Hi all,

I'm curious as to whether any of you out there who don't have sleep troubles still feel the fatigue associated with PCS? I'm wondering whether my fatigue would significantly decrease if I could get my quality of sleep improved or if it's just a part of PCS that you feel fatigued even if you sleep well.

Any of you out there that don't have sleep troubles but still feel fatigued? I remember with my first concussion that once I got my sleep quality back (which wasn't a linear development at all, it just came back suddenly just like that), everything got better very quickly.

I can say for certain that when I do not sleep well, I can get easily fatigued. Often, I will have a foggy day with times when I just want to close my eyes.

If I sleep well, my chance of fatigue goes down sharply.

What is your routine in the 4 hours before you try to sleep ?

I have dinner around 8-9, either watch some shows on TV or play video games until 12 which is when I usually go to bed. Maybe these things are too stimulating; especially the video gaming. I've recently started taking l-tryptophan an hour prior to going to bed. Also, I'm on your vitamin regimen and I take my vitamins with my dinner. I've been wondering whether I should take them in the morning instead. The only one I take in the morning instead of at night is B-12.

My issue is that it takes me a while to fall asleep and I can never get more than 4-5 hours of uninterrupted sleep. I wake up like 3-4 times a night and always wake up before my alarm..

Video games need to stop at least 2 hours before bed. Stimulating TV should also be limited those last 2 hours.

Do you wake up ready for the day before your alarm or is this just one of those many times you wake up but decide to get up because you know the alarm will go off soon ?

What times does you alarm go off ?

Why do you eat so late ? Do you work late ?

I set my alarm at 9 and I wake up at like 7:30, 8 most of the time. I'll try to go back to sleep but it usually just ends up being tossing and turning and not actual sleep. On top of that I wake up multiple times throughout the night, sometimes as soon as 2 hours after I went to sleep.

I'm done working at around 6:30. By the time I get home, get settled, cook etc. it's like 8-9.

i have terrible fatigue.. absolutely awful especially when i try to do any work. i wake up very tired in the morning as well even though i fall asleep quickly. mark: do you have any suggestions on fighting the fatigue? my sleep has always been pretty bad but i was never this fatigued with mental work as i am now.

If you wake up tired, you either are not sleeping good or you are not breathing properly during your sleep. people with sleep apnea usually have no problem going to sleep. They just struggle to sleep soundly as they gasp for air during their sleep. They also are tired during the day.

A sleep test can be helpful. A take home sleep test will show how you sleep in your own bed. My father-in-law did one last week at the sleep lab and did not sleep well in a strange bed. A portable recording pulse-ox system will track your O2 as you sleep. A couple hundred dollars will buy a high tech version with USB and bluetooth connectivity.

I had horrible insomnia for several months earlier on in my recovery and the fatigue was unbearable. About 5 months ago I finally started sleeping well. Now I sleep 9-10 hours a night straight through, and it is amazing. I still fatigue easily, but it has been slowly getting better. So yes, it is still somewhat there even with good sleep, but not nearly as bad as with bad sleep. I feel like the fatigue for me will be one of the last things to go away.

I had sleeping problems early on after not sleeping for 3 night straight (A streak that was started by police banging on my apartment door at 1am looking for my roommate who had holed himself up in his office to work for a few days without telling anyone, so his girlfriend called the police. The police found him, oblivious in his office, watching a romcom instead of working. I often wonder if my recovery would have gone differently were it not for this).

I was put on klonopin (something every doctor I've talked to since winces when he/she hears) for 2.5 months to help with sleep. I've had bouts of waking and not being able to get back to sleep, but I think generally increasing my activity level, especially exercise, has helped me sleep better.

I do still wake up once or twice, rarely 3 times a night, usually to go to the bathroom, but I don't have much trouble falling back asleep. I did this before the concussion though. Sleeping straight through the night would be great, but I don't think it's absolutely necessary to have restful sleep. Before modern light pollution, apparently many people would wake for a couple hours in the middle of the night, experiencing a strange calm/alertness, which some have described as an altered state of consciousness.

I didn't start having massive fatigue until about 5-6 months after my concussion. I couldn't figure out why, but thanks to a friend who was then seeing the SLP I'm seeing now, I think I did. For the first 4 months or so, I was recovering from whiplash. That kept me from doing a lot of physical activity, including dance, which was a huge social and emotional thing for me. Once I got the OK to start dancing again, I did, a little at a time. I think adding this to working full time and still dealing with the cognitive symptoms of PCS kind of put me over the edge.

The way my SLP explains it is this: Imagine a circle, then divide it in half. Divide one of those halves into 3 parts: Mental Energy, Physical Energy, Emotional Energy. The entire circle represents your daily 'allotment' of brain energy, and the 3 small sections are the amounts of energy a non-brain injured person would use on an average day. The large empty half is surplus energy. If you have a big test, or are running a race, or have a major fight with a partner, you might need to borrow some of that surplus. But usually, there's a lot left over at the end of the day.

Now, imagine another circle. Divide this one into four parts. Label 3 of them as Mental Energy, Physical Energy, and Emotional Energy. That's how much brain energy it takes for a brain-injured person to get through an average day. That remaining one-fourth is all the surplus that's left, and it's a lot easier to not only need that surplus, but to actually use it up. That's where the brain fatigue comes in.

She also told my friend and I that in her experience, the after-effects of one of these heavy days often takes about 48 hours until it really hits. And that was exactly what was happening to me. I'd have a day where something came up, I dealt with it, and felt really good about myself...and then 2 days later, I couldn't get out of bed in the morning. Sadly, it didn't matter if it was "fun" energy (like dancing), either. Too much was too much. And it didn't have anything to do with sleep.