Traumatic Brain Injury (TBI) and Deficits of Sleep: A Review

Posted May 30, 2014 | By csponline

When brain injury occurs, regardless of whether it is associated with a traumatic injury or an acquired injury, the normal flow between activity and rest in the brain can be disrupted. Following these types of injuries, the brain requires extensive time for repair and regeneration. When the brain is able to rest, neuropathways that were disrupted by the injury can be rebuilt. The reconstruction of neural pathways in the brain generally requires more time to heal than other injuries to the body. It can take up to several years to reach full healing potential.

While the brain is in the process of recovery, neuro networks may not follow the usual patterns of functioning. A wide range of brain functions can be changed due to the disruption of neuronetworks. One of the most common changes manifests in a disruption of sleep patterns.

Because the brain’s way of functioning has changed, this may impact its ability to shut down certain areas of the brain. This can cause a lack of sufficient rest, which may contribute to further difficulties for the individual in multiple domains of functioning. When the brain is unable to rest, recovery can slow down, and the individual may experience lethargy and clouded perceptions. Although some of the symptoms may actually result from a brain injury, it should also be taken into account that they could be associated with a lack of sleep as well. It is, therefore, important for individuals struggling with disrupted sleep to discuss the issue with their health care provider.

Some of the symptoms exhibited in this context may include fogginess, frequent yawning, fatigue, irritability, problems concentrating, and memory difficulty. It is often difficult to isolate the specific cause of these symptoms. Following a brain injury it is important to consider that associated consequence may be perpetuated by a lack of adequate sleep. In order to ensure that symptoms are not exacerbated by lack of sleep, it is important to encourage regular and consistent sleep patterns. To support this process, medical professionals often prescribe sleep medication, meditation, relaxation exercises and aromatherapy, or restrict the use of TV or computers prior to bedtime. Cognitive behavioral therapy for insomnia (CBT-I) is another approach used to treat insomnia.

Sleep may be regulated by understanding current patterns of sleep and activity. Monitoring hours of sleep that are logged each night, while identifying activity levels and periods of fatigue throughout the day, may enhance this understanding. This can then be utilized to analyze how lack of sleep or disrupted patterns of sleep possibly impact recovery and daily functioning.

In addition, other aspects can emerge that may be connected to a disruption of sleep, fatigue, and to the recovery from brain injury. Psychological problems, such as post-traumatic stress disorder (PTSD), following a brain injury should also be considered as a contributing factor to inadequate sleep. Anxiety, fear, and panic reactions are frequent in individuals who have experienced traumatic events and may be associated with significantly changed sleep patterns.

When individuals deal with strong emotional reactions to an injury, those feelings may trigger nightmares and stressful dreams, which in turn may result in significant sleep deprivation. This can lead to a catch-22 of sorts in which the individual requires healthy sleep to improve the healing processes of the brain. In this respect, the management of mental health concerns is vital to promote healing and increased functioning as it pertains to brain injury and sleep complaints. Understanding the significant impact a lack of sleep may have on an individual with brain injury is crucial for recovery.

To learn more about how you can enter the field of forensic mental health and the treatment of traumatic brain injuries, visit Concordia University St. Paul’s Forensic Mental Health Certificate and Master of Arts in Human Services – Forensic Mental Health program pages.

About the Authors:

Lisabeth Mackall, M.S. CCC-SLP is a speech-language pathologist with nineteen years of experience treating adults and children with neurological impairments.

Jerrod Brown, M.A., M.S., M.S., M.S., is the Treatment Director for Pathways Counseling Center, Inc. Pathways’ focus is to provide programs and services that benefit individuals impacted by mental illness and addictions. Mr. Brown is also the founder and CEO of the American Institute for the Advancement of Forensic Studies (AIAFS). Email:

See also: Adult FASD Provider Network

Pamela Oberoi is currently the manager of the refugee mental health program at Pathways Counseling Center, Inc.

Gennae Falconer, M.A., is the Director of Community Engagement for the Greater Minneapolis Council of Churches. In this role, she facilitates mentoring programs for kids ages 5-18 and adults leaving prison and re-entering the community. She also coordinates the mission of Urban Immersion Service Retreats (UISR), a program that facilitates trainings to address the complexities of poverty.

Erv Weinkauf, M.A., is a retired 40-year law enforcement veteran who also has 19 years teaching experience. He currently serves as Criminal Justice Department Chair at Concordia University, St. Paul.

Also published on Medium.