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Fatigue After Brain Injury: Why It Occurs and How to Overcome It

woman with fatigue after brain injury rubbing her temples

Extreme fatigue after brain injury is a common but frustrating problem for many TBI survivors. Not only can it make everyday activities more challenging to perform, but it can also interfere with rehabilitation outcomes. Fortunately, there are effective ways to reduce fatigue after brain injury and improve your quality of life.

To help you understand fatigue after TBI, this article will discuss its:

Causes of Fatigue After Brain Injury

Fatigue is one of the most long-lasting and common effects of brain injury. In fact, up to 73% of individuals report fatigue up to 5 years after sustaining their injury.

Various factors can contribute to increased fatigue after TBI. One reason fatigue is so prevalent is because, in the early phases following a TBI, the brain focuses most of its energy on healing. While this is essential for stabilizing the brain after injury, it also leaves less energy to be devoted to other tasks.

Another explanation is the coping hypothesis, which suggests that individuals are more likely to experience fatigue after brain injury because the brain must work harder to compensate for impaired functions.

Moreover, feelings of fatigue may not be directly related to brain injury at all. Instead, they can stem from secondary effects of TBI, such as depression, pain, poor-quality sleep, and endocrine dysfunction.

In the following section, we’ll discuss different types of fatigue that an individual may experience after brain injury.

Types of Fatigue That Can Occur After Brain Injury

Everyone experiences the effects of TBI differently. Fatigue may be more severe for some than for others; however, fatigue is not correlated to the severity of TBI. In other words, fatigue is just as common in individuals with mild TBIs as in those with severe TBIs.

It’s important to understand what type of fatigue you’re experiencing to target your specific symptoms and effectively treat them.

There are 3 primary types of fatigue that an individual may experience after brain injury:

  1. Physical fatigue. With this type of fatigue, you feel exhausted after participating in any sort of physical activity. Even the simplest tasks can cause feelings of exhaustion. It usually is most severe in the evening but gets better after you sleep.
  2. Cognitive fatigue. With this type of fatigue, it is challenging to concentrate. For example, you may find that reading a book or trying to listen to someone talk wears you out quickly. As with physical fatigue, mental fatigue is usually worse at the end of the day.
  3. Psychological fatigue. This type of fatigue shares many of the same symptoms as physical and mental fatigue; however, it does not get better after rest.

The type of fatigue you experience after a brain injury will primarily depend on which areas of the brain are affected as well as the types of secondary complications you experience. While it is possible to experience all three types of fatigue after brain injury, most individuals experience cognitive fatigue.

Is It Normal To Feel Sleepy After A Head Injury?

It is normal to experience fatigue or sleepiness after head injury, with 73% of survivors experiencing fatigue up to 5 year post-injury. There are many reasons why survivors may feel fatigued or sleepy after a head injury, and it’s important to take all factors into account. After a TBI, the brain is healing, and this alone takes up energy, leaving less energy left over for other tasks (the coping hypothesis)

Although fatigue is common and expected, it is also important to pay attention to any patterns associated with it.

For example, because it’s common to experience cognitive fatigue after brain injury, it could be considered normal for a survivors to feel tired after completing a cognitively demanding task, such as reading a book or even playing games. (Games often double as cognitive rehabilitation exercise because they require attention, pattern recognition, comprehension, and many other cognitive skills.)

Furthermore, if a survivor struggles with impaired mobility, they may tire more quickly after light exercise or movement because it takes more energy to move than before injury.

However, if fatigue is overwhelming, or if it’s not associated with an increase in cognitive or physical exercise, talk to your doctor to rule out other conditions such as post-traumatic hypersomnia.

Up next, we’ll discuss the risks associated with unmanaged fatigue after brain injury and why treatment is essential.

Risks Associated with Post-TBI Fatigue

Fatigue after brain injury can significantly affect an individual’s quality of life. For example, it can discourage physical activity, self-care, and socialization. It not only makes it tiresome to participate in everyday activities but can also affect your motivation.

As a result, fatigue can discourage individuals with traumatic brain injuries from pursuing rehabilitation. Many functions affected by brain injury can be relearned and improved because the brain has neuroplasticity. Neuroplasticity refers to the brain’s ability to make adaptive changes and rewire its neural circuitry. The most effective way to promote it is through highly repetitive and specific practice.

However, constantly practicing the same exercises over and over again can be extremely challenging for individuals with fatigue. As a result, fatigue can make it difficult to stay motivated and practice the repetitions you need to improve.

In the following section, we’ll discuss various ways individuals can reduce fatigue after brain injury to improve their quality of life.

