Sleep Disruption with TBI's

Many people who have brain injuries suffer from sleep disturbances.  Sleep is a complex process that involves many parts of the brain.  The brain directs sleep by putting your body to rest.  When you injure your brain, it can lead to many changes in sleep.  For this reason, and depending on the location and the extent of the injury, many different kinds of sleep disturbances can occur after a brain injury.  Not sleeping well can increase or worsen depression, anxiety, fatigue, irritability, and one’s sense of well-being.  It can also lead to poor work performance and traffic or workplace accidents.  A review of sleep disorders studies and surveys revealed that a sleep disorder is three times more coming in TBI patients than in the general population.  Women are more likely to be affected, as are the elderly. 

Some common sleep disorders include:

Insomnia-difficulty with falling asleep or staying asleep or sleep that does not make you feel rested.  Insomnia can worsen other problems resulting from brain injuries, including behavioral and cognitive difficulties.  Insomnia makes it harder to learn new things, and is typically worse directly after injury, and often improves as time passes.   

Excessive Daytime Sleepiness.

Delayed Sleep Phase Syndrome-Mixed up sleeping patterns.

Narcolepsy- Falling asleep suddenly and uncontrollably during the day.

Common sleep syndromes include:

Restless Leg Syndrome (RLS): Urge to move the legs because they feel comfortable, especially at night or when lying down. 

Bruxism: Grinding or clenching teeth.

Sleep Apnea: Brief pauses in breathing during sleep, resulting in reduced oxygen flow to the brain and causing loud snoring and frequent awakening.

Periodic limb movement disorder (PLMD): Involuntary movement of legs and arms during sleep. 

Sleepwalking: Walking or performing other activities while sleeping and not being aware of it.

Things You Can Do to Improve Sleep:

Set an alarm to try to wake up at the same time every day.

Include meaningful activities in your daily schedule.

Get off the couch and limit TV watching

Exercise every day.

Try to get outdoor for some sunlight during daytime. 

Don’t nap for more than 20 minutes a day.

Go to bed at the same time every night.

Follow a bedtime routing.

Avoid caffeine, nicotine, alcohol, and sugar for five hours before bedtime.

Avoid eating prior to sleep to allow time to digest, but also do not go to bed hungry.

Do not eat, read, or watch TV while in bed.

Keep stress out of the bedroom.  Do not work or pay bills there.

Create a restful atmosphere in the bedroom.

If you don’t fall asleep in 30 minutes, get out of bed and do something relaxing or boring until you feel sleepy.  

Helpful Tips for People with TBI's to Maintain Independence

People who get their TBI later in life, often feel that their independence has been taken away.  Here are some helpful tips to help you maintain some of that independence!


To address problems with memory, attention span, and organization:

Try creating daily schedules and checking things off as you do them. 

Use alarms to remind yourself of things you need to do throughout the day, such as taking medications.  Keep calendars where they are easy to see, and review and update them every day.

Have specific places for things that you use a lot, such as your house keys. 

If reading is challenging, listen to recorded books from the local library.

Play games that use memory and problem solving skills, such as cards, dominoes, checkers, chess, word search puzzles, and board games. 

Reduce distractions such as noise and clutter to help make you concentrate and make fewer mistakes. 


If you want to feel more in control of your emotions and behavior:

Try to avoid things that make you angry or frustrated.

Make time to do the things you enjoy, such as hobbies or being with friends.

Allow yourself to grieve your losses.

Accept help from people you trust.

Get enough sleep and rest.  Being tired and in pain can make it harder to cope.

Join a support group to share your experiences and learn from others.


To ensure that you are being as safe as possible:

Keep emergency contact numbers on the refrigerator, where they are easy to find, and see. 

Remember that you may need more help than you realize.  Ask for support from a family member or friend. 

Use household appliances that have fewer risks until you have been evaluated.  For example, use the microwave instead of a stove.

If you want to drive, have an evaluation before getting behind the wheel.  If you can’t drive, look into an alternative transportation in your community.

Install safety grab bars near the toilet, and in the tub if you have poor strength and balance. 

Look into some sort of an emergency call button so that you are able to call for help if need be.

If you would like to get back into participating in work, school, or volunteer opportunities:

Think about things you enjoy and are good at.  How can you apply these to work, school, or volunteer positions?

Meet with your employer or school administrator to talk about your skills, and what you need help with.

Consider taking a different job in the same company if you are having trouble at work.

Ask for feedback or assistance from a trusted friend or colleague.   

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