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TBI Sleep Disorders: Types, Causes, and Treatments

Woman asleep at laptop because she's suffering from TBI sleep disorders

Sleep disorders are some of the most disabling effects of TBI. If left untreated, they can severely set back your recovery.

In today’s article, we’re giving you all the info you need to know about the most common TBI sleep disorders, including the best ways to treat them.

Let’s get started!

TBI Sleep Disorders

Your brain does its most heavy repair work when you are asleep, because that’s when it can devote all its energy to healing. Without enough restful sleep then, your recovery will slow down.

Lack of sleep also worsens all of your cognitive functions.

That’s why it’s so important to educate yourself on the various sleep disorders you can develop after TBI. The sooner you treat them, the less damage they will cause.

What Causes Sleep Disorders After TBI?

Most TBI sleep disorders happen when the brain structures that control your sleep patterns get damaged.

While the entire brain works together to keep you awake and help you fall asleep, there are three areas that play a pivotal role in the sleep/wake cycle:

  • Brain stem. The brain stem houses the reticular activating system (R.A.S.), which helps you stay awake. When you sleep, the brain stem inhibits the R.A.S.
  • Pineal gland. The pineal gland is the part of the endocrine system that resides in the brain. This gland releases a hormone called melatonin, which relaxes your brain and makes you sleepy.
  • Hypothalamus. The hypothalamus is the one in charge of the sleep cycle. It sends signals to both the brain stem and the pineal gland and tells them when to put you to sleep or wake you up.

In addition, there are a whole slew of neurotransmitters involved that help you stay awake or asleep, such as histamine and dopamine.

If a TBI upsets the delicate chemical balance of those transmitters, or impairs the three brain regions above, you will experience sleep problems.

Types of TBI Sleep Disorders

TBI doesn’t only make it difficult to get enough sleep. It also affects the quality of the sleep you do get.

In fact, there are five major sleep disorders that can arise after brain injury. We’ll discuss each one in more detail below.

1. Insomnia

man wide awake at night suffering insomnia, one of the most common TBI sleep disorders

If you can’t sleep after your head injury, you most likely have insomnia.

Insomnia is by far the most common TBI sleep disorder. Between 30% to 50% of TBI patients experience insomnia.


Some ways to overcome insomnia include:

  • Create healthy sleep habits. Changing your lifestyle can help you get your sleep under control. Try waking up and going to bed at the same time each day and make sure you exercise regularly.
  • Use natural sleep remedies. Herbal tea and melatonin can help relax your mind and get your sleep cycle back on track.
  • Try medications. If nothing else works, your doctor can prescribe medications that will help you sleep. You should only use these as a last resort, though, because some drugs cause daytime drowsiness and cognitive problems.

2. Hypersomnolence

On the opposite end of the TBI sleep disorder spectrum is hypersomnolence.

This disorder causes people to sleep too much. They will take naps throughout the day, have difficulty waking up from naps, and will feel disoriented when they do.

Sometimes people with insomnia will experience daytime sleepiness, but this is not the same thing.

3. Narcolepsy

woman asleep at office desk, her coworkers are looking at her

It’s easy to confuse hypersomnolence with narcolepsy, but they are in fact separate conditions.

The primary difference between narcolepsy and hypersomnolence lies in the quality of sleep each has. A person with narcolepsy will fall asleep without warning, sometimes while they are in the middle of talking. However, they don’t sleep very long and feel refreshed when they wake up.

People with hypersomnolence, on the other hand, feel tired before they fall asleep, and they will sleep for hours if you let them. Their sleep never refreshes them either, unlike narcolepsy.


The best way to treat both narcolepsy and hypersomnia is through medication. Doctors will usually prescribe a stimulant such as modafinil.

Modafinil is not as addictive as older stimulants and does not cause as many side effects.

Some antidepressants can also help you stay awake. Talk to your doctor to find the right medication for you.

4. Circadian Rhythm Disorders

Other common TBI sleep disorders will disturb your circadian rhythm.

The circadian rhythm, also known as your sleep/wake cycle, is your brain’s internal clock that helps it know when to rest and when to stay alert.

Normally, this cycle is pretty regular, and is triggered by light. When your eyes detect darkness, they send a signal to your hypothalamus, which in turns sends a signal to the pineal gland.

The pineal gland then releases melatonin, which tells your body it’s time to sleep. That’s why most people get sleepy once the lights go out.

After a brain injury however, this process can break down. Either the pineal gland will stop producing melatonin, causing you to stay awake at night, or it will release melatonin at the wrong time, making you fall asleep during the day.


The best way to beat this problem is to reset your circadian rhythm. You can do this by going to bed at the same time every night and taking melatonin supplements right before bed.

You’ll also want to avoid watching TV or reading on the computer for about an hour before bed. The blue light of the screens can trick your brain into thinking it’s still day and will prevent melatonin production.

5. Sleep Apnea

man snoring because he has sleep apnea caused y brain injury

Sleep apnea causes a person breathing difficulties while they sleep.

This can happen because of damage to the brain stem, which controls breathing, or because the person’s soft palate (the muscle behind the roof of your mouth) lowers down and blocks their airways.

Either way, sleep apnea is a dangerous condition that causes oxygen deprivation, which can lead to further brain damage if left untreated.

Sleep apnea can also cause parasomnias, such as sleepwalking or violent sleep behavior, which put the person at risk for injury.


Treatment for sleep apnea usually involves a CPAP machine that helps you breathe safely at night. You can also try to strengthen your soft palate with exercise, which will keep it from slipping down and blocking your throat.

Traumatic Brain Injury and Sleep Disorders

Sleep disorders cause fatigue, slow your thinking, and make it hard to function in general.

But for TBI patients, sleep disorders are even more serious, because their brains are already compromised. Lack of sleep can set back recovery, or even worse, cause significant brain damage.

However, as this article shows, these disorders can be overcome. With the right treatments and habits, you can finally have a peaceful night’s sleep again.

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