Managing Fatigue After Brain Injury

Generally, fatigue is most severe immediately after brain injury. While it may take some time for fatigue to improve, there are ways to manage fatigue and feel less tired throughout the day.

Below, we’ll share some helpful tips for overcoming fatigue after brain injury.

1. Ease into Exercise

Although it may sound counterintuitive, regular physical exercise is an excellent way to combat fatigue after brain injury. Exercise increases endorphin levels in the brain, which helps relieve stress and pain. It also increases oxygen levels in your blood and improves cerebral blood flow, which promotes optimal functioning of the brain.

Unfortunately, with cognitive fatigue, it can sometimes feel like you are stuck in a vicious cycle: you must exercise to beat your fatigue, but you are too fatigued to exercise.

To break this cycle, doctors recommend that you start with a short, simple workout. Then, gradually increase the intensity and frequency of your exercise routine over time. It is okay if you can’t do much at first. Just start with what you can.

home exercise device to help individuals improve energy after brain injury

One of the best ways to do this is with the help of the FitMi. This home therapy device includes 40 exercises for the hands, arms, legs, and core. It adapts to your ability level to make sure you’re being challenged the perfect amount.

Gradually, you’ll develop a better tolerance for exercise and improve your overall physical and mental health.

2. Eat Energy-Boosting Foods 

What you eat significantly affects the way you feel and how much energy you have. Consuming a diet packed with energy-boosting foods such as fruits, vegetables, lean proteins, and whole grains can help reduce your fatigue.

Likewise, try to avoid heavily processed and sugary foods as they can cause extreme spikes and dips in energy levels. Eating five to six smaller meals rather than three large meals may also help reduce fatigue and provide your body with more useable energy throughout the day.

Many of the foods that promote brain function, such as those found in a good brain injury diet, are also great at boosting energy.

3. Reduce Stress

Stress is a major cause of fatigue, and taking steps to reduce it can significantly improve your energy levels.

Yoga and other practices that emphasize mindfulness are great ways to lower your stress and increase energy.  Mindfulness focuses on acceptance and staying present-minded. While it may not be possible for you to do this all the time, try to spend at least ten minutes a day practicing it.

Even just taking a minute or two at various times throughout your day to close your eyes and simply focus on your breathing can help with stress reduction without significantly interfering with your daily tasks. You can also take advantage of the large variety of apps and devices designed to guide periods of mindfulness and remind you to practice throughout your day.

4. Talk to a Sleep Specialist

sleep specialist advising woman on treatments to manage fatigue after brain injury

If exercise and diet changes do not help relieve your fatigue, and you are tired even upon waking up in the morning, you may want to consider talking to a sleep specialist.

Sleep disorders, such as sleep apnea and insomnia, are very common in individuals following TBI, and they can contribute to fatigue. For example, sleep apnea describes when a person’s breathing is disrupted during sleep. This can lead to an excess amount of COin the bloodstream, which can cause extreme fatigue.

A sleep specialist can help identify sleep disorders and recommended helpful treatments to ensure you get a better night’s rest.

5. Talk to Your Doctor About Medications

Medications used to treat secondary complications of brain injury such as spasticity can cause fatigue. Make sure to speak with your doctor about the potential side effects of medications you’re taking and whether there are other options worth considering.

Some doctors may prescribe stimulants to counter fatigue. If you do decide to try stimulants, make sure you do so under close medical supervision.

6. Plan Ahead

Reducing fatigue after a brain injury takes time. Although being ambitious and motivated is essential for recovery, it’s also important to be realistic and avoid overexertion. Planning in advance will help you prepare for the day and avoid doing too much at once.

You can learn to adapt your schedule to your current energy levels by:

  • Taking regular breaks
  • Taking naps and resting before you become tired
  • Splitting up responsibilities throughout the day
  • Allotting extra time to get tasks done
  • Focusing on one thing at a time
  • Avoiding distractions

As your brain gets better at managing a set amount of everyday activities, you can gradually start to increase task load. This will help accustom your brain to performing a certain amount of work at a time and make it easier to add more responsibilities without exhausting yourself.

Fatigue After Brain Injury: Key Points

Fatigue is a common effect of brain injury that can make it challenging to adjust back to your everyday life. However, there are several ways to successfully overcome fatigue. By managing physical activity, diet, stress levels, and sleep quality, individuals can promote optimal functioning of both the mind and body.

Remember to start small and find the right balance of activity and rest that your brain can handle.

We hope this article helped you understand why you’re experiencing fatigue after TBI and how to effectively manage it.

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