Sleep quality improvement strategies
There are several things you can do to restore your normal sleep ‘rhythm’. For many of us, we have not paid conscious attention to sleep ‘rhythm’ yet we have still functioned seemingly fine. But in the face of a concussion, resetting this to its full potential will be useful for recovery.
It is thought that brain synaptic activity returns to a low baseline rate during sleep as compared to when one is awake, when it consumes 80% of the brain’s energy. Sleep quantity, quality and timing are all important variables that require attention and they are commonly manipulated by athletes to train for success.
Lack of effective sleep can also cause other problems – e.g., cognitive issues, headaches, etc. – in and of itself, further confounding the post-concussion clinical assessment. It is useful to regulate sleep and make it as effective as possible.
1. Sleep habit changes to promote better sleep
a. Always maintain the same bedtime and wake time (even on weekends).
b. Have a fixed bedtime routine. A warm bath/light massage might be nice.
c. Allow 1 hour before bedtime to unwind — avoid screens and bright lights.
i. Only use daytime sleepiness (not fatigue) to guide your decision for taking a nap.
ii. In the first hours/days, naps are a natural part of recovery and shouldn’t be limited.
iii. After this period, naps can interfere in night-time sleep quality and should be avoided.
iv. If you can’t avoid the urge for a nap:
• Limit it to one nap/day
• Keep it shorter than 30 minutes
• Make sure you take it before 3:00 pm
• Nap in your bed and not in another room or in front of the TV
2. Lifestyle & nutritional changes to promote better sleep
a. Avoid consumption of caffeine within 4-6 hours of bedtime.
b. Avoid consumption of alcohol.
c. Consider adding a bedtime snack containing protein.
d. Avoid sugar 4 hours before bedtime.
e. Melatonin production by your brain is important for good sleep rhythm. You need adequate vitamin & mineral intake to make it, specifically, Magnesium, Iron and Vitamin B12.
f. When tolerated and medically indicated, 30-60 minutes of moderate exercise a day – not within 2 hours of bedtime – will help improve sleep.
g. Expose yourself to natural light during the day.
3. Sleep quarters checklist for better sleep
a. Sleeping area should be dark (no source of light), cool, comfortable, neat, clean and quiet.
b. Only use your bedroom for sleep and only sleep in your bedroom.
c. Reading, TV, games, etc., should be done in another room.
d. Remove all electronic equipment from your room. At the very least, switch off all electronics.
e. Don’t look at the time if you do happen to wake up overnight — remove your digital clock from your bedroom.