Traumatic Brain Injury and Post Concussion Syndrome For traumatic brain injury (TBI) and post concussion syndrome (PCS).


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Old 05-28-2014, 06:21 AM #1
SuperElectric SuperElectric is offline
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Default Sleep advice?

Since my head injury I've had problems getting to sleep and staying asleep, even when I was prescribed tamazepam the week after my injury I only slept for 4 hours. Before my injury it sometimes used to take me a little while to get off but once asleep I would sleep soundly until morning. Now I just wake up for no reason after a couple of hours and can't settle back to sleep again, I've lost that relaxed sleepy feeling, I must be getting only 3 hours and it's getting frustrating and debilitating, I was hoping it was just a phase but it's not. Having tinnitus since my injury doesn't help.

A while back I was prescribed amitryptaline, an anti depressant, in a low dose (10mg) to aid sleep, I didn't take them because I'd never taken anti depressants so was a bit wary. Now I'm beginning to think I may need something as I'm feeling increasingly down. Another doctor I saw more recently suggested I try a more modern AD -an SSRI like citalopram or mirtazapine but I've read stories about how hard it can be to get off them and how long it takes for them to work. Anyway, I'm thinking of trying the amitryptaline, I figure 10mg is a low dose. Can't get to see a doctor until next week.
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Old 05-28-2014, 08:01 AM #2
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Full disclosure: I did my research and decided that SSRIs absolutely were not for me.

As for the Amitriptyline, when using it as a sleep aid, people sometimes find that they have to keep increasing the dosage. I know TBI patients who claim to have had better results with a newer tetracyclic antidepressant called Remeron (Mirtazapine). Like I said, I can offer no firsthand experience.

When you sleep, do you dream? Do you wake with any sense of refreshment?
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Old 05-28-2014, 08:17 AM #3
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SE,

Amitriptyline at 10 mgs is a common prescription for insomnia. That dose is very low. It is worth a try.

I need to eat a complex carb before going to bed so my body has sleep energy. I also need to be very comfortable, with soft sheets and pajamas so I have no odd sensations to stimulate my senses.
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Old 05-28-2014, 08:46 AM #4
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Sometimes I remember dreaming, I think I might even wake during dreaming. No, I don't feel refreshed when I wake, I don't feel anxious as such but a bit wired. It's as if an alarm goes off at 5am, it's uncanny. It's like I've got into some sort of bad sleep habit.

Basically I don't understand how I can wake up tired, yawn during the day but fail to fall asleep at night, it's bizarre! Maybe I'm getting too much brain stimulation during the day because pre injury I'd be zombied on 3 hours sleep but I'm not now. When I see the PCS neurologist I'll ask for some hormone tests to see what my cortisol and melatonin levels are, I wonder if they might be awry. I'm open to suggestions though.

I tried mirtazapine once, a friend who is on them for depression said they made him sleep so gave me one to try. It certainly made me feel sleepy and relaxed especially when I woke up it was like the old days of waking on a Sunday morning, but it made me constipated and lowered my blood pressure, pretty powerful stuff. I hear coming off them can give you insomnia :-(

EDIT

One other thing lately I feel queasy when I wake up...anyone else have this?
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Old 05-28-2014, 09:27 AM #5
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Quote:
Originally Posted by SuperElectric View Post
Sometimes I remember dreaming, I think I might even wake during dreaming. No, I don't feel refreshed when I wake, I don't feel anxious as such but a bit wired. It's as if an alarm goes off at 5am, it's uncanny. It's like I've got into some sort of bad sleep habit.

Basically I don't understand how I can wake up tired, yawn during the day but fail to fall asleep at night, it's bizarre! Maybe I'm getting too much brain stimulation during the day because pre injury I'd be zombied on 3 hours sleep but I'm not now. When I see the PCS neurologist I'll ask for some hormone tests to see what my cortisol and melatonin levels are, I wonder if they might be awry. I'm open to suggestions though.

