Sleep disorders after a brain injury
Disruptions to sleep are very common
after a brain injury.
Problems can include imsomnia, sleeping too much, sleep apnea,
teeth grinding and restless leg syndrome.
Apart from the brain injury itself, changes in sleep routines
may be due to stress, worry, work, living situation, family illness
or injury, or changes in your physical health.
Good sleep patterns are important so that you have enough energy
for all your daily activities (work, home, driving, having a social
life). Lack of sleep can affect alertness, concentration and mood.
Here are some simple strategies that you can use to improve the
quality of your sleep.
Get into a good sleep
Go to bed only when you feel sleepy at night-time. Try to get to
sleep at about the same time every day. No matter how poor your
sleep at night, get up at the same time every day - use an alarm
clock. Don't oversleep because of a poor night's sleep.
Sleep only at night
Sleep during the day will affect your sleep at night so try to
avoid more than a short nap during the day. Early on after an
injury, people may find they need to have day-time rest or sleep to
manage fatigue, but try to keep the naps short and don't nap after
mid-afternoon. If you get tired, try to just have a rest on the
couch. Don't rest on your bed.
Wind down before
Don't watch exciting movies just before bedtime. Do some
relaxation exercises or listen to some relaxing music. Start
preparing for bed at least 30 minutes before bed e.g. lock the
house, have a shower, put on pyjamas, brush your teeth, turn down
the lights. Try a warm drink such as milk.
Spend time in bed
Don't do other activities in bed e.g. reading, watching
television, or eating. Keep the bed only for sleeping. If you are
awake for a long time, get out of bed. Do an activity until you are
sleepy (make sure it is something boring). Go back to bed and
repeat the above steps if needed.
Avoid caffeine after lunch as this may affect your sleep at
night-time. Caffeine is in coffee, tea, chocolate or cola drinks so
be sure to avoid all of these after midday. Try decaffeinated tea
or coffee as an alternative.
Alcohol, drugs, and
Avoid drinking alcohol, especially at night time. Alcohol
changes the kind of sleep you have, and can make sleep restless. If
you smoke cigarettes, nicotine levels may also affect your sleep so
try to cut down.
Some prescription and recreational drugs can change your sleep
patterns, so ask for information from your pharmacist or
doctor. Over-the-counter medications such as pseudoephedrine
can also change your sleep patterns, so ask for information about
all your medications.
Get some gentle exercise regularly as this
will help with your sleep. Don't overdo it if you haven't been
getting exercise for a while. Talk to your doctor or a
physiotherapist about the kind of exercise you can do. Avoid
exercising at least four hours before bed-time.
Spend some time in the sunshine during the day, because this may
help with your sleep patterns e.g. sit outside with a book or
magazine or the newspaper (remember sunscreen and a hat). Go for a
short walk or do an activity outside in the fresh air e.g.
gardening, walking the dog.
Make your bedroom and bed as comfortable and pleasant as
possible. Remove clutter and get rid of any noise or distractions
e.g. use ear-plugs to cut down on noise. Use curtains to block out
light and noise and dim the lights. Make sure your pillow and bed
are comfortable. Make sure the bedroom is the right temperature for
the weather. Essential oils like lavender also can be relaxing, so
a couple of drops in your bath water, or on your pillow may help
create a relaxing feeling.
It can take time to re-settle sleep patterns, so don't expect
changes to happen overnight. Keep using the new ideas and you
should start to see changes gradually. If you need further advice,
talk to your GP or a psychologist.
References and further information
This article is reprinted with the permission of ABIOS (Acquired
Brain Injury Outreach Service), a specialist community-based
rehabilitation service assisting people with ABI in Queensland,
their families and carers. Visit www.health.qld.gov.au/abios/
for more of their fact sheets