RELIEF FOR INSOMNIA [ back to What's New ]
Following a traumatic brain injury, most persons experience insomnia on a chronic basis. It appears that multiple causes are probably at work. The most obvious factors to consider would be anxiety, depression and chronic pain. These can be treated with medications, and in some instances medications can lessen sleep problems, even if they do not eliminate them. It has been suggested by some physicians that chronic insomnia in TBI patients is due to complex neurotransmitter imbalances, which cause such patients to wake up as much as 40, 45 or 50 times a night, rendering them fatigued rather than refreshed in the morning. Whether or not this is occurring in a given patient can be measured in a sleep laboratory. Unfortunately, even if such a maladaptive sleep of constantly broken sleep is detected, there is at present no sure fire cure for the problem.

Until a therapy is designed to return people with TBI to a normal sleep pattern, doctors will tend to resort to traditional sleep remedies. It has been pointed out that sleep medications may have a negative rebound effect by impairing short term memory or causing day-time drowsiness or mental cloudiness. Neurologists and neuropsychologists who work with patients having this problem agree that some remedies are acceptable, some unacceptable and others uncertain. Going to bed in random fashion with no set routine is bad. Drinking alcohol to sedate oneself backfires, and causes the person to bolt awake in the middle of the night. Smoking or drinking coffee right before bed will keep you awake. Eating a big meal or eating sweets just  before bed will do the same. Napping during the day will also keep you awake. Regular exercise during the day, a glass of warm milk or a warm bath all seem to help people fall gently to sleep. Keeping your room not too hot and not too cold helps. Keeping the mind on pleasant thoughts or images, to block out anxiety, helps. What about Melatonin? This is a human hormone produced by the pineal gland in the brain and is a breakdown product of serotonin. For people who have a true shortage of this hormone, Melatonin in pill form from the health food store may help, but anyone trying this remedy should be aware that no studies exist on the long term adverse effects of taking it. Further the Melatonin sold in pills may be impure, mislabeled or sold in unknown concentrations, which makes dose-response impossible to measure. Anyone contemplating taking a sleep medication, anti-depressant or Melatonin, should discuss it with the neurologist treating their brain injury.