I tried mirtazapine once, a friend who is on them for depression said they made him sleep so gave me one to try. It certainly made me feel sleepy and relaxed especially when I woke up it was like the old days of waking on a Sunday morning, but it made me constipated and lowered my blood pressure, pretty powerful stuff. I hear coming off them can give you insomnia :-(

EDIT

One other thing lately I feel queasy when I wake up...anyone else have this?
You might not be entering restorative REM sleep. This can happen with TBI/stroke patients. Sometimes it passes as the brain heals.
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Old 05-28-2014, 10:03 AM #6
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I'm on amitriptylan 50mgs a night (I also have anxiety issues) and I do very well on it. Don't be afraid to try it if you need it. A good night's sleep is one of the most important aspects of recovery.
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What Happened: 3/6/14 I was leaning in to pick my phone off the floor of my car and hit my head on the door frame. No immediate problems but I woke up the following day with blurred vision, nausea, fogginess and memory issues. Headaches came the next day along with speech problems. CT scan was clear. Took a few weeks off work. Went back for half days for two weeks.
Then: 4/14/14 While still recovering from the first concussion I hit my head on the edge of my desk. Immediate headache, nausea and blurred vision. Doctor referred me to a neurologist who prescribed physical therapy for my neck, as I get incredibly stiff/sore necks daily which helps to bring on the headaches. Doctor also referred me to a counselor, who is helping me to cope with the anxiety and panic that has come up in my post concussion world. I deal with severe sensory problems and the frequent bout of aphasia.
And Then : 10/6/14 I was cleaning something (ok cat puke) up from underneath my new glass table when I stood up too fast right into it and voila, trauma #3. I was out of work for a month and a half this time. Noise problems, aphasia, etc.
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Old 05-30-2014, 08:07 AM #7
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A sleep study could help.

My sleep seems to be okay and then I go through phases of unrest.

My sleep study results showed I did not have sleep apnea but I do have interrupted sleep. That night the temp in the room was cool when I went to sleep but shot up hot as the night went on.

I notice I am MUCH more sensitive to well my senses. I need a cotton shirt, soft cotton sheets, a light source (no light at all and I get vertigo easily) a cotton quilt, down pillow on the flatter side to sleep on and a heavier down pillow to put on my head both with cotton cases. I need the temp cool and a fan running (fan must not make variations in sound tones or it's fired) to block out my tinnitus.

Without these things I do not rest well.

I see my sleep neurologist in a few weeks to discuss test results and how to have a more regular sleep pattern. The more of a normal schedule of sleep the better I function all around.

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*TBI with mild to severe damage November 2012 from car crash. Stroke with hemorage & 4 clots in veins in brain Feb/Mar 2015.

*Vestibular damage, PCS, hypercusis, severe visual processing and tracking issues, short term memory loss, headaches/migraines, occipital neuralgia, cognitive issues, neurological issues, brain fog, brain fatigue when over stimulated, twitching, vertigo, neck issues, nerve issues, PTSD, personality change, Since stroke left side weakness, rage, worsening of vestibular problems, recall, speech, memory.

*Can't drive or work. Have done occupational therapy, cognitive therapy, physical therapy. Learning work arounds, and strategies to be competent in daily life. Change your attitude/perspective changes your life. As TBI survivors this is a vital part of our healing and living.

*Working on getting to know and accept the new me.
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Old 06-04-2014, 05:37 AM #8
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Well, I've been trying the amitryptaline, it seems to get me to sleep quicker but I still wake up a couple of times and in the morning I feel depressed and rough for a few hours. Seeing the doc today and ask if I can try some mirtazapine. Last night I slept from 12:30 to 1:30 then from 2 to just past 4 then kind of snoozed from then on. One day I'll sleep a full 6 hours! I was expecting some progress on this but I hear it can take a year before sleep gets better.
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Old 06-05-2014, 01:20 PM #9
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Vitamin B helps me sleep. No clue why. It also makes me have super vivid dreams.
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Old 06-05-2014, 02:06 PM #10
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Sometimes I can sleep pretty well and then at other times, such as right now, I don't, waking up all the time or being 1/2 asleep the whole time and feeling weird (?)

I have a ritual I have to do or get upset (?) like Living_Dazed, have to have a fan on but it has to be the same noise all the time, certain sheets and pillow case, complete darkness.

If the fan is not on I feel like going berserk, don't know why.

My concussion was over a year ago, hope you get some good sleep soon
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