Illustration of a person sleeping peacefully in a bed, symbolizing sleep and recovery after a traumatic brain injury

Decoding Sleep After Brain Injury: Why You're Tired and What You Can Do

Samir D’Costa in Health & Wellness December 2025 • 5 min read.

"New research sheds light on persistent sleep disturbances following moderate to severe traumatic brain injuries, offering hope and actionable insights."

Dealing with the aftermath of a moderate to severe traumatic brain injury (TBI) can be a long and winding road. Alongside physical challenges, many individuals experience persistent sleep-wake disturbances, often characterized by excessive daytime sleepiness and an overwhelming sense of fatigue. Understanding these challenges is the first step toward finding solutions.

A recent study, published in Sleep Medicine, has delved into the intricacies of sleep patterns in individuals with chronic TBI. Researchers aimed to uncover whether these sleep disturbances are linked to irregular sleep patterns or stem from TBI-related factors. The study also considered the impact of TBI severity, common health conditions, and the use of medications on sleep.

This article breaks down the key findings, offering a clearer picture of the sleep struggles faced by TBI survivors. We'll explore the connections between sleep duration, fatigue, medication use, and overall well-being. More importantly, we'll discuss actionable strategies to improve sleep and reclaim a better quality of life.

Why Sleep is a Challenge After Brain Injury: Unpacking the Research

Illustration of a person sleeping peacefully in a bed, symbolizing sleep and recovery after a traumatic brain injury

The study compared 34 adults with moderate to severe TBI to a control group. Participants completed questionnaires to assess sleepiness, fatigue, sleep quality, mood, and pain levels. They also kept a sleep diary and wore an actigraphy device (like a sleep-tracking watch) to monitor their sleep-wake patterns over seven days. This comprehensive approach allowed researchers to gather both subjective experiences and objective data.

The results painted a clear picture: Compared to the control group, individuals with TBI reported higher levels of sleepiness and fatigue, along with poorer sleep quality. Actigraphy revealed that TBI participants tended to go to bed earlier, spend more time in bed, and take more naps during the day. The findings also highlight the impact of medication; TBI patients using psychoactive medications showed more pronounced changes in their sleep-wake schedules.

Increased Sleepiness and Fatigue: TBI survivors commonly experience heightened daytime sleepiness and fatigue, impacting daily activities.
Extended Time in Bed: Individuals often spend more time in bed than the general population.
Impact of Medication: Psychoactive medications appear to influence sleep patterns, potentially exacerbating certain issues.

The researchers found a strong link between the severity of the injury and sleep disturbances. Factors like injury severity scores and longer hospital stays were associated with increased fatigue, sleepiness, and longer sleep duration. Moreover, the study highlighted the connection between psychological factors, such as anxiety and depression, and sleep quality. These connections underscore the importance of addressing both physical and mental health when treating sleep issues after TBI.

Taking Action: Improving Sleep and Quality of Life After TBI

The research emphasizes the importance of a holistic approach to managing sleep disturbances following TBI. Addressing fatigue, sleepiness, and psychological well-being can significantly improve the quality of life. If you're experiencing sleep difficulties after a brain injury, consider the following steps: Consult with a healthcare professional specializing in TBI to get personalized advice. Practice good sleep hygiene, such as establishing a consistent sleep schedule, creating a relaxing bedtime routine, and optimizing your sleep environment. Explore therapies such as cognitive behavioral therapy for insomnia (CBT-I), which can teach you effective strategies to manage sleep problems. Consider joining a support group or connecting with others who understand your experiences. Remember, taking proactive steps can lead to better sleep and a more fulfilling life after TBI.

About this Article -

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Everything You Need To Know

Why do people often feel so tired after experiencing a moderate to severe traumatic brain injury (TBI)?

Following a moderate to severe traumatic brain injury (TBI), individuals commonly experience persistent sleep-wake disturbances, leading to excessive daytime sleepiness and overwhelming fatigue. This stems from irregular sleep patterns and TBI-related factors, including the severity of the injury, co-occurring health conditions, and medication use. Research indicates that injury severity scores and longer hospital stays are associated with increased fatigue, sleepiness, and longer sleep duration. Psychological factors, such as anxiety and depression, further impact sleep quality, highlighting the complex interplay between physical and mental health in post-TBI sleep disturbances.

How do sleep patterns change after a moderate to severe TBI according to recent research?

Research indicates that individuals with moderate to severe TBI often exhibit altered sleep patterns. Actigraphy studies reveal that TBI participants tend to go to bed earlier, spend more time in bed, and take more naps during the day compared to control groups. These changes contribute to higher reported levels of sleepiness and fatigue. The use of psychoactive medications can also exacerbate these sleep-wake schedule changes, further disrupting normal sleep patterns. Understanding these specific shifts is crucial for developing targeted interventions to improve sleep quality after TBI.

In what ways do medications affect sleep after a moderate to severe traumatic brain injury (TBI)?

Medications, particularly psychoactive medications, can significantly influence sleep patterns after a moderate to severe traumatic brain injury (TBI). Research suggests that TBI patients using psychoactive medications show more pronounced changes in their sleep-wake schedules. These medications may exacerbate certain sleep issues, potentially increasing daytime sleepiness or disrupting nighttime sleep. It's important for healthcare professionals to carefully consider the impact of medications on sleep when treating individuals with TBI and to explore alternative options or adjust dosages when necessary to minimize sleep disturbances.

What practical steps can individuals take to improve their sleep and overall quality of life after a moderate to severe traumatic brain injury (TBI)?

To improve sleep and quality of life after a moderate to severe traumatic brain injury (TBI), a holistic approach is essential. Consulting with a healthcare professional specializing in TBI can provide personalized advice. Practicing good sleep hygiene, such as establishing a consistent sleep schedule, creating a relaxing bedtime routine, and optimizing the sleep environment, is crucial. Therapies like cognitive behavioral therapy for insomnia (CBT-I) can teach effective strategies to manage sleep problems. Additionally, joining a support group or connecting with others who understand these experiences can offer emotional support and practical tips.

How do psychological factors like anxiety and depression relate to sleep quality after a moderate to severe traumatic brain injury (TBI)?

Psychological factors, such as anxiety and depression, are strongly connected to sleep quality after a moderate to severe traumatic brain injury (TBI). Research highlights the relationship between these psychological conditions and impaired sleep. Anxiety and depression can lead to difficulties falling asleep, staying asleep, or experiencing restful sleep. Addressing both the physical and mental health aspects is crucial when treating sleep issues in TBI survivors. Integrating mental health support, such as therapy or counseling, alongside sleep-focused interventions can improve overall well-being and enhance sleep quality.