Sleep

Coping with sleep challenges

Here we share information and strategies on management of symptoms affecting sleep after mild traumatic brain injury (mTBI) and concussion.

Why we sleep

Sleep is a quiet, restful, active brain state during which our brain performs several important functions:

  • Restores energy
  • Stores and organizes memories
  • Restores ability to concentrate and pay attention
  • Regulates our metabolism, hunger, and cravings
  • Repairs muscles and allows them to recover
  • Processes our emotions
  • Rebuilds our health and wellbeing

The sleep-wake cycle is regulated by two biological mechanisms:

  • Sleep drive: The pressure to sleep, builds up in our body throughout the day. Pressure increases the longer we stay awake. Pressure decreases during sleep, reaching a low after a full night of good-quality sleep. This process restarts as we awaken and repeats daily.
  • Circadian rhythm: A 24-hour cycle that is part of the body’s internal clock. It is naturally aligned with the cycle of day and night. It runs constantly in the background of our mind and body, managing processes like alertness or sleepiness, appetite, and body temperature. It can be disrupted by situational or environmental factors, including travel and work. It can also be disrupted by underlying medical or psychological conditions, such as traumatic brain injury, obstructive sleep apnea, depression, or anxiety.

According to the National Sleep Foundation, most adults need about 7 to 9 hours of restful sleep each night. Unfortunately, nearly 30 percent of adults get less than 6 hours of restful, restorative sleep, and about one in three adults report difficulty sleeping.

Understanding sleep disorders

A sleep disorder involves problems with sleep quality and quantity and can result in daytime stress and difficulty completing daily life tasks. Sleep disorders often occur along with medical conditions, mental health conditions such as depression and anxiety, and cognitive difficulties.

What is insomnia?

Insomnia is the most common sleep disorder, one that affects 6 to 10 percent of adults. Symptoms include:

  • Dissatisfaction with quantity or quality of sleep
  • Difficulty falling asleep, taking more than 30 minutes
  • Difficulty staying asleep, waking up multiple times per night
  • Undesired early-morning awakenings, typically between 2 to 4 a.m.
  • Not feeling well-rested upon awakening
  • Feeling tired and sleepy during the day
  • Feeling more irritable, depressed, or anxious
  • Having more difficulty paying attention or remembering things

With insomnia, these symptoms occur at least 3 nights per week, causing significant distress and impairments in important areas of daily functioning. Symptoms can last for varying lengths of time.

People who get more restful, restorative sleep tend to feel more energized, think more clearly, have fewer emotional challenges during the day, and handle stressors more easily.

Tips for better sleep

By adopting healthy sleep hygiene practices, you can pave the way for a restful and rejuvenating slumber.

  1. Stick to a consistent sleep schedule. Aim to wake up at the same time every day, even on weekends or during vacations. Minimize daytime naps unless medically recommended. If you benefit from naps, limit them to 20-30 minutes. This all helps set your body’s internal clock, making it easier to fall asleep and wake up naturally.
  2. Set a sensible bedtime. It’s crucial to ensure you get enough sleep each night. The recommended sleep time for a healthy adult is typically seven to eight hours; however, everyone is unique. Plan your bedtime accordingly to allow your body enough time to rest and rejuvenate.
  3. Listen to your body. Only go to bed when you’re sleepy. If you find yourself lying awake for more than 20 minutes, don’t force it. Instead, get out of bed and engage in a quiet activity with minimal light exposure until you feel drowsy.
  4. Create a bedtime oasis. Quality of sleep is just as important as the amount of sleep you get. Keeping your bedroom cool, dark, and quiet can create a more restful environment and might promote better sleep.
  5. Stay active and eat well. Regular exercise and a balanced diet contribute to better sleep quality. Engaging in physical activity during the day can help you fall asleep faster and enjoy deeper sleep at night. Avoid intense workouts close to bedtime as they can temporarily increase alertness.
  6. Create a bedtime routine. Establishing a soothing bedtime routine can signal to your body that it’s time to wind down. Reading a book, taking a warm bath, or practicing gentle stretches are all examples of calming bedtime activities. Start winding down at least 30-45 minutes before your normal bedtime.
  7. Keep the bed for only sleep and intimacy. Avoid using your bed as a workspace or a place to watch movies, as this can disrupt your sleep patterns.
  8. Avoid caffeine and alcohol. Both can disrupt your sleep patterns. Avoid drinking caffeine in the afternoon or evening and avoid consuming alcohol before bedtime.
  9. Keep snacks to a minimum. Heavy meals before sleep can cause discomfort and disrupt your sleep. If you’re hungry at night, opt for a light and healthy snack to satisfy your hunger without overloading your digestive system.
  10. Turn off electronics 30 minutes before bed. Studies have shown that using your phone, computer, or television before bed can interfere with the body’s production of melatonin, a natural hormone that is released to help you feel tired and ready for sleep. The bright lights on your devices can stimulate feelings of alertness when you should be dozing off.
You're on Shepherd Center's patient education website. For our hospital's main website, please visit shepherd.org.