Sleep after brain injury
Sleep disturbance is common after brain injury and stroke. It can be difficult to pinpoint the issues involved. Poor sleep could be a side effect of the emotional and physical difficulties caused by a brain injury or it may be a result of damage to parts of the brain which regulate alertness and sleep.
Common factors affecting sleep
- Pain, worry, lifestyle or home environment.
- Side effects of certain medications.
- Hormone imbalances, which may require investigation.
Effects of lack of sleep
Lack of sleep can have a significant effect on our thinking skills, as well as our emotional and physical health.
Many of the problems commonly experienced following a brain injury, such as impaired memory, poor concentration, low mood, anxiety and irritability, can be made worse by a lack of sleep.
Sleep hygiene
Sleep hygiene involves doing things known to improve sleep and avoiding those things which are known to disturb sleep.
There are many excellent resources on how to improve your “sleep hygiene”, see overleaf.
What can I do to help?
If you are having problems sleeping, the following actions may help.
Routine - Try to have regular sleep times, like going to bed and getting up at the same time. This will help to regulate the body’s internal clock.
Relax and wind down before going to bed - It is important to prepare the body for sleep. Try to find a way to relax at least an hour before bed, such as reading, a warm bath, listening to an audio book or soothing music. If you are struggling to switch off/relax due to anxiety or stress, discuss this with our service
Switch off electronic devices - mobile phones, tablets and computers emit blue light. Exposure to blue light at bedtime can cause sleep issues. Switch off electronic devices at least an hour before bed.
Bedroom environment - try to keep the bedroom sleep friendly. Ensure it is comfortable, dark, quiet, cool in temperature and free from electronic gadgets. Black-out blinds or eye masks can be beneficial. Earplugs are also useful if noise is an issue.
Do not consume caffeine after lunchtime - caffeine is a stimulant and can keep you awake. Products containing caffeine (tea, coffee, cocoa, chocolate, soft drinks, etc.) should be avoided after lunchtime. Consider trying decaffeinated coffee and tea.
Avoid alcohol and nicotine before bedtime - alcohol may initially promote sleep, but can disrupt the quality of sleep later in the night. Nicotine is a stimulant and should be avoided 2 hours before bedtime.
Exercise and natural light - regular exercise (even mild) is good for sleep, but should be completed at least 3 hours before bed. Exposure to natural daylight helps your internal clock with the sleep-wake cycle.
Nap early - a daytime rest is highly recommended following a brain injury/stroke. Ensure your nap/rest is early in the afternoon and no longer than an hour in duration.
If your difficulties continue consult the Acquired Brain Injury Service, your GP or Consultant.
If you would like this information in another format, please speak to a member of CWP staff or email cwp.
May 2021 Version 1
www.cwp.nhs.uk