Top tips for a good night's sleep

Sleep and rest are effective ways to reduce the symptoms of fatigue, one of the most common effects of a brain injury. However, for many brain injury survivors, a good night’s sleep isn’t always easily achieved.

Despite being extremely tired, many people have difficulty falling asleep, staying asleep, or waking too early in the morning. A lack of sleep has many negative effects on a person’s physical and mental wellbeing, especially in the early stages of brain injury recovery. It may also exacerbate some of the symptoms of the brain injury, such as memory loss, lack of concentration, poor balance and mood changes.

It is important to remember that increased sleep need and napping in the daytime can be an important part of the brain healing process and this should not be interfered with in the early stages of recovery.

We’ve put together some top tips to promote a good night’s sleep:

1. Routine

Try to go to sleep and wake up at the same time each day. This helps to regulate your body’s internal clock.

If you work full-time during the week it might be tempting to lie-in late at the weekends, however doing so can disturb your natural sleep-wake rhythm.

2. Bedroom environment

The mind has a strong association between the bedroom and sleep. Therefore, it is important to create a relaxing environment free from electronic gadgets, bright lights and noise.

Ideally, the bedroom should be dark, quiet, tidy and kept at a temperature somewhere between 18C and 22C.

Thick curtains or black-out blinds can be useful for blocking out natural light and, if noise is a problem, consider investing in some earplugs.

3. Switch off technology

Electronic devices, such as TVs, mobile phones and computers, emit high levels of blue light.

Sleep experts recommend switching off such technology at least two hours before bed.

This is because blue light exposure can trick your brain into thinking it’s still daytime and reduce the quality of your sleep.

4. Don't consume caffeine too late

Used in moderation, caffeine maybe beneficial for enhancing focