How Bad Is It Really to Sleep After a Concussion?

Maybe you remember your mother or grandmother warning you against going to sleep after a concussion. But have you ever questioned that advice?

Concussions are serious. And years ago, experts had a good reason for telling people who've had one to avoid going to sleep. The recommendations have changed, though. Here's why, and what you need to know about sleeping after a concussion.

First, it's important to know the symptoms to look for, so you're sure it's a concussion you're dealing with.

A concussion is a traumatic brain injury caused by a bump, blow or jolt to the head. The jarring force can cause the brain to bounce or twist in the skull, which can lead to chemical changes in the brain and potentially damage brain cells, explains the Centers for Disease Control and Prevention (CDC).

A concussion can cause physical signs and symptoms along with changes in thinking and behavior, notes the Mayo Clinic, including:

• Headache
  
• Ringing in the ears
  
• Nausea
  
• Vomiting
  
• Drowsiness or fatigue
  
• Blurry vision
  
• Confusion or foggy thinking
  
• Dizziness
  
• Amnesia (loss of memory) surrounding the event
  
• Slurred speech
  
• Delayed response to questions
  
• Dazed appearance
  
• Forgetfulness
  
• Temporary loss of consciousness
  

Concussion symptoms in kids and teens are generally the same as in adults, though some kids might simply complain that they feel "off" or don't feel right, says the American Academy of Pediatrics.

You might notice other signs in babies and toddlers after a head injury, per the University of California San Francisco Benioff Children's Hospitals. These may include:

• Irritability or excessive crying
  
• Being inconsolable
  
• Loss of interest in their usual activities
  
• Looking like they're dazed or daydreaming
  
• Crying when you move the baby's head
  
• Holding their head
  
• Dizziness or stumbling when walking
  
• Having trouble transitioning from one position to the next (that they were previously able to do) like rolling, pulling to stand or sitting to stand
  
• Sensitivity to light, sound or touch
  
• Refusing to eat or drink
  
• Sleeping more or less than usual
  
• Drowsiness
  

It's safe to let an adult, child or baby sleep after a concussion as long as they've been evaluated by a physician and received a CT scan of their brain. The evaluation and CT scan are crucial, to make sure the person isn't experiencing any bleeding in the brain, explains Anjali Bharati, DO, an emergency room physician at Lenox Health Greenwich Village in New York City.

Years ago, experts warned that long stretches of sleep after a concussion was unsafe.

"This came from the days before we had imaging tests to evaluate for bleeding in the brain, which could cause them to go into a coma," Dr. Bharati says. "So the recommendation was to wake them periodically and ask them simple questions to make sure their condition wasn't getting worse."

Now that CT scans allow physicians to confirm a person's brain isn't bleeding after a head injury, there's no need to keep the person awake. In fact, adequate rest is a must for helping the brain heal, experts say.

According to one September 2021 ‌Journal of Neurotrauma‌ study, sleep is thought to help clear waste from the brain after a traumatic head injury.

It's perfectly fine to check on someone while they're sleeping, of course. You can take a quick peek to make sure their breathing pattern sounds normal and that they seem comfortable. But there's no need to actually wake them up, notes the Cleveland Clinic. (If their breathing ‌doesn't‌ seem normal, get them to a doctor immediately.)

A concussion can have a temporary effect on sleep while the brain heals. Many people are more sleepy than usual for the first week or so after a brain injury; after that, they might have a harder time falling asleep or wake up earlier than usual, notes an April 2016 paper from ‌Neurology Clinical Practice.‌ These disturbances often last for two or three weeks.

"Patients may have a mild headache, nausea or dizziness that prevents them from getting their usual sleep," Dr. Bharati says. "They may also sleep a little more than usual or be more fatigued. These are all normal after a concussion."

Rest helps the brain heal after an injury, so aim to get eight to 10 hours per night while you're recovering, recommend experts at the University of Michigan. Try going to bed 30 to 60 minutes earlier if you're not waking up refreshed in the morning.

If you're having trouble falling or staying asleep, try to:

• Make sure your bedroom is cool, dark and quiet.
  
• Avoid taking naps if possible, especially after the first few days of recovery.
  
• Do a relaxing activity at night to help you wind down (think: reading, meditation, stretching).
• Put your phone and other devices away at least an hour before bedtime.
  
• Don't consume alcohol or caffeine in the late afternoon or evening.
  

Try to take it easy when you're awake, too, especially for the first 48 hours after your concussion. Limit mentally taxing activities like work, schoolwork, reading, watching TV or using the computer, especially if they make your symptoms worse.

You can do light exercise after a concussion, but avoid physical activities that worsen your symptoms, the Mayo Clinic recommends. You can gradually get back to your normal routine when you start to feel better.

It's a good idea to see a doctor after a blow to the head if you or a loved one are showing symptoms of a concussion, Dr. Bharati says. An imaging test like a CT scan can check your brain for signs of a serious injury, including bleeding in the brain.

The Mayo Clinic recommends seeking emergency medical care for concussion symptoms including:

• Repeated vomiting or nausea
  
• Loss of consciousness for more than 30 seconds
  
• Worsening headache
  
• Fluid or blood draining from the nose or ears
  
• Vision changes, or changes to the size of the pupils
  
• Ear ringing that doesn't go away
  
• Arm or leg weakness
  
• Appearing pale for more than an hour
  
• Changes in behavior
  
• Confusion or disorientation
  
• Slurred speech
  
• Clumsiness
  
• Seizures or convulsions
  
• Dizziness that isn't going away
  
• Symptoms that get worse instead of better
  
• In babies and children, large head bumps or bruises in areas other than the forehead
  

Sleep is important for healing after a concussion, so there's no reason to avoid it. Just make sure you or your loved one has seen a doctor and received an imaging test first, to make sure there's no bleeding in the brain.