Why You Should Never Skip the Neck in Concussion Evaluation & Rehab.
Every patient with a concussion is a patient with a neck injury. Let me explain. A concussion results when the brain undergoes such rapid acceleration-deceleration that shearing and stretching of…
Rethinking Concussion Recovery: The Case for Active Rehabilitation Concussions are more than just a bump on the head, or “getting your bell rung”; they are a type of mild traumatic…
Introduction Appropriate concussion management is crucial for ensuring the well-being and long-term health of individuals who have experienced a mild traumatic brain injury. One aspect of concussion management that has…
How Hard is Too Hard? Examining the Forces Behind Concussive Impacts.
Introduction to Concussions A concussion (or mild traumatic brain injury) is a type of traumatic brain injury (TBI) that occurs when the brain experiences sudden movement or impact. This can…
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 Theory: Waking someone up after a concussion
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.
The new thinking: What are the recommendations for sleep after concussion now?
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.
What about kids?
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.
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.
Complete Concussions specializes in collaborative, evidence-based concussion care. Our evidence-based training programs and integrated healthcare technologies empower multidisciplinary teams to implement standardized care for those impacted by concussions.
Our network and patient database enables large-scale research to advance concussion management, and ultimately, the long-term health and well-being of concussion patients and also teach them some concussion care at home.
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