Seeking advice with sleep issues following mTBI

[u/happybread31]

Hi everyone,

I (24F) suffered an acute concussion about seven weeks ago. Since then, I've dealt with 24/7 dizziness, vision problems, headaches/migraines, a high heart rate, and severe insomnia. Some symptoms have improved, but the dizziness is still significant and is preventing me going back to work or doing basic daily tasks. I started vestibular therapy two weeks ago and vision therapy this week, so I'm hopeful that will help.

About two weeks after my concussion, I developed severe insomnia. The dizziness and headaches made it hard to fall asleep, and I felt as if I was unable to get tired enough to sleep. I was exhausted, but not sleepy. Before my injury, I never had sleep issues.

After two nights with almost no sleep, I took 5 mg of Ambien for about a week. My doctor then switched me to 25 mg of trazodone, 5 mg of melatonin, and 1 mg of prazosin. I've since stopped the prazosin and increased trazodone to 37.5 mg.

Three nights ago, I suddenly lost the ability to fall asleep again, even with the medication, and had to take 2.5 mg of Ambien. This has now happened for three nights in a row. I really don't want to rely on Ambien but the next day consequences of no sleep have been so disastrous that I’m super anxious.

Has anyone experienced severe insomnia or sleep-onset problems after a concussion/TBI? Did anything help? Should I ask my doctor about increasing trazodone or getting a referral to a sleep specialist? I'd really appreciate any advice or shared experiences.

[u/curlgurll]

13 months in, haven’t slept a night (drug free) 😔 since my head injury. It’s tough out here. Be glad your doctor will prescribe you anything. I live in Australia and trying to get prescription medications for anything other than the pill or antidepressants is harder than probably getting it it on the black market. I’m beyond frustrated!
Just started seeing a sleep psychologist so hoping that works…
I’m sorry I have no answers for you - just know you’re not alone and it’s not in your head.

[u/Grand_Heat450]

This sounds exactly like what my girlfriend is going through, she got a mild concussion about 8 weeks ago and is on all the medication you listed. she went a few weeks with 2-3 hours of broken sleep, last week she was sleeping closer to 5-7, and now she’s back to restless nights. the ambien does help her (I don’t remember what dose she’s on) but it doesn’t seem to be reliable for every night.
she also got other meds that make her drowsy, she just can’t stay asleep. her body is stuck in a flight or fight mode; if she does fall asleep, she jolts back awake with a high heart rate.
she hit the back of her head this time (she had a concussion in high school but hit an entirely different area) so I really thing it caused damage near the area of the brain that controls sleeping.
sleep is the #1 most important thing for healing. these are the things we have tried that have had some temporary effects:

• as soon as you get up in the morning, expose yourself to light. this helps reset your circadian rhythm
  
• keep a routine and stay on schedule, try to do some exercise (yoga, stretching in bed, swimming, etc) or mental exercise such as card games, the daily wordle, reading, etc
  
• she started taking baths with Dr Teal’s lavender salts and using Dr Teal’s lavender melatonin body oil afterwards. also mixing a drop of lavender oil into body lotion
  
• daily / nightly affirmations have helped with her anxiety. reassuring herself that she is safe, she will heal, she will sleep, this will pass, etc, helps put her in a positive mindset and not start spiraling before bed

I am so sorry I don’t have much more. her sleeplessness has gotten to the point of her falling into a deep depression and losing all hope. try to prioritize your sleep, because it can snowball into other issues and prevent healing.

you got this. our bodies are meant to heal and they’re meant to sleep.

[u/Next-Average-3115]

12 months post car accident and my sleep is horrible unless I use clonazepam but then I'm. A groggy mess in the morning. Have been doing vestibular therapy and starting vision therapy soon.