Disordered sleep is exceedingly COMMON, after a Traumatic Brain Injury with excessive sleep or disrupted sleep reported by most patients. Unresolved sleep disturbance can prolong brain injury recovery. Basically, your brain needs sleep to heal.
Sleep-Wake disturbances are reported in up to 70% of all brain injury, occurring at more than 3x the rate of people without brain injury. The sleep disturbances caused by brain injury can surface up to 3 years after a traumatic event. So, good sleep routines and hygiene is important for not only recovery but brain health in general.
Some people are more likely to develop disordered sleep after a brain injury including:
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Women
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People poor preinjury sleep quality
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poor sleep/cognition within 2 weeks after injury.
Disordered sleep is the #1 contributing factor to developing neurocognitive or neurobehavioral deficits in TBI patients including:
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Depression
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Anxiety
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Memory loss
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Difficulty concentrating or remembering
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Chronic pain
Breaking Down Common TBI Sleep Disturbances:
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Insomnia: 30-60% of cases of all severities
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6% of patients with no TBI
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20% of patients after a single TBI
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50% of patients with history of multiple TBIs
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Excessive Daytime Sleepiness: 57% of TBI patients
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Occurs in less than 20 of the population with no TBI history
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Hypersomnia: increased need for sleep:
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22% of patients reported they need 2 or more additional hours of sleep than before their brain injury
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Sleep breathing disorders:
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25-35% of patients have obstructive sleep apnea following TBI
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Circadian Rhythm Sleep Disorders:
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36% of TBI patients experience disruptions to day/night sleep patterns
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Abnormal Movements and Behaviors during Sleep
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42% of TBI patients experience Parasomnias or abnormal moving during sleep including walking & talking).
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25% of TBI patients report increase in teeth grinding and bedwetting in adolescents with TBI
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Best Practices for Addressing Sleep Disturbances
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Sleep Hygiene
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Make the room dark to help increase natural production of melatonin at night
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Keep electronics out of the bedroom
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Turn electronics off 2 hours before bed
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Consider a protein snack before bed to help balance blood glucose
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Phosphatidylserine Supplements
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Promote healthy nerve cell membranes and myelin increasing brain function and resilience. It supports cognition, language skills, memory formation, and ability to focus. When taking before bed can have a profound impact on sleep after TBI. (stop back on Friday for a deep dive into his important brain healing supplement)
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Melatonin
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Particularly helpful for initiating sleep cycles within 20 minutes of taking.
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Botanicals like:
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Valerian Root, Valeriana Officinalis, is especially helpful post-brain injury for it’s GABA promoting actions. It also helps reduce anxiety around sleep.
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Passion Flower, Passiflora Incarnata, is useful in supporting insomnia and nervous system disorders.
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Lemon Balm, Melissa Officinalis a member of the mint family, uplifting and soothing to insomnia and the nervous system.
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If you are still struggling with sleep, schedule a consultation to talk about other therapeutic options for sleep or speak with your physician.
PMID: 30347632, 28329120, 24992464