Something a lot of those with brain injuries find, is that they have trouble getting to sleep. I don’t mean the impromptu power naps, I mean when you go to bed expecting to recharge your batteries but it feels like you can’t find the “off” switch.
Why is sleep so important for those who have a brain injury?
When you are tired everything can feel so much more difficult. It can affect your memory, speed of processing and higher cognitive functions, such as decision making just to name a few. Most of these things are challenging enough when you have a brain injury, so a lack of sleep can feel devastating. But perhaps more importantly, the sleep process is even more crucial when your brain is trying to heal.
So we know some quality ZZZZZ’s are good for you, but what can you do to improve your sleep?
- Get into a routine. Go to bed and get up at the same time each day. This should also include weekends where possible, at least initially. You need to retrain your brain and body what shift they are on.
- Have some exercise in the day. Most people want the kids or pets to burn off some energy so they are more restful later, and the same works for all of us. Even if you just go for an afternoon stroll. But avoid the evening or close to bedtime as the adrenaline needs time to wear off.
- Limit your intake of caffeine and sugar. We all know it helps us get going in the morning, but if you have it to late in the evening it stop you from winding down. 4 hours before bed stop having it, or switch to a decaf alternative.
- No alcohol 2 hours before bed. Alcohol is know to disrupt sleep even though we might find we feel sleepier. It can stop us from failing into a deep restful sleep. So keep it to a minimum and if you are going to have a glass it’s best to have it at dinner time.
- Don’t watch TV or eat in bed. Your brain and body have to be trained that the bed is only exclusively for two things, sleep and sex. Once they have accepted this you will find it much easier to wind down when your head hits the pillow.
- Once you’re in bed taking a few minutes to do some mindfulness meditation helps to calm the mind. You can have a guided session on your mp3 player using head phones, or if you are more experienced just meditate in your usual fashion. I have a 10 minute body scan meditation which you can access for free here.
- Stop checking your phone when you’re in bed! As well as trying to train yourself that this is when you should be asleep, the blue light emitted from most phones actually over stimulates our brains and puts them into “wake up” mode.
- Avoid checking the time in the night. All that you do is worry more about how much sleep you are or you’re not getting, it doesn’t change anything by knowing the time. It can make you more anxious and stop you from sleeping well.
- If you are struggling to sleep get up. Don’t just lie there getting frustrated as that’s counter intuitive. Go and do something but don’t look at any screens. That means the TV, computer and your phone are out of the question. You can do some tidying up or read a book. Paper is the best but an e-reader that isn’t backlit will suffice. Avoiding the back lit versions reduces the blue light screens emit, but using a regular reading lamp in fine.
- Even if you have got up in the night because you were struggling to sleep still get up at the planned time. Yes you’ll be tired but you have to go through this part. The brain will always find a way to get as much sleep as it needs when it is deprived so you have to be cruel to be kind. It’s tough I know.
- Limit naps. If you nap too much in the day your brain will struggle to switch off at bed time. Naps are important for those with fatigue, but try to limit them to 20 minutes at a time. It’s enough to give you a needed boost without disrupting the routine you’re building.
This is a process a Neuropsychologist put me through and it worked for me.
She warned me that I would have lapses where I might check the time or get my phone out, but not to beat myself up about it too much. She made me keep a sleep diary where I put down what times I got to bed and got up, as well as estimated periods of being awake. Estimated because I wasn’t allowed to check the time.
And there were times I broke the rules, but the sleep diary proved that the nights where I didn’t follow all the instructions, I slept worse. So that gave me the motivation to follow through properly and I rediscovered a more healthy sleeping pattern.
Since writing this I carried on experimenting, and I found another trick to help me go to sleep which you can read in Fall asleep faster. Tips to give brain injury cold-shoulder.
Sleep in really important, but fatigue isn’t connected to just the lack of it. Read more in Fatigue. Wicked exhaustion backlash after brain injury.
