Brain Injury and Better Sleep: The Basics

The first impacts after my injury were two-fold.  First, was a desperate need for more sleep to enable me to function.  Second, for the first time in my life, falling asleep was no longer as easy as it once was.  Learning the habits of proper sleep hygiene and developing the version that worked for me was a slow process.  Even now, I still struggle with keeping a consistent sleep cycle.

I didn’t even know there was such a term as “Sleep Hygiene” until after my injury, but now it’s all too familiar to me.  Effectively, sleep hygiene refers to a variety of practices and general habits that are needed for restful sleep.  Generally speaking, these are the recommendations given:

• Consistency.  Try to go to sleep at the same time each night and rise at the same time in the morning.
  • Consistency in practices become habits, both mentally and physically.
• Ensure your bedroom is quiet, dark, relaxing, and kept at a temperature that’s comfortable for you.
  • A sleeping mask and soft earplugs for sleeping can make a difference here.
• Remove electronic devices from your sleeping space.
  • Don’t just turn them off – take them out of the room.
    • Television
    • Computer
    • Smart phone
      • I know this is a tough one, but at the very least configure it with a quiet time and turn it face down.
    • A bedroom should be for sleep and sex only.
  • My bedroom has one exception to this, a single Bluetooth speaker that softly masks outside noise with gentle music from my Pandora channel playing music for sleeping.
• Avoid caffeine later in the day.
• Alcohol should be avoided when you have a brain injury – plain and simple.  If you do indulge in a beer or a glass of wine, don’t do so near your bedtime.
  • While alcohol can help us fall asleep initially in some situations, it can disrupt your sleep cycle in the middle of the night.
• Exercise and physical activity are important.  While you should not exercise right before bed, being physically active during the day can help you sleep better at night.
• Also, to help you stay asleep, you may want to reduce fluid intake before bed bedtime.

If you are having sleeping issues, it’s advisable to talk with a trusted medical professional about it.  If you need to do this, be sure to keep a sleep diary for at least a week for your doctor or therapist to review with you.  You can find many of these online—here’s a sleep diary from the National Sleep Foundation that works very well.

My own experience with sleep after the injury was grueling, to say the least.  As I discuss in my Hello darkness, my new friend post, my needs for sleep initially were at the 9 hours or more point per night.  Below 9 and I’d struggle, below 8 and I’d be dysfunctional – unable to communicate effectively and emotions sitting way too close to the surface.  Less than 7 hours generally put me at a point where I really needed to just stay inside and cut off all voice communication requirements until I could sleep. 

Through these last three years, my needs have changed.  Now, I can almost function on a social level after one bad night of sleep – “almost” means that my communication skills are challenged, and my emotions are too close to the surface.  Where the problem comes in now is if I have two bad nights in a row.  After the second bad night, my ability to speak is severely impaired, my emotions feel raw and exposed.  When you can’t even communicate simple ideas effectively, tears flow at the slightest provocation, and it’s all beyond your ability to control – you realize that your world has changed.

I’ve worked hard on my sleep habits and have finally reached a point of equilibrium with my sleep cycle which, on most evenings, keeps me in the 8 to 9 hour range.  I have a few stand-by options that I keep at the ready for when they are needed.  My doctor has prescribed Trazadone, considered a mild and non-addictive sedative, as an “as needed” sleep aid that I use only occasionally.  My doctor recommended I consider a timed-release melatonin supplement, I tried RemFresh and the results were such that I now use it every night. 

If you’ve read other posts in this blog, you may know that I’m a family caregiver for my elderly mother who has dementia.  That said, some nights her TV gets so incredibly loud I’m forced to reach for the soft sleeping ear plugs that I keep on my night stand. I keep a comfortable sleeping mask on my nightstand as well.  Although my room gets very dark, there are still a couple of annoying light sources like the smoke detector.  If it gets to a point where even that is bothering me, I don the mask.

Practice sleep hygiene to the best of your ability, and find the habits and tools that work best for you.  May you rest deeply, sleep peacefully, and awake refreshed more nights than not.