Can't Sleep After A Concussion Causes What To Do

Difficulty sleeping after a concussion is more than just an inconvenience—it can significantly slow recovery and worsen symptoms like headaches, brain fog, and irritability. While rest is essential for brain healing, many individuals find themselves trapped in a frustrating cycle: they need sleep to recover, yet the injury itself disrupts their ability to fall or stay asleep. This article explores the physiological and psychological reasons behind post-concussion insomnia, outlines evidence-based strategies to regain healthy sleep patterns, and provides actionable steps to support long-term recovery.

Why Concussions Disrupt Sleep Patterns

A concussion is a mild traumatic brain injury (mTBI) that temporarily alters brain function. Even though structural damage may not appear on imaging scans, the brain’s electrical activity, neurotransmitter balance, and circadian regulation can be significantly disrupted. One of the most common and persistent side effects is disturbed sleep.

The hypothalamus, which regulates sleep-wake cycles, can become impaired following head trauma. Additionally, concussions often affect the production of melatonin, the hormone responsible for signaling sleep onset. Neuroinflammation and changes in cerebral blood flow further contribute to irregular sleep architecture, including reduced REM and deep sleep stages—both critical for cognitive restoration.

“Sleep disturbances are among the most underrecognized yet impactful consequences of concussion. They don’t just result from pain or anxiety—they’re often a direct effect of neural disruption.” — Dr. Laura Greene, Neurologist & Brain Injury Specialist

Common Causes of Insomnia After a Concussion

Sleep problems post-concussion stem from a combination of neurological, physical, and emotional factors. Understanding these causes is the first step toward targeted intervention.

• Neurochemical Imbalance: Concussions alter levels of dopamine, serotonin, and GABA—neurotransmitters involved in mood and sleep regulation.
• Circadian Rhythm Disruption: The suprachiasmatic nucleus (SCN), the brain’s internal clock, may lose synchronization due to trauma.
• Persistent Symptoms: Headaches, dizziness, and sensitivity to light or sound can make it difficult to relax enough to fall asleep.
• Anxiety and Hyperarousal: Many patients develop heightened alertness or worry about recovery, leading to racing thoughts at bedtime.
• Medication Side Effects: Pain relievers or anti-inflammatory drugs prescribed post-injury may interfere with sleep quality.

Tip: Track your sleep and symptoms daily using a journal or app to identify patterns and triggers.

Step-by-Step Guide to Improving Sleep After a Concussion

Recovering sleep after a concussion requires patience, consistency, and a multi-pronged approach. Follow this timeline-based strategy to gradually restore natural sleep rhythms.

1. Days 1–7: Prioritize Rest, Not Sleep
   Focus on reducing stimulation. Avoid screens, loud environments, and cognitive strain. Lie down in a dark, quiet room even if you're not sleeping—passive rest supports healing.
2. Days 8–14: Reestablish Circadian Rhythms
   Wake up at the same time every morning, even on weekends. Expose yourself to natural sunlight within 30 minutes of waking. Limit naps to 20 minutes and avoid them after 3 PM.
3. Weeks 3–6: Implement Sleep Hygiene Practices
   Create a consistent pre-sleep routine: dim lights, read a physical book, practice gentle breathing. Keep your bedroom cool (60–67°F), and remove electronic devices.
4. Week 6+: Address Lingering Issues
   If sleep problems persist beyond six weeks, consult a neurologist or sleep specialist. Consider cognitive behavioral therapy for insomnia (CBT-I), which has proven effective for post-concussion patients.

Do’s and Don’ts: Managing Post-Concussion Sleep

Do’s	Don’ts
Stick to a regular wake-up time	Use smartphones or tablets in bed
Practice relaxation techniques (e.g., diaphragmatic breathing)	Consume caffeine after noon
Engage in light physical activity during the day (with medical approval)	Force yourself to stay in bed if you can’t sleep
Use blackout curtains and white noise machines if needed	Take over-the-counter sleep aids without consulting a doctor
Seek professional help if insomnia lasts more than four weeks	Return to intense physical or mental work before cleared

Real Example: Sarah’s Recovery Journey

Sarah, a 28-year-old graphic designer, sustained a concussion after a cycling accident. Within days, she noticed worsening fatigue but couldn’t sleep more than three hours at a stretch. She felt anxious each night, worrying about missing deadlines and whether her brain would ever recover.

Her primary care physician referred her to a concussion clinic. There, she began a structured recovery plan: morning light therapy, scheduled rest periods, and CBT-I sessions focused on reducing sleep-related anxiety. She eliminated screen use two hours before bed and started journaling to offload racing thoughts.

By week eight, Sarah was sleeping 6–7 hours per night and reported improved concentration. Her case highlights how combining medical guidance with behavioral changes can break the cycle of post-concussion insomnia.

Checklist: Immediate Actions to Improve Sleep

• ✅ Set a fixed wake-up time (even on weekends)
• ✅ Get 15–30 minutes of morning sunlight
• ✅ Turn off screens at least 60 minutes before bed
• ✅ Keep your bedroom dark, quiet, and cool
• ✅ Practice 5–10 minutes of box breathing or progressive muscle relaxation
• ✅ Limit caffeine and avoid alcohol
• ✅ Write down worries in a journal before bed
• ✅ Consult a healthcare provider if sleep issues last beyond 4 weeks

Frequently Asked Questions

Can lack of sleep make my concussion symptoms worse?

Yes. Poor sleep exacerbates headaches, memory issues, mood swings, and fatigue. The brain uses sleep to clear metabolic waste and repair neural connections—skipping this process delays recovery.

Is it safe to take melatonin after a concussion?

In low doses (0.5–3 mg) and under medical supervision, melatonin can help reset circadian rhythms. However, self-medicating is not advised, as improper timing or dosage may worsen sleep fragmentation.

How long does post-concussion insomnia usually last?

For most people, sleep improves within 4–6 weeks as the brain heals. However, 15–30% experience persistent sleep disturbances lasting months. Early intervention improves outcomes.

Conclusion: Reclaim Your Rest, Accelerate Your Healing

Sleep is not a luxury after a concussion—it’s a cornerstone of recovery. While it’s normal to struggle with rest immediately following an injury, allowing insomnia to persist unchecked can prolong symptoms and impact quality of life. By understanding the underlying causes, applying structured behavioral strategies, and seeking timely medical support, you can rebuild healthy sleep habits and give your brain the environment it needs to heal.

💬 Have you or someone you know struggled with sleep after a concussion? Share your experience or tips in the comments—your insight could help others navigate this challenging phase.