tips to help with sleep
- Avoid caffeine, nicotine and alcohol a few hours before going to bed
- Avoid exercise in evening hours
- Don’t keep your room too hot
- Avoid sleeping with head under covers – breathing same air increases carbon dioxide & may cause headaches or interfere with sleep
- Dark room
- Quiet room
- Rest quietly without napping
- Go the bathroom before going to bed
- Do not eat or drink anything 2 hours before bed
- Routine-Wake up and get up same time daily. Go to bed same time daily.
- If you don’t fall asleep within 30 min, get out of bed and watch tv or read a book
- Don’t keep clocks visible if it’s a distraction
- Avoid smoking or any nicotine
Problem solving on an individual basis and search for relationship of sleep problems
- Keep a sleep diary.
- Document the amount of sleep
- What you have done during the day
- Nutrition habits-Foods and beverages consumed
- Daily activities
- Medications and times you take them
Are you dealing with sleep disturbances? What is helping and what is not? How many years have you been dealing with it?
- Poor sleep and sleep habits in adolescence may raise health risks (wqad.com)
- Smokers may have more sleep problems: German study (todayonline.com)
- Poor sleep in adolescents may increase risk of heart disease (eurekalert.org)
- Insomnia in Older Adults (aaramblog.com)
- Does smoking lead to poor sleep? (time4sleep.com)