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Sleeping Difficulties

After any injury to the brain, many people struggle with sleep. When you do not sleep well, life is harder. Day time fatigue is worse, depression is worse, thinking is harder.

You may have difficulty falling asleep or staying asleep. Either of these can lead to daytime sleepiness. Sleep apnea is also more common after brain injury. This is brief pauses in breathing during sleep and leads to decreased oxygen to the brain.

Reasons for and how to improve sleeping diffuclties?

After injury, the brain may not work as well at telling the body to fall asleep and to wake up.

Medications may lead to difficulty sleeping.

Daytime napping may make it more difficult to sleep at night.

Pain will make sleep more difficult.

A lack of exercise makes sleeping more difficult.

Depression often makes sleep worse.

Caffeine may keep you awake at night.

Improve sleep hygiene

  • Wake up and go to bed at the same time each day. This is super important for sleep.
  • Get exercise each day.
  • Try to get some sunlight each day.
  • Keep daytime naps to less than 30 minutes.
  • Stop screen time a couple of hours before bedtime.
  • Don’t eat, read, work or watch TV in bed.
  • Use relaxation strategies, such as meditation, music, or mindfulness.
  • Avoid caffeine, nicotine, and alcohol for a few hours before bedtime.
  • If you don't fall asleep in about 30 minutes, get out of bed and do something relaxing until you feel sleepy.

Sleep treatments

  • Treat depression or anxiety with counseling.
  • Phototherapy (light therapy).
  • Over the counter medications such as melatonin.
  • Prescription medications. Avoid medications that cause daytime drowsiness or cognitive difficulties.

Who can help me improve my hand use?

  • Occupational therapists
    • Occupational therapists help people improve their ability to use their arms and hands. They help people regain independence in their daily living skills, such as eating, dressing, and bathing. They can help you relearn to type, to cook. They can help you be more successful at school or work.

    • Occupational therapists help you strengthen weak muscles or improve coordination. They also help you find adaptive devices to make tasks easier. Items such as a built up spoon, a reacher for dressing, a pen grip, or elastic shoe laces can make life easier. There are so many inexpensive devices available to help. Occupational therapists are experts in knowing what devices can help.
  • Physiatrists
    • Physiatrists (doctors specializing in Physical Medicine and Rehabilitation) can help with figuring out how to help improve your hand use. A physiatrist can determine why you are having hand or arm difficulties. Is it weakness, spasticity, decreased coordination, pain, or another issue? He or she can then give you exercises, prescribe therapy, give injections for spasticity, prescribe a brace or determine if surgery might be helpful. Some physiatrists treat patients with brain injury and other physiatrists treat musculoskeletal conditions like back pain. Be sure that the physiatrist you see treats brain injury survivors.