Sleep Disorders and Brain Injury

Brain injury and sleep disorders can become a vicious cycle. Brain injuries can cause sleep disorders and poor sleep makes the problems associated with brain injuries even worse. Some of the effects of brain injury and sleep disorders are exactly the same. Correcting or improving sleep disorders in people with brain injuries can also improve the brain injury symptoms. In order to do that you have to understand a little bit about sleep disorders.

A recent study, published in Neurology, found that mild brain injury may increase your likelihood of developing circadian rhythm sleep disorder (CRSD). CRSD is not mere insomnia. It is a disorder of the sleep cycle. Insomnia is simply the inability to fall or remain asleep, and it can be an element or side effect of CRSD. CRSD affects the timing of your sleep.

When CRSD is misdiagnosed as insomnia patients are given sedatives, and the sleep cycle problem is not addressed. The timing of sleep is governed by the release of certain hormones which make you sleepy or alert. While sedatives may help you fall asleep, they will not change the timing of the release of these hormones and, therefore, do not create quality sleep or alertness when awake.

CRSD can cause immediate problems including:
· Irritability
· Difficulty thinking and concentrating
· Insomnia
· Lack of energy during the day
· Headaches
· Gastrointestinal problems

Long term effect of CRSD can include:
· Depression
· Anti-social personality
· Hyperactivity
· Difficulty learning
· Addiction

With some types of CRSD, the solution can be as simple as changing your schedule to fit your sleep cycle, but in reality, not everyone has that option. Other types of CRSD are more problematic and difficult to resolve.

Delayed sleep phase
People we refer to as “night owls” usually have delayed sleep phase CRSD. Most people are aware of this form of CRSD, but don’t realize that it is more than just a preference for staying up and sleeping late. Sleep and waking hormones are produced in the normal amounts and for the normal length of time, but they are released later in the night and day. People with delayed sleep phase CRSD do not sleep well until very late at night, and in the morning are still under the influence of sleep hormones, making it difficult to wake up and interfering with daytime alertness. Most experience a “second wind” in the evening, feeling alert, awake, and at their optimum performance level. If you have this form of CRSD and no other sleep disorders, the good news is that you can get good sleep and adequate rest by simply adjusting your schedule to accommodate your sleep cycle.

Advanced sleep phase
“Early birds,” again not just a matter of taste, this is the exact opposite of delayed sleep phase and can result in becoming sleepy in the afternoon or very early evening. For early birds, like night owls, adjusting your schedule to accommodate your body is the best remedy.

Non-24 hour sleep cycle
A constantly shifting sleep cycle, that does not conform to a 24-hour day and is much more difficult to address with lifestyle change, the non-24 hour sleep cycle is very common in people who are blind because cycles of light and dark help regulate the sleep cycle.

Irregular Sleep/Wake Cycle
The sleep cycle occurs at irregular times of day and often more than once a day, often resulting in only brief periods of sleep and extreme sleepiness during waking hours. Irregular Sleep/Wake Cycle is also very difficult to accommodate with a change in schedule.

Circadian amplitude disorder
When your body does not produce enough of sleeping and waking hormones, you can’t get restful sleep and/or never really feel awake and alert. This cannot be changed by merely adjusting your schedule.