Sleep Disturbance

What is Sleep Disturbance?

A sleep disturbance is a change to your regular pattern of sleep. In normal cases, simple sleep disturbances may be caused by using a mobile device in bed, an illness or excessive noise from neighbours. Sleep disturbance following a TBI needs a medical diagnosis as it may involve more substantial conditions such as insomnia, hypersomnia or be occurring as a consequence of other TBI symptoms.

Sleep Disturbance following TBI

Sleep disturbance is a common symptom following TBI with an estimated 30 – 70 % of people with TBI suffering from conditions such as insomnia, fatigue, sleepiness or disruptive sleep patterns.1


Insomnia is the inability to fall asleep, and/ or maintain sleep for a period of at least one month. The lack of sleep makes it difficult to function during the day.2

Following a TBI, insomnia may only be a short-term problem, but can be linked to other symptoms including post-TBI headaches and mood disturbances such as anxiety and depression. For some people, post-TBI insomnia may go on to be a persistent problem for months or even years following their injury.


Hypersomnia is excessive daytime sleeping or sleepiness when a person should be awake. Hypersomnia accounts for around 30% of sleep disturbances following a TBI, with patients who suffer from hypersomnia also reporting fatigue, headaches and cognitive impairment.6 To some extent Hypersomnia is a part of recovery and should be encouraged following a TBI.


Fatigue is one of the most common symptoms following TBI of all severities. At 5 years post-injury, fatigue can still affect up to 73% of patients.3 It is thought that fatigue following TBI may be due to the extra energy needed to complete everyday tasks in the presence of underlying brain damage.4

Further information on fatigue can be found here.

Other TBI Symptoms

Other TBI symptoms are also thought to cause sleep disturbances.5 These include headaches, vertigo (feeling as though you are dizzy or moving when you’re not), and mood disorders such as anxiety and depression.

Further information on Anxiety and Depression can be found here.

Seeking Help

If you are experiencing sleep disturbances after your TBI it is important to seek medical advice as there are treatments and management strategies available.


  1. Orff, Henry J. MS; Ayalon, Liat PhD; Drummond, Sean P. A. PhD Traumatic Brain Injury and Sleep Disturbance: A Review of Current Research, Journal of Head Trauma Rehabilitation: May-June 2009 – Volume 24 – Issue 3 – p 155-165 doi: 10.1097/HTR.0b013e3181a0b281
  2. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders—IV. Washington, DC: American Psychiatric Association; 2000.
  3. Olver, H., Ponsford, J., & Curran, C. (1996). Outcomes following traumatic brain injury: A comparison between 2 and 5 years after injury. Brain Injury, 10, 841–848.
  4. van Zomeren, H. & Brouwer, W.H. (1994). Clinical Neuropsychology of Attention. New York: Oxford University Press.
  5. Viola-Saltzman M, Watson NF. Traumatic brain injury and sleep disorders. Neurol Clin. 2012;30(4):1299-1312. doi:10.1016/j.ncl.2012.08.008
  6. Watson NF, Dikmen S, Machamer J, Doherty M, Temkin N. Hypersomnia following traumatic brain injury. J Clin Sleep Med. 2007;3(4):363-368.