Sleep disturbance

Like fatigue, sleep problems are very common in patients with mild head injuries.

Types of Sleep Disturbance

1. Hypersomnia 

Hypersomnia means sleeping excessively, usually waking up still tired and feeling sleepy during the day.

2. Insomnia 

This can mean difficulty getting off to sleep, staying asleep or waking up too early.

One of the commonest causes of insomnia is the development of anxiety about sleeping. Often what happens is that someone finds they feel really tired but then as soon as they get in to bed they start to worry about how they can’t get to sleep and what a terrible night they are going to have. Falling asleep should be an automatic process. If you start thinking about it too hard then it doesn’t work as well. Learning to undo this can be difficult, but understanding what has gone wrong is the first step.

3. Nightmares – PTSD

A small number of people who sustain a mild head injury in a serious accident or assault may develop unpleasant anxiety symptoms, nightmares, or intrusive mental ‘flashbacks’ of the event immediately afterwards. In the vast majority of people these symptoms will settle down over the following weeks as the event becomes an unpleasant memory. However sometimes these symptoms do not settle down so quickly – or even get worse –  and a condition called Post Traumatic Stress Disorder (PTSD) can arise. If the symptoms are still present six weeks after the event, it is worth discussing with a doctor to see if treatment may be helpful.

Read more about PTSD

What Can I Do to Help Myself Get Better?

Simple tips for a better night’s sleep:

  • Keep regular hours. Going to bed and getting up at roughly the same time, all the time, will programme your body to sleep better.
  • Try not to take naps during the day.
  • Create a restful sleeping environment. Your bedroom should be kept for rest and sleep and it should be neither too hot, nor too cold; and as quiet and dark as possible.
  • Make sure your bed is comfortable. It’s difficult to get deep, restful sleep on one that’s too soft, too hard, too small or too old.
  • Take more exercise. Regular, moderate exercise such as swimming or walking can help relieve the day’s stresses and strains. But not too close too bedtime or it may keep you awake.
  • Cut down on stimulants such as caffeine in tea or coffee – especially in the evening. They interfere with falling asleep and prevent deep sleep. Have a hot milky drink or herbal tea instead.
  • Don’t over-indulge. Too much food or alcohol, especially late at night, just before bedtime, can play havoc with sleep patterns. Alcohol may help you fall asleep initially, but will interrupt your sleep later on in the night.
  • Don’t smoke. Yes, it’s bad for sleep, too: smokers take longer to fall asleep, wake more often and often experience more sleep disruption.
  • Try to relax before going to bed. Having a warm bath, listening to some quiet music, doing some yoga – all help to relax both the mind and body. You could try one of these relaxation exercises as well.
  • Deal with worries or a heavy workload by making lists of things to be tackled the next day.
  • If you can’t sleep, don’t lie there worrying about it. Get up and do something you find relaxing until you feel sleepy again – then go back to bed.

Further Reading

Here you can find an article written by Professor Colin Espie on How to Improve Your Sleep, published in the Guardian.

Moodjuice Sleep Self Help Guide – Moodjuice is a website developed by Choose Life Falkirk and the Adult Clinical Psychology Service, NHS Forth Valley. They have a very helpful self help guide to help you cope with sleeping problems.

Sleeping Problems Self Help Guide – This leaflet from Northumberland, Tyne and Wear NHS Foundation Trust, contains information on sleep and sleep problems and describes healthy sleep habits.

The Sleep Council – The Sleep Council is a website funded by the trade association for British bed manufacturers. They aim to raise awareness of the importance of a good night’s sleep to health and wellbeing and provide advice and tips on how to improve sleep quality.