How Sleep Affects Concussions and Overall Brain Wellness
Get a good night’s sleep. Don’t lose sleep over it. Did you sleep well? Sweet dreams! The many idioms and expressions about sleep in our culture indicate the significance of this basic, yet highly essential, function when it comes to our health. The National Sleep Foundation explains how sleep works, why it’s fundamental to our well-being, and why sleep is critical for our physical and mental development. All this being said, it makes sense that our brain injury specialists often get asked the question: “Does a concussion affect sleep?”
Sleep Disturbances Following Concussions Are Common
Sleep disturbances following a concussion are more common than you probably think. In a 2025 article published in Frontiers of Sleep, researchers from Children’s Hospital of Philadelphia reported that nearly two-thirds of the 4,469 concussion patients aged 5-18 that they studied had self-reported changes in sleep after injury. This was higher than the 51% that had been previously reported in earlier research. And sleep disturbances following a concussion turned out to be the second strongest predictor of prolonged recovery past 28 days in the study population. What’s more,the Model Systems Knowledge Translation Center (MSKTC) reports that a review of sleep disorder studies suggests that sleep disorders are three times more common in traumatic brain injury patients than in the general population.
How Sleep Affects Concussions and Overall Brain Wellness
“Damage to various regions of the brain after a traumatic brain injury (TBI), such as a concussion, can disrupt the sleep process,” say Dr. Vincent Schaller, MD, DABFM, CIC, medical director of Mid-Atlantic Concussion (MAC) Alliance. The types of sleep disturbances during the post-concussion recovery period can include a wide range of symptoms, from someone who feels very sleepy during that first week following concussion to someone who experiences insomnia for several months. “Sleep is a complex operation that requires the brain to basically orchestrate, and if you have a concussion this function can be affected,” says Dr. Schaller.
Types of sleep disorders and syndromes can include:
- Delayed Sleep Phase Syndrome (DSPD): A disorder resulting in a disturbance in normal sleep-wake cycles and patterns that can lead to excessive daytime sleepiness.
- Hypersomnia: A disorder that makes you feel excessively sleepy during the day, even after long stretches of sleep. This is also called excessive daytime sleepiness (EDS)
- Insomnia: A disorder that makes you have trouble falling or staying asleep.
- Narcolepsy: A condition where you are overwhelmed by daytime sleepiness and suddenly fall asleep. It makes it difficult to stay awake for long periods of time, regardless of the circumstances.
- Sleep apnea: a syndrome where breathing stops and starts repeatedly as you sleep. It can be potentially serious, and is often characterized by loud snoring and feel tired even after a full night’s sleep.
- Restless Leg Syndrome (RLS): a condition resulting in an urge to move the legs because they feel uncomfortable, especially at night or when lying down.
In addition, neuro-trauma can disrupt production of neurotransmitters melatonin and serotonin which can result in depression and anxiety, affecting concentration and memory.
Sleep is Critical for Brain Health and Overall Wellness
Every living creature sleeps. The Sleep Foundation says that “the ramifications of sleep deprivation offer strong support to the view that sleep does not have just one biological purpose but in fact, through its complexity, is an important contributor to the proper functioning of nearly all the systems of the body.” Simply put, sleep helps us stay healthy.
Sleep Duration and Quality Impact the Brain
A fascinating recent video from Boston University lets us watch what takes place in the brain while we sleep. Following research in 2013 on how sleep helps us maintain “clean” brains by taking out neurotoxins associated with disease, the Boston University researchers took the concept a step further. They monitored the brain waves of 13 healthy individuals while they slept via encephalography and images of cleansing cerebrospinal fluid (CSF). In this video, we see how brain waves during REM and non-REM sleep triggers this incredible cleansing function.
Addressing Sleep Difficulties with Better Habits
Sleep is an important part of the post-concussion recovery program, and any difficulties or changes in your sleep should be discussed with your concussion specialist, neurologist or medical provider. Even if you are not recovering from a concussion, healthy sleeping habits are important for brain wellness.
12 Tips to Help You Sleep Better:
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- Establish consistent bedtime and rising schedules.
- Create calming bedtime routines (listening to music, stretching, meditating).
- Avoid caffeinated beverages or heavy meals within 4-6 hours before bedtime.
- Limit naps to only once a day, if that, and making sure you take the nap before 3 p.m. and do not nap more than 30 minutes at a time.
- Aim for a dark, cool room and turning off all electronic devices. (That includes cell phones, folks!)
- To improve circadian rhythms, try to have some exposure to daytime sunlight. This can improve natural melatonin production inside the body, and improve both energy and mood.
- Do not use tobacco in any form.
- Breathing exercises or visualization techniques (such as counting sheep or imagining your “happy place”) before sleep or during periods of sleep disturbance may help calm the central nervous system.
- Playing white noise, wave machines, rain sounds improve sleep quality.
- Consume foods that help with sleep, like those with tryptophan (turkey), high in complex carbohydrates (whole grains) and contributing significant levels of vitamin B6 (milk, cheese, leafy greens and more),
- Aerobic exercise for 30 to 60 minutes per day can help improve energy regulation, which in turn can improve your quality of sleep.
- Stop exercising at least three to four hours before bed.
“Sometimes, post-concussion patients are prescribed medications to help them get the sleep they need in order for the brain to repair itself,” says Dr. Schaller. These medications need to be selected on an individual basis, based many factors, including:
- The type and severity of the brain injury sustained
- Medical history
- Other medications currently being taken
- Use of any supplements, such as melatonin, omega 3, etc.
“We want to help improve sleep, not work against it,” says Dr. Schaller.
Immediately After a Concussion: To Sleep or Not to Sleep?
It once was thought that it was critical to keep an individual awake after a head injury, in case they would not wake up after a concussion. But today that is not a steadfast practice. Concussions are not normally physical damage injuries. They are considered functional injuries caused by blows or jolts to the head, and one of the main treatments is indeed cognitive rest, i.e., sleep. Provided an individual is communicating, does not have dilated pupils or problems walking, sleep is fine. In fact, sleep is generally considered beneficial for healing after a concussion.The rule still stands that within 24 hours of head injury patients are instructed to not sleep for more than 2-3 hours straight without someone waking them up, checking their pupils, asking a simple question. This is in case a slow bleed develops during those first 24 hours from the blunt force of the head injury. These 2-3 hours “neuro-checks” allow detection of a change in status that may require a trip to the ER for a CT scan of the head. A CT scan of the head does not rule out a concussion, but it can detect a brain bleed. This is an important fact because a brain bleed can be deadly and may need immediate treatment. So, if during those every-2-to-3-hour “neuro-checks” the pupils are different in size or dilated, if the patient is confused, vomiting, having a severe headaches or unable to be aroused, they should be taken immediately to the local ER to get a CT scan of the head to rule out a brain bleed.
When to Talk to a Concussion Specialist About Sleep Disturbances
Mac Alliance recommends various post-concussion treatments that create an individualized program for each patient, based on their diagnosis, health and medical needs. The brain rest protocol is a key factor. If you have received treatment post-concussion and are still experiencing sleep difficulties, contact you’re your concussion specialist for help. At MAC Alliance, our certified concussion specialists can assist patients throughout Delaware, Maryland, New Jersey, New York, Pennsylvania, Virginia, and Georgia. To find out more, contact us.
[Originally posted on 1.22.2021]
[Post updated on 3.9.2026]
