Sleep Disorders
 

Hello All,

After years of near perfection, I've finally lost it. Have any of you had trouble sleeping? (It's staggering how many Americans--not just PCS people--have difficulty sleeping.) What are your experiences like? What do you do about it?

Many thanks.

I don't sleep well at all :( I'm lucky if I get 2-4 hours. I go to bed, so exhausted, but them, bam. Eyes wide open. Pain keeps me up.

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Oh. I have tried sleeping pills, they don't work normal on me. My brain is all wired goofy now. So I do nothing. Dr's have wanted me to try different approaches and goofy herbal crap. I will not take that stuff. Not tested. I don't feel safe.

Watch caffeine, trying to cut it out; really. Kids really exhaust me, but still. It's the physical pain. Let me know what you do :)

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I have trouble with sleep disturbances after head injury. I went to see a sleep doctor/pulmonologist and did an overnight and a daytime sleep study. I was diagnosed with mild insomnia and sleep apnea and narcolepsy without cataplexy or excessive daytime sleepiness. I have been treated for the most part with a stimulant and Provigil. It was helpful for a while. I would suggest that you get a referral or see a sleep specialist/neurologist and pursue an overnight and daytime sleep study. do you have names of sleep specialist/neurologist in your area?

It's Still Early
 

Thanks, you guys.

I seem to be in a period of instability. I tend to crash naturally when sleep has been deficient so I actually got enough W. and Th. night (last night), but I had this awful episode last night just after good sleep that ended midnight with all these self-destructive, senseless, obsessive thoughts haunting me, losing my ability to enjoy the companionship of my kitty cats and compelling me to get up and walk around the house mumbling, an unprecedented event . . but then settled down and got some more before my rise time of 3 am!(?) Then today I had a lovely nap in the middle of the day but it made me a little disoriented and depressed. Many sources including Mark warn of over-sleeping. I seem to be swinging from one extreme to another. So my situation may differ from yours.

But I just got some hydroxyzine. It works well on anxiety with virtually no side-effect except drowsiness and maybe dry mouth. I'm against using drugs . . For starters I just want to have something ready for crisis situations . .

I went through a terrible period of sleep disturbance.

For the most part I sleep ok now but I still have those nights where I wake often from a very active mind and strange dreams.

Bud

Hey Bud
 

Bud,

Is your journey posted in more detail somewhere that I can read it? Yours sounds rich and interesting.

I've found several online books on neuroscience that I'm currently gobbling . .

I'm approaching two years and my sleep is still not back to normal. I can't stay asleep for more than about 41/2 hours then have a hard time getting back off again. I think it's central sleep apnea but haven't had it officially confirmed. Sometimes when I wake my pulse is faster than it should be (lack of oxygen?) but mostly I just wake for no apparent reason. I've started taking 5-HTP again to see if it helps as the sleep symptoms are like depression although I feel fine otherwise.

Good news is my mind is better than it was, I seem to be able to clear it and relax deeper, I can day dream again, but I often feel tired in the day which is a bummer. This has coincided with a lessening of my tinnitus which seems to suggest more calming of the brain is needed.

SuperElectric,

Is your journey posted somewhere in more detail that I can read?

I usually wake up frequently, between cycles, but this is not abnormal. Did you use to sleep more than 4&1/2?

It's not uncommon to have difficulty going back to sleep, but one thing I notice in myself is kind of hyperactivity somewhere in my brain probably which can make going back very difficult. It is known that PCS people have excessive activity in the sympathetic nervous system.

Oddly, eating a lot of calories seems to boost this hyperactivity in me. I doubt it's glycemic index, though I do eat potatoes, rice, and pasta. No, what I'm feeling after my injuries seems new.

I had trouble sleeping for my first month after wards but I found that tea helps me so much. I drink the brand sleepy time, and I get their "extra" tea bags. It honestly works like a charm for me. It may be a placebo by now but the act of getting into bed with my hot tea and drinking it gets my body ready for bed and helps me stay asleep up to 8 hours.

This obviously may not work for serious sleep conditions but it helped me get past my bed night time anxiety.

Brown,

I don't know of anywhere my PCS journey is chronicled other than my head. It surely has been interesting.

Feel free to pm anything if you wish. I'm not a wealth of information such as Mark and the others who have been here awhile but I am 22 months down the road now.