6 replies on “11 steps for better quality sleep after a brain injury”
You got similar advice that I was given and it worked. Limiting screen use 1 hour before bed time and no coffee after noon seemed to work best for me. As for excersise walking my dog first thing after breakfast was most beneficial as I used that time to clear my head of any negativity that was troubling me
Glad it works for you too David. More people need to try this 😴
Hello, I will try those tips you have given thanks. I am in a routine with no tv, 2 hours before sleep, a bath then restful music or reading, using lavender body lotion too. But I have a problem with nightmares and my mind racing. I will wake sweating, stressing, sometimes shouting, in the night. It’s like my thoughts are controlling me, not me controlling my thoughts. I try to battle it away with mindfulness breathing and concentration on a part of my body, but this isn’t easy and seems difficult when you are at a heightened state from the nightmares. It can have a knock on effect the next day, then I can become anxious about it reoccurring the next night, like a vicious circle. Exercise especially swimming seems to help. I really hope it improves in time. Thanks for the tips .
Oh Jo that sounds awful. I do hope that those tips help. Let me know.
I’ve tried ALL these for years. I eventually got much better at sleeping when I was in my own home (18? months after my ABI? but since I lost that (debts since my accident = had to sell it) and have been moved around to many rented awful temporary flats my sleep’s got far far worse again (can’t get to sleep & constant wakings throughout the night) plus since mega stresses & threats of homelessness+ I’ve started having loads of really awful vivid nightmares, some repeat time after time nearly the same but often with new terrible twists.
I don’t understand the advice not to look at the clock when you wake up: I’ve had to put blackout curtains up in my bedroom because the light wakes me so I have to look at the clock to see if it’s time to get up or not because I often feel exhausted even when it is time to get up so I can’t tell without looking at clock.
And it’s all very well telling us to get up if we can’t sleep but I go to bed at night not only because my brain is totally exhausted, I’m also in mega pain long before I go to bed and crave the darkness, quiet (earplugs) and lying flat with my eyes closed, if I can’t sleep I have to hurt more being up plus my brain’s too exhausted usually to read, listen to music or do ANYTHING. And if you live somewhere there’s no heating or can’t afford to put it on you have to stay in bed to keep warm, I had to do that for 5 years in my last place: way too cold to get up when it’s 8C inside. After bad nights (nights from hell) I’m good for nothing at all the next day, my pain is far worse, I can hardly chew & swallow (even soup & bread I’ve dunked in it) and I cry a lot and get very very down (‘depressed’): exhaustion overload = despair.
I hate having to use earplugs: they make the insides of my ears hurt but without them I hear every sound (since my brain injury I’m hugely sensitive to everything including light and smells) – and I don’t even get them on prescription, I have to buy them.
Some of the tablets docs give me really help (some, diazepam, ‘the most addictive’, are really wonderful and I get such amazing restful sleeps and they also relax my muscle spasms) some are like placebos and do nothing at all, I wish they’d let me have ones that work without me having to try explain and argue, I know medication isn’t great but without it (at the moment anyway) I really need help to get some half-good sleep or I have too many wasted days in the bin. People who need other medications are allowed them, they are ‘addictive’ also because they WORK, I had no idea before my brain injury what this sudden new inability to sleep was like and I don’t think anyone does until it happens to them so I don’t think most docs really know at all how totally debilitating it is and we don’t beg for medication unless we really need it, I don’t anyway.
I don’t know if my living situation and life got better whether I’d regain my ability to sleep or whether it’s got too wrecked now by my brain being forced to do much too much for way too long so that now I can’t ever really relax by e.g. listening to music or in a bath (as I used to, even after my brain injury) because my brain isn’t being kept busy but that’s the problem now: my brain can’t stop – and that’s the fault of those who push me/it too much with too many difficult & complicated tasks (maybe thinking they’re helping ‘rehab’ or something?). I really hope that those who treat people with brain injury learn from my experience and NEVER overload damaged brains because i think it makes us create too many connections which isn’t good for us at all.
Then on top of all that I can’t get my neck comfy (ever really, even sitting) because of my neck & throat injuries: I can’t put the pillow in the right place for my neck because then it pushes on my damaged throat (& broken bit in front/side) and when I lie on my back I often have to put my hand behind my head/neck to support the really painful bit and then have to switch hands because they (& arms) get shaky and numb; often when I wake in the night and I’m on my back one or both hands are very numb – especially little fingers (left most) is/are totally ‘dead’. Things like this are never mentioned in sleep problems but they should be.
I’m glad the tips work for you and others (and did for me after my brain injury but before I lost my ability to relax, my security & my long-term comfy home, but sadly they don’t work for all of us, believe me how hard I’ve tried.
I get what you mean about the clock as if there is no other indication if morning has arrived or not then you need it. Sorry that these steps aren’t for you.