Sleep Disturbances / Insomnia

Altered sleep patterns are very common after TBI. This problem is usually worse in the first several weeks to months after injury.

Many people with a TBI sleep during the day and are awake at night. They may now nap routinely, even if they did not before the injury.

Stay positive. Most people with a TBI usually resume a more normal sleep pattern and one similar to the one they had prior to the injury.

Time, patience, and some creative problem solving may help. Developing a consistent sleep routine, taking medications on a temporary basis to aid sleep, and changing the bedroom to create a relaxing, quiet, and darkened space can improve sleep.

What might you see?

  • Difficulty falling or staying asleep (this is known as insomnia)
  • Awake at night, sleeping during the day
  • Frequent naps
  • Sleeping too much or too little

How can you help?
As directed by the provider:

  • Avoid or decrease napping during the day, especially for long periods of time.
  • Avoid or decrease caffeine, including coffee, tea, energy drinks, and dark sodas, at least six hours before bedtime.
  • Avoid or decrease alcohol intake, nicotine (smoking), heavy meals, and drinking fluids two hours prior to bedtime.
  • Exercise routinely, but do NOT exercise within four or five hours of bedtime.

Other tips:

  • Avoid use of bed for activities other than sleep and intimacy (for example, avoid watching TV, reading, or other activities not related to sleeping).
  • If worrying or nightmares are contributing to poor sleep, consult a provider.
  • Work with the healthcare team to establish healthy sleep patterns.
  • Monitor the bedroom environment: Turn the clock away from the bed, and use room-darkening shades. Most people sleep better in a cooler environment, but the key is to make sure the room temperature is comfortable prior to going to bed.
  • Go to bed at the same time every night, and get up at the same time every morning.
  • Go to bed when sleepy; if the service member or veteran can’t sleep have them get out of bed to read or watch TV until they feel sleepy and are ready to try falling asleep again.
  • Do NOT take an over-the-counter medication without direction from your provider.
  • Relax before bedtime by having a warm shower or bath; do NOT work, play, or read from a handheld device or computer to relax before bedtime.
  • Keep a sleep diary to establish a record of sleep patterns to assist your provider in sleep evaluation.