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Sleeping Patterns

Sleeping Patterns

Julie
Sam deals with migraines right now on a daily basis, and I think that stress is a big part of it. He can’t deal with too much at any one time. He gets overwhelmed. It really helps when we can persuade him to take a nap.

Carl
Julie’s right. I think his stress level is the key. And it really seems to help if he gets a good night’s sleep. 

Tracy
So how is Sam sleeping?

Julie
Well at first he hardly slept at all, and when he did it was during the day, when we were trying to meet with the doctors and communicate with family. Then, he’d stay awake all night. And we felt that we should be awake, too, so Carl and I weren’t getting any sleep either.

Tracy
Altered sleep patterns are... they’re very common after TBI. It can be hard to fall asleep, or to stay asleep. And some people sleep much more than usual, and then others sleep very little. So the first several weeks to months even after the injury are usually the worst. Initially the sleep patterns can be totally off, but try to stay hopeful. Most people with TBI usually resume a more normal sleep routine, similar to the one that they had before the injury. Now I know you are probably really tired of hearing this, but it just takes some time.

Carl
You’re right Tracy. Sam’s sleeping definitely improved, but it took awhile. Those first couple of months were rough, for all of us…

Tracy
It does get better over time. I know everyone is at a different phase in their recovery, so some of the strategies may not apply.  Now if your loved one is in the hospital or in a rehab facility, work with the health care team to establish healthy sleeping patterns. And once you transition home you’ll have to determine what works best for your daily schedule considering appointments, therapy, that sort of thing.

Napping may be an issue, so if it seems like your loved one is napping on and off all day they may suggest that you limit daytime naps.  That will promote better sleeping at night. If your loved one becomes agitated or frustrated, it may be that a nap is needed during the daily routine. Other recommendations for better sleep are to avoid caffeine, energy drinks of course, exercise, video games, fluids too close to bedtime.

And establishing a consistent routine also helps. So have your loved one wake up and go to bed at the same time every day. Time, patience, creative problem solving… that’s all going to really help.

Carl
One of the therapists suggested making some changes in Sam’s room, like turning the clock away from the bed, using room-darkening shades, keeping the bedroom cool. So far these have helped, but sometimes Sam just can’t sleep no matter what.

Tracy
Well, if Sam simply can’t fall asleep or stay asleep, maybe you could have him get out of bed, watch TV, read, if he’s able to, you know until he feels really tired and can just sleep naturally.

You can also talk with a member of the team about temporarily using a sleep medication or some kind of alternative therapy to establish that sleep schedule.

Carl
We’ve tried most of those things at one time or another. Some things work better than others. It just seems to depend on the day, and how Sam’s feeling. Like I said before, it does get better, so don’t get discouraged.

Sensory Changes

The brain is the center for all five of our senses: sight, hearing, taste, smell, and touch.

When the brain is injured, each of the senses is at risk for change. There is often not much to be done about these changes in the first year after injury.

Doctors often use a “wait and see” approach with the hope that sensory changes will go away on their own.

For some sensory changes that don’t go away over time, surgery may help. For others, therapy and learning to live with the effect will be in order.

What you might see:

  • Vision changes, such as blurry vision, double vision, or sensitivity to light 
  • Hearing changes, including muffled hearing or ringing in the ears (tinnitus) in one or both ears
  • Changes in taste and smell. This could be a complete lack of taste and smell or an altered taste, such as a metallic flavor in the mouth

How you can help:

  • A neuro-ophthalmologist can evaluate visual changes. A neurologist can evaluate other sensory changes.
  • Reinforce wearing of an eye patch or special glasses if ordered for double vision.
  • Ask your service member/veteran to avoid alcohol. It may increase sensitivity to light and noise.
  • Seek professional advice about whether or not it is safe for your family member to drive if he or she is having a change in vision.
  • Have his or her hearing checked. Use hearing aids, if needed. 
  • Ask a dietitian about tips for eating if taste and smell are lost or altered.
  • Make sure you have a working smoke alarm in the house if his or her sense of smell has been lost.
  • Try to be patient. Sensory changes can improve over the first several months or years after TBI. Work with the health care team to track how the senses are working. Seek further evaluation and treatment options as needed.
Related Information:
Sleep Changes
Other Physical Effects
Glossary
Frequently Asked Questions
"A really super thing for us in terms of communicating with the hospital staff—and the hospital already had this installed in the room—is a big dry erase board. Some people use it and some people don’t. We use it to make a list of all the things we want to talk about with the doctors. That way, if I’m not in the room when the doctors come by on their rotation, they’ve got the big list right there and they can see it clearly. That helps keep the communication going." -  Anna E.

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