CEMM Virtual Library

The Caregiver's Journey

Sleep Changes

Altered sleep patterns are very common after TBI. This problem is usually worse in the first several weeks to months after injury.

Many people with TBI sleep during the day and are awake at night. They may nap now, when before they did not.

Stay hopeful. Most people with TBI do usually resume a more normal sleep routine similar to the one they had before the injury.

Time, patience, and some creative problem-solving help. Developing a consistent routine, using medications on a temporary basis, and changing the bedroom can improve sleep.

What you might see:

  • Difficulty falling or staying asleep (insomnia) 
  • Awake at night, sleeping during the day 
  • Frequent naps 
  • Sleeping too much or too little

How you can help:

  • Work with the healthcare team to establish healthy sleeping patterns. 
  • Encourage your service member/veteran to:
    • Limit daytime naps (talk to the healthcare team first).
    • Avoid caffeine (coffee, tea, energy drinks, dark soda) after the morning.
    • Exercise during the day; avoid exercise too close to bedtime.
    • Avoid fluids two hours prior to bedtime.
    • Try to eat the last meal of the day four hours before bedtime.
    • Go to bed at the same time every night and get up at the same time every morning.
    • Avoid use of bed for activities other than sleep and sex (e.g., watching TV).
    • If worrying or nightmares are contributing to poor sleep, consult a doctor or nurse.
  • Monitor the bedroom: turn the clock away from the bed, use room-darkening shades. Most people sleep better in a cooler environment.
  • If your service member/veteran simply cannot fall or stay asleep, have him or her get out of bed and watch TV or read (if easy to do without assistance) until he or she feels tired and is ready to try again.
  • Talk with your service member/veteran’s doctor about temporarily using sleep medication or complementary/alternative therapies to help establish a sleep schedule.
  • Make sure to tell your doctor if your service member/veteran is taking an over-the-counter medication.

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