By Lauren Fournier, PT, DPT
Most concussion symptoms will improve within a month, but 20-30% continue with post-concussion syndrome. Patients with slow concussion recovery are more likely to continually visit health-care professionals, miss school and, therefore, their parents need to take more time off of work.
The most common lingering symptom is insomnia, which is defined as difficulty falling or staying asleep, restriction in the number of hours of sleep or feeling that sleep is not refreshing. Studies have shown that the worse the insomnia, the worse the post-concussion symptoms (i.e. headaches, balance problems and dizziness, worse anxiety and depression, as well as more self-reported problems with attention and memory).
One successful treatment is a type of psychotherapy — called cognitive behavioral therapy for insomnia (or CBT-I). Another proven approach is setting and sticking to a regular wake-up time or sleep schedule. Although it may feel hard at first, it gets kids back to normal activities and it helps to ensure that when bedtime comes, they are actually tired. Also, if a child isn’t sleeping, they shouldn’t be lying in bed. If they need to rest, doing so on the couch is just fine. Finally, there should be no electronic devices in bedrooms. Unfortunately, they are known for disrupting sleep, even when they are turned off! The American Academy of Pediatrics recommends bedrooms be 100% media-free zones, meaning it would be best to remove all electronics from bedrooms.
The main take-home message is that concussion-related insomnia is a treatable problem, and that by improving sleep, concussion symptoms may also improve.