Brain injury recovery sleep connection

Decoding Sleep After Brain Injury: Are You Sleeping More Than You Need To?

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Reese Marlowe in Health & Wellness December 2025 • 4 min read.

"New research sheds light on why some traumatic brain injury (TBI) survivors experience increased sleep duration, and what it might mean for their recovery."


Traumatic brain injury (TBI) can turn your life upside down, and one of the most persistent challenges many survivors face is disrupted sleep. It's not just about struggling to fall asleep; many TBI patients report an overwhelming need for more sleep and a constant battle against daytime fatigue. If you've experienced this, you're likely wondering why it's happening and what you can do about it.

For years, researchers have observed a curious phenomenon: a significant portion of TBI survivors sleep longer than normal, yet they still don't feel rested. This has led to a lot of questions about whether these sleep changes are a direct result of the injury, related to other health issues that arise after TBI, or perhaps even influenced by the medications used to manage symptoms. Pinpointing the cause is the first step in finding effective solutions.

A recent study published in Sleep Medicine has provided valuable insights into this complex issue. By examining the sleep patterns of adults with moderate to severe TBI, researchers aimed to unravel the factors contributing to increased sleep duration in this population. This article breaks down the key findings, offering practical takeaways to help you better understand your sleep and navigate the recovery process.

Unpacking the Connection: TBI and Sleep Duration

Brain injury recovery sleep connection

The research involved comparing 34 adults with moderate to severe TBI (one to four years post-injury) to a control group of 34 individuals without TBI. Participants underwent thorough assessments, including questionnaires to gauge sleepiness, fatigue, mood, and pain levels. They also kept sleep diaries and wore actigraphy devices (wrist monitors that track movement) for seven days to objectively measure their sleep and wake patterns.

Here's what the study revealed:

  • Subjective Complaints: TBI participants reported significantly more sleepiness and fatigue, along with poorer sleep quality, compared to the control group.
  • Objective Measures: Actigraphy data showed that TBI participants had earlier bedtimes and spent more time in bed overall. However, their sleep efficiency (the actual time spent sleeping while in bed) was similar to the control group during the nighttime episode.
  • Napping: TBI participants took more naps during the day and accumulated more total sleep time over a 24-hour period.
  • Medication Matters: These group differences were even more pronounced when considering only TBI participants who were using psychoactive medications.
  • Comorbidity Link: The study also found a positive correlation between comorbidities, injury severity, longer hospital stays, and increased fatigue, sleepiness, and sleep duration.
These findings suggest that while TBI survivors may feel like they need more sleep, their objective sleep-wake schedules aren't drastically different from those of people without TBI. The increased time spent in bed might be an attempt to compensate for fatigue and sleepiness, but it doesn't necessarily translate into better quality or more restorative sleep.

What Does This Mean For You?

If you're a TBI survivor struggling with excessive sleepiness and fatigue, these findings offer a few important takeaways: <ul><li><b>You're not alone:</b> Many TBI survivors experience these challenges.</li><li><b>It's complex:</b> Increased sleep duration is likely influenced by a combination of factors, including the injury itself, related health issues, and medications.</li><li><b>Focus on quality:</b> Prioritize strategies to improve sleep quality and address underlying issues like pain, anxiety, and depression.</li><li><b>Talk to your doctor:</b> Discuss your sleep concerns with your healthcare provider. They can help you develop a personalized plan to manage your symptoms and optimize your recovery.</li></ul>

About this Article -

This article was crafted using a human-AI hybrid and collaborative approach. AI assisted our team with initial drafting, research insights, identifying key questions, and image generation. Our human editors guided topic selection, defined the angle, structured the content, ensured factual accuracy and relevance, refined the tone, and conducted thorough editing to deliver helpful, high-quality information.See our About page for more information.

Everything You Need To Know

1

What specific sleep changes do Traumatic Brain Injury (TBI) survivors commonly experience?

TBI survivors often report an overwhelming need for more sleep and a constant battle against daytime fatigue. The study highlighted that TBI participants reported significantly more sleepiness and fatigue, along with poorer sleep quality. Objective measures indicated earlier bedtimes and more time spent in bed. They also take more naps during the day, leading to increased total sleep time over a 24-hour period.

2

How did the *Sleep Medicine* study investigate the link between TBI and sleep duration?

The study published in *Sleep Medicine* compared 34 adults with moderate to severe TBI to a control group of 34 individuals without TBI. Participants completed questionnaires to assess sleepiness, fatigue, mood, and pain. They also used sleep diaries and wore actigraphy devices to objectively measure their sleep and wake patterns. This allowed researchers to compare subjective experiences with objective sleep data.

3

What role do psychoactive medications play in the sleep patterns of those with TBI?

The study found that the differences in sleep patterns between TBI participants and the control group were even more pronounced when considering only those using psychoactive medications. This suggests that medications used to manage symptoms after TBI can significantly influence sleep duration and potentially exacerbate feelings of fatigue and sleepiness. It underscores the importance of discussing medication effects with a healthcare provider.

4

Beyond sleep duration, what other factors are associated with sleep disturbances in individuals with TBI?

The study found a positive correlation between comorbidities, injury severity, longer hospital stays, and increased fatigue, sleepiness, and sleep duration. This suggests that factors beyond the direct impact of the brain injury itself, such as co-existing health conditions, the severity of the injury, and the duration of hospitalization, can influence sleep patterns and contribute to increased sleepiness and fatigue in TBI survivors.

5

If a TBI survivor is struggling with excessive sleepiness, what are the recommended steps to take?

If a TBI survivor is experiencing excessive sleepiness and fatigue, they should recognize they are not alone, as many survivors face similar challenges. It is important to understand that increased sleep duration is likely influenced by a combination of factors, including the injury itself, related health issues, and medications. Focus on strategies to improve sleep quality and address underlying issues like pain, anxiety, and depression, and most importantly, discuss sleep concerns with their healthcare provider to develop a personalized plan to manage symptoms and optimize recovery.

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