Brain injuries, like concussions, can affect parts of your brain responsible for sleep regulation, which can result in sleep disturbances like insomnia.

Concussions are a type of traumatic brain injury (TBI). They develop when a forceful movement causes your brain to suddenly bang against the inside of your skull.

The impact causes physical injury to the brain and can disrupt the natural balance of neurotransmitters, affecting function. Bruising, bleeding, and swelling are also possible, and severe concussions can be life threatening.

Whenever you injure a part of your brain, the functions it’s responsible for — and functions that rely on those functions — can be affected. For many people, sleep is one area where concussions make a significant short- and long-term impact.

Insomnia is one type of sleep disturbance that a concussion can cause.

A concussion can lead to short-term insomnia within the first few weeks after the injury. In addition, experiencing a concussion may also increase your risk of developing insomnia later in life.

A 2021 study of almost 200,000 veterans, for example, found those who experienced TBI, including concussions, had a 41% increased chance of developing a sleep disorder during the 14-year follow-up.

Among veterans in the study with a history of TBI, 12% went on to develop insomnia specifically, compared with 7% of those without a history of TBI.

According to a research review from 2021, experiencing “poor” sleep quality from insomnia or other sleep disturbances in the chronic phase of a concussion is associated with emotional and cognitive impairment after a concussion.

Is insomnia a common symptom of concussions?

Although many people feel significant fatigue after experiencing a TBI, insomnia is considered a common symptom of a concussion. Insomnia can present as difficulty falling or staying asleep or waking up before you’ve gotten enough sleep.

Insomnia isn’t the only sleep disturbance possible after a concussion, either. According to a scientific review article from 2018, sleep apnea, narcolepsy, and sleep-related movement disorders are also more prevalent among people with TBI than those without TBI.

Insomnia caused by a concussion will develop after the concussive event.

Not everyone who’s had a concussion is aware of the symptoms. Sometimes, concussion symptoms are mild or don’t appear until a fewdays after you’ve injured your head.

You may have had a concussion if you recently bumped, hit, injured your head, or experienced a whiplash event. Following the incident, you may notice that you experience:

  • headache or a feeling of pressure in your head
  • nausea
  • vomiting
  • dizziness
  • neck pain
  • balance problems
  • numbness
  • blurry vision
  • sound and light sensitivity
  • confusion
  • poor concentration
  • forgetfulness
  • memory problems
  • general feeling of being unwell
  • slurred speech
  • seizures
  • loss of consciousness
  • inability to fall asleep or difficulty waking up

Insomnia can appear in the days or weeks following a concussion. You may experience:

  • an inability to fall asleep
  • difficulty to stay asleep
  • an inability to go back to sleep if you wake up prematurely

There’s no way to know how long your symptoms of concussion insomnia will last. Most people recover from a mild concussion within a few weeks, but the following factors may affect this:

  • age
  • severity of the concussion
  • history of other TBI
  • overall health

Concussions can cause permanent damage to the brain, and it’s possible for insomnia to remain a persistent challenge.

Experiencing multiple concussions over time or a second concussion before the initial one has healed increases the chances your brain may experience lasting impairment.

Treatment of concussion insomnia focuses on helping your brain recover and heal and also helping you get enough rest.

Multiple types of treatment may include medication, sleep devices, and lifestyle modifications. Your doctor will advise you to avoid any treatment that could be harmful after a concussion.

Concussion treatment focuses on getting enough rest, pain management, and monitoring for any consequences — such as seizures or difficulty concentrating.

Your goal during concussion recovery is to avoid any activities that might aggravate your TBI or cause further injury. Getting ample rest allows your brain the time it needs to heal.

Before prescribing medications, your doctor may recommend making sleep hygiene changes to your lifestyle to address concussion insomnia.

Sleep hygiene is a collective term for sleep habits that promote optimal slumber.

If sleep hygiene doesn’t improve your concussion insomnia, or if insomnia becomes persistent, your doctor may recommend 6 to 8 weeks of cognitive behavioral therapy for insomnia (CBT-I).

CBT-I incorporates sleep hygiene practices with behavioral strategies to help you fall asleep faster and naturally regain a regular sleep-wake cycle.

If there’s no risk associated with your TBI, your doctor may also prescribe sleep medications. Short-term and long-term insomnia medications are available, but not all medications are safe when you’ve experienced a TBI.

Before taking any medication or sleep aid, talk with your doctor about the risks.

Sleep matters when you experience a TBI. According to a study from 2021, sleep is an essential time when the brain clears out metabolic waste proteins. Being unable to sleep after a TBI can interfere with that process.

Tips for sleeping with a concussion follow the same guidelines as general sleep hygiene recommendations and include:

  • keeping your bedroom quiet, cool, and dark
  • going to bed and waking up on a consistent schedule
  • avoiding stimulants like caffeine or nicotine before bed
  • avoiding naps during the day
  • limiting electronic screen time before sleeping
  • being physically active during the day (following concussion guidelines from your doctor)
  • keeping the bedroom a place for sleeping, not working, eating, or watching TV
  • decorating your bedroom in a way that creates a sense of comfort and peace
  • making sure your pillows and mattress aren’t causing physical discomfort

Depending on the nature of your concussion and your symptoms, your doctor may recommend elevating your sleep position slightly to help reduce swelling.

Is it dangerous to fall asleep immediately after a concussion?

It’s a common belief that sleeping immediately after a concussion is dangerous, but this isn’t entirely true. Sleep is not going to worsen your concussion or your symptoms.

The risk is in the concussion itself. If you haven’t had your TBI evaluated by a doctor, there’s no way to know how serious the injury your brain injury is.

Falling asleep and being unable to wake up is a warning sign that your concussion is severe and needs prompt medical attention.

Trying to sleep off a head injury can be dangerous because the injury could be so severe that you need treatment. It could get worse while you’re asleep, potentially even leading to death from the worsening brain injury.

Once you’re getting care in the hospital or cleared by a doctor to go home, it’s perfectly fine to rest after a concussion.

Insomnia is common after experiencing a concussion. Injury to your brain and disruption to your neurotransmitters can cause symptoms across multiple areas of function, including sleep.

Treatment for concussion insomnia will vary depending on your:

  • symptoms
  • concussion severity
  • medical history

However, sleep disturbances can improve with sleep hygiene and behavioral interventions, as well as medications, if necessary.