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To Sleep or Not to Sleep…

The question of sleep is very common after a concussion injury…..

Courtesy of CCMI – Complete Concussion Management

  • Can I sleep?
  • How long should I sleep for?
  • What if I can’t sleep?
  • Do I need to be woken up every hour after a concussion?
  • When should I wake up?

After a concussion, it’s very common for people to feel fatigued. They feel drowsy and tired. They want to go to sleep.

But, can they? Should they?

The idea behind not letting someone sleep is not because of concussion; it came from concerns for something more severe and potentially deadly, like a bleed.

The Theory: Waking someone up after a concussion

The recommendation for years, or the “old way” of concussion management, was to wake up a concussed person every hour – or every two hours – throughout the night.

Why?

If there is a bleed in the brain, the person may go unconscious. But, if they are already sleeping, you would have no idea that they were actually in need of some serious attention.

The direction was to wake them regularly to ensure they were easily awoken and not showing signs of deterioration. If you could not wake them up or they started to have slurred speech and signs of deterioration, it would be better to catch it earlier than in the morning when it may be too late.

The new thinking: What are the recommendations for sleep after concussion now?

This practice of waking people up after a concussion is no longer recommended, and experts suggest there is no benefit. [1,2] Rest is recommended in the acute stage, immediately following injury – up to 24 to 48 hours – before guided, a gradual return to activity. [3]

The reality is that these more concerning injuries usually appear in the first 3 to 6 hours after injury. Therefore, you should keep a concussed person awake and monitor them. If they show ANY signs of getting worse, or if you are concerned, they should be brought to the emergency room immediately.

It’s essential to keep in mind that a concussion is a functional and not a structural injury. It can sometimes involve loss of consciousness (less than 10% of cases). Although it is rarely associated with bleeds or fractures, you should always look for the “Red Flag” signs and symptoms and immediately go to the hospital if any are present.

Unless your healthcare provider calls for an MRI or CT scan, a concussed person should follow proper protocol. Rest in the acute stage, followed by guided and gradual recovery.

What about kids?

The same rules apply. You should let them sleep if there are no signs of them worsening. But, if you are very concerned as a parent or guardian, monitor them throughout the night and wake them up. It won’t do any harm and will give you peace of mind.

If you or a loved one suffers a concussion, ensure they are appropriately assessed by a medical doctor or a licensed healthcare practitioner with training in concussion management. If you see any potential red flags, immediately take the concussed person to the nearest emergency room or call emergency services.

If you have a concussion and need some help, give us a call! Our physiotherapists trained in complete concussion management will help you get back on your feet.

Services Offered:

Baseline Testing
Concussion Management
Physiotherapy
Vertigo & Vestibular Rehabilitation

Related Conditions:

Concussions

Patient Resource Guides:

Concussion Myth Busting

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