The question of sleep is very common after a concussion injury.
Can I sleep?
How long should I sleep for?
What if I can’t sleep?
Do I need to be woken up every hour after a concussion?
When should I wake up?
After a concussion, it’s very common for people to feel fatigued. They feel drowsy and tired. They want to go to sleep.
But, can they? Should they?
The idea behind not letting someone sleep is not because of concussion, it came from concerns for something more serious and potentially deadly, like a more serious brain injury ie. a bleed.
The recommendation for years, or the “old way” of concussion management, was to wake up a concussed person every hour – or every two hours – throughout the night.
Why?
If there is a bleed in the brain, the person may become unconscious. But, if they are already sleeping, you would have no idea that they were actually in need of some serious attention.
The direction then was to wake them regularly to make sure that they were easily awoken and not showing signs of deterioration. If you were unable to wake them up or they started to have slurred speech and signs of deterioration, it would be better to catch it earlier rather than in the morning when it may be too late.
This practice of waking people up after a concussion is no longer recommended, and experts suggest there is no benefit.[1,2] In fact, rest is recommended in the acute stage, immediately following injury – up to 24 to 48 hours – prior to guided, gradual return to activity.[3]
The reality is that these more concerning injuries usually show up in the first 3 to 6 hours after injury. Therefore, you should keep a concussed person awake during this time and monitor them. If they show ANY signs of getting worse, or if you are at all concerned, then they should be brought to the emergency room immediately.
It’s important to keep in mind that a concussion is a functional, and not a structural injury. It can sometimes involve loss of consciousness (less than 10% of cases), and although it is rarely associated with bleeds or fractures, you should always be on the lookout for the “Red Flag” signs and symptoms, and immediately go to the hospital if any are present.
Unless your healthcare provider calls for a MRI or CT scan, then a concussed person should follow proper protocol. Rest in the acute stage, followed by guided and gradual recovery.
The same rules apply. You should let them sleep if there are no signs of them getting worse. But, if you are very concerned as a parent or guardian, monitor them throughout the night and wake them up. It won’t do any harm, and will give you peace of mind.
If you or a loved one suffer a concussion, make sure they are properly assessed by a medical doctor or a licensed healthcare practitioner with training in concussion management. If you see any potential red flags, immediately take the concussed person the nearest emergency room or call emergency services.
This article is not intended as a substitute for the medical advice of doctors and/or healthcare professionals. The reader should consult their physician and/or healthcare providers in matters relating to their health, and in particular, with respect to any concussion and/or symptoms that may require diagnosis or medical attention.
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