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Are there ways that that survivors can get better sleep and and deal with that fatigue?

This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition.

Clinical Specialist

Answer transcribed from the Brightway Answers interview with clinical specialist Marlene Rivera:

Absolutely. Whether you sustain a brain injury or not there are some sleep hygiene practices that we all can engage in. Being aware of what those are can help you improve the quantity and quality of your sleep.

Assessing your daily schedule, and planning and preparing so that you're proceeding at a pace that meets your current level of cognitive and physical endurance is important. Maybe you're someone who can function with eight hours of sleep, maybe you're someone who can function with six hours of sleep. You really need to figure out what's most productive for you.  If you need to, you can seek out recommendations from a medical professional to see what would best suit you based on your current needs.

Rest breaks are also important.  If I could, I would take a siesta every single day, because resting your mind is really important.  And that again looks different for everyone - some people can take 10-minute power naps, while some people need to be in bed for an entire hour to feel refreshed.  But the most important part of this is to figure out what sleep cycle works best for your lifestyle, then to make that rest time non-negotiable.  You want to create a sleep wake cycle that works for you.

A few other sleep hygiene practices to try are minimizing screen time before you go to bed, setting a specific bedtime for yourself and sticking to it.  I know that's hard especially when we have our Monday to Friday and then different weekends. But for an individual with a brain injury, it might be harder to have those differences in bedtimes and wake times because the routine gets thrown off. If you can set a specific time and stick to it, then you'll have the greatest level of success.

You should consult with a physician as well. There are sleep disorders that might be preventing you from getting better sleep. There are individuals who may have sleep apnea, but you might not even realize you have sleep apnea unless someone has told you. Unless you have someone who can recognize that, you might not even know. So it's important to reach out to a health professional to see if you can get a sleep study done.

There are also mood factors for individuals who have sustained a brain injury. Mood changes can definitely affect sleep as well. The chemistry of your brain has changed and that can impact so many different things, so sometimes that might mean pharmacological intervention.  You may need to take some medications that you didn't have to before. Sleep issues could also be from before your injury, but it's exacerbated after the injury. So again it's definitely something you want to get addressed because it impacts how you function throughout the rest of your day.

To get a sleep study or potentially medication, I recommend starting with your primary care physician. Let your primary care doctor know what's going on and they can make referrals out to whoever you need to go to. They may recommend a sleep center or they may recommend a neuropsychiatrist who can help identify what type of medications to address mood and sleep.

Division Director PM&R

Answer transcribed from Brightway's interview with Dr. Thomas Franz:

Certainly, I think that it starts with a visit to a doctor who is familiar with brain injury or or to a sleep disorder specialist, depending on what kind of problems you're encountering.

You want to start with some simple basic lab work to make sure there aren't those abnormalities for hormone levels in the blood. It may be important to do a sleep study. Sometimes the respiratory drive is off or perhaps because of physical inactivity from paralysis or in coordination after the head injury the person's put on a lot of weight and then they have obstructive sleep apnea. So assessing for those common things first, and making sure those aren't the issue are important.

And then looking at the medicines that are prescribed to see if any of the medications that are prescribed are known for causing fatigue as a side effect? Particularly people who are on seizure medication may find that fatigue is a big side effect of the medicines they're already taking, and it may be possible to change the dosing or change the medicine itself, and so there are a number of ways to address that.

If the person has more of the problems with the racing thoughts, then sometimes training the person in relaxation techniques and mindfulness techniques and meditation may help. Sometimes medications need to be prescribed if the problem is severe.

If there's some underlying issues related to anxiety and coping with the brain injury, where counseling is required, then that may need to be ordered, but starting with somebody who really understands sleep and preferably somebody else who understands brain injury is a good place to to get started with those problems.