Bud

Sleep is especially important for people with PCS
 

Some people think their poor sleep before their concussion is just continuing after a concussion and since it was not a big deal before, it still isn't. But, once you have a concussion, your brain gets flooded with toxins. Poor sleep restricts how the brain can flush out those toxins. The brain purges these toxins during slow wave sleep. This was discovered in 2012. People with PCS or TBI need to have full cycle sleep, especially REM cycle and slow wave cycle.

REM cycle for the neurorepair. Slow wave for flushing the toxins.

REM is also needed for consolidating short term memories into long term. Without long term memories, many get confused and frustrated about day to day life. This can contribute to anxiety. Lack of sleep contributes to many PCS symptoms. Medicated sleep does not accomplish what proper quality sleep does.

I just heard this in a presentation by a neurorehab sleep specialist who follows the latest research and greatest minds in sleep and neurorehab.

Excellent Points
 

Mark! That's right, I've just been reading about some of that stuff . . believe it or not, I've known for decades about the role of REM sleep in consolidation. . it's a fascinating topic. Is your incredible journey posted somewhere in more detail? Lemme know.

Bud! What does pm mean?

Yes, sleep is crucial for recovery which is why sleep problems are so frustrating! I used to sleep a consistent 7/8 hours before my injury so I know it's not a continuation of bad sleep. Sleep patterns can be altered through concussion, it can affect the circadian rhythm and REM sleep. We will go into REM sleep much sooner than normal. No one knows the reason for this, but eventually it will pass.

@brownehn pm means send a private message through the forum ;-) Click on Bud's name and choose send private message.

The value of slow wave sleep in flushing the brain of toxins was discovered when they discovered the glymph system in 2012 that is that drain for flushing the toxins. During slow wave sleep, the neurons shrink 40% in size. That space allows the glymph system to dilate or open up allowing the toxins to flow to the cerebral spinal fluid to be expelled. The glymph system is a very fine sheath over the vascular structure that opens up to a minute level to allow flow. Doctors and researchers had been looking for this drain system for decades.

Brain Blood Flow
 

Mark, how much is known about how blood flow overall to the brain is controlled. Actually it sounds like this glymph system is involved. Why is it that immediately after trauma, blood flow into the brain is reduced?

I've never seen anything that suggest blood flow to the brain is reduced after a concussion. It non-blood oriented intracranial pressure goes up, blood will not flow as freely. Blood flows under pressure. Glymph flow does not have a pressurized mechanism. In the brain, there is a vast valve like network that directs blood flow to where it is needed more. After a concussion, this brain blood flow can get dysfunctional because this blood flow regulating system can malfunction. They do not know why this happens.

I wonder if the bigger problem is this need to flush the toxins out. Many cellular systems need a proper exchange and emptying before new nutrients can enter. Oxygen is a simple on. Oxygen and CO2 exchange places on blood cells so cells can function. When one gets CO (carbon monoxide) poisoning, the CO gets stuck on the hemoglobin so that oxygen cannot properly swap places with it.

If the glymph system is not functioning and allowing toxins to exit the cells, there is no room for the fresh nutrients to enter the cells. It's like a full elevator car. You cannot get on until someone gets off.

So, if one is not getting proper sleep with all the stages, there is no opportunity for the cells to drain off the toxins.

I'm finally managing to get 6 to 6 1/2 hours of sleep these days (2 1/2 yrs post). Initially, I was lucky to get 2-3 hours.

I'm taking 400mg magnesium & 5-HTP (200 mg 2x/day). Over the months, it has had a positive influence on my sleeping. I've never had a problem falling asleep, it's staying asleep that is the issue.

Unfortunately, my headaches are worse again the past 2 weeks and my depression increasing as every time I push myself to do something social, the noise is too stimulating for me & my head is ready to explode.

Just found out about some nasal injections used for headache & hope my concussion doc will do this for me on Wednesday. Any one tried this yet?


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Mark, so actually blood flow WITHIN the brain IS disrupted. I think I read somewhere that this lasts about 4 weeks. I believe they refer to this valve-like control as autoregulation. Good area for further research . .

I'll bet there isn't anything definite, but have there been any studies on sleep of PCS people? I would guess they vary all over the map.

Your comment was about blood flow being reduced. My comment was about blood flow being disrupted. It can flow too much or too little due to this disruption. I've never seen anything about 4 weeks of disruption. Anecdotal evidence says it varies widely. Every brain injury is different.

The glymph system is a passive system from what they can tell. It does not control anything. It functions when the sleep cycle allows slow wave sleep.

They know that people with brain injuries have disruptions to their normal sleep process. They know this impacts the brain's ability to recover. They have discovered a need for them to be disciplined to re-establish proper sleep processes. What else would need to be known ?

My point was that they know that getting the full range of sleep stages is important to recovery.

This whole thing is fascinating.


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It's also been shown that concussion can have an effect on hormone levels which can affect sleep. Typically serotonin production is reduced which can lean to early waking and depression, conversely norepinephrine is raised leading to high anxiety.

This link is long winded but an interesting read and goes into the symptoms.

http://www.drjoecarver.com/clients/4...Imbalance.html

I've known how important sleep is for decades. That's why I'm really concerned when mine deteriorates. It just seems like I'm not sleepy enough whereas my waking brain is a little too alert, focuses too much when it should yield.

I'll read that article, SuperElectric. Thanks. How is your sleep and what are your symptoms etc.?

You too Joannetb.

Also somebody said they think we over-dream. Do you any of you suspect this?

I guess my sleep is typical insomnia, takes a while to get off then wake about 3 or four hours later for no apparent reason. Then I'm wide awake. I have been through short periods where I've slept for about six hours but I've never found out why. I've reached the stage now, after two years, where my other symptoms have gone and I feel optimistic again, so it's puzzling how my sleep issues are lingering. I know what you mean about the feeling of sleepiness is missing. I wonder how you can get that feeling back? That Sunday morning feeling where you just yawn and drift off again.

It is important to understand one's sleep style. Early birds and night owls are genetically predisposed to these traits. Normal wake and sleep times can only be adjusted an hour or so. It makes late shift work all but impossible. The key component is wake time. It should be consistent day to day, 6:00 am to 8:00 am or so. This sets up the sleep system to start to be ready for sleep 12 to 14 hours later.

If you struggle to fall asleep at night, try waking up earlier. Stop all active cognitive efforts and activities 2 hours before your hoped sleep time. Passive activities can help the brain settle down. Many can be sleepy but alert. Set up your sleep environment so you do not have to do anything when that sense of sleepiness happens except turn off a light or two and climb into bed.

If you have a project you were working on cognitively in the evening, make notes of your stopping point with comments about the next step for the next day. In other words, do not take cognitive tasks to bed.

I watch TV shows that I can turn off at any time. Nothing important or that creates a sense of "What comes next?" Reruns are good for this.

If there is a metabolic issue like thyroid, it should be addressed. If a 50 mgs or 100 mgs of 5-HTP helps with serotonin, then use it. For most, it is just poor sleep planning and anxiety or cognitive stimulation.

Do not nap during the day. It resets to sleepiness timer.

Great info Mark.

Brown when, mine is all over the map. I'll sleep for 8 to 9 hours 3 nights in a row, and then struggle for the next 5 nights. Either I have Trouble falling asleep or I wake up in the middle of the night and can't seem to go back to sleep.

I'm going to try Mark's suggestion of really slowing down a couple of hours before to see if that helps.

:)


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Oh, and about dreams. I've had crazy extreme dreams for the last 12 ish years, but that's Effexor as far as I know. Luckily, up until the concussion, those dreams didn't effect me emotionally. I could wake up from a horribly sad dream and simply think 'what a weird dream".

I have noticed the last year that some dreams are actually starting to bother me. I find dreams very interesting, very frightening, and very strange. It could be because my depression has kicked up a bit. Who knows. It's a mystery:)


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I have sure had to develope a lot of new habits....all of which really have been to my benefit in the long run.

In some strange ways I think this accident will be a big help in dealing with old age, I'm not sure I could handle 85 gracefully without some lessons in patience and life.

SuperE...good read.

Bud

Irregular sleeping hours is widely reported by PCS people.

I JUST STARTED this, a little bit back last Week (8) and now this Week. For example, Wed. I slept well, getting near 8 hours (which actually I think is more than I need). Suddenly on Th. and F. I struggled to fall and then stay asleep and only got somewhere around 5 or 6. Sa. I slept another 8 but the next day felt tempted--resisted--to nap during the day. The two periods feel different (see also my 'Journey' thread): during the difficult sleep period I develop this odd dread as the day nears the end. During the easy period I feel relaxed and maybe a bit too hyped at times, but closer to my normal self. Though it's not unusual to have stressed periods, the way these two conditions flips back and forth is abnormal.

I've just learned something important. This may apply to many situations with erratic hours.

If you want to sleep better, do more during the day.

This doesn't say you HAVE to do more.