9th Nov 2010

Sleep disturbance is a relatively common complication following Traumatic Brain Injury (TBI). It has been reported that individuals with brain injury have significantly more insomnia (56%) and pain complaints (59%) than those who are non-brained injured. One recent study reported 30% of individuals with brain injuries were found to suffer from insomnia. Oftentimes, factors such as pain, depression, anxiety, medications, and the nature of the brain injury play a role in the sleep disturbance.

For those with TBI, sleep disturbance can be particularly disruptive to neurobehavioral function – resulting in increased agitation, poor performance, decreased attention, memory confusion, somatic complaints, and decreased seizure threshold. For some TBI patients, sleep-inducing medications may be enough to manage the problem. Yet, in many cases, a combination of strategies must be implemented to improve their ability to sleep

The process of reducing sleep disturbances begins with making modifications to sleep hygiene and environmental factors. This is particularly important for those with brain injuries. These necessary changes include creating a restful sleeping environment, going to bed and waking up at a consistent time, maintaining a room temperature of between 65 and 72 degrees Fahrenheit, incorporating moderate exercise into one’s daily routine, limiting intake of both alcohol and caffeine, and playing white noise.

Along with improving sleep hygiene, cognitive behavioral therapy has also been proven to be beneficial in minimizing sleep disturbances following TBI. This form of psychotherapy is utilized to assist in changing behavior, perception, and feelings about sleep. By helping individuals with TBI identify and correct thoughts and beliefs that contribute to sleep disorders, cognitive behavioral therapy can help establish sleep goals.

As well, many TBI patients suffering from insomnia spend too much time in bed unsuccessfully trying to get enough sleep. In these cases, a sleep restriction program can be beneficial. Using this technique, patients are allowed only a few hours of sleep during the night. Then, gradually the sleep time is increased until a normal sleep pattern is achieved.

Finally, relaxation therapy is frequently recommended to individuals with TBI who suffer from sleep disturbances. Methods of relaxation therapy, such as progressive muscle relaxation (PMR), imagery, self-hypnosis, and deep breathing techniques, are often used to augment other forms of treatment. In fact, there is growing research that theorizes that deep breathing may actually contribute to the healing process following a brain injury as it helps feed oxygen to the brain. Most experts recommend a daily routine of relaxation techniques in conjunction with other therapies to enhance the effectiveness of overall treatment of sleep disturbance.

For TBI patients, maintaining healthy sleep patterns is an essential component to recovery. This requires the proactive assistance of a team of healthcare professionals that often includes physicians, psychotherapists, psychiatrists, and hypnotherapists. Once a comprehensive treatment plan is developed and managed by this collaborative team, patients have their greatest chance to overcome their sleep disorder and ultimately heal from their injury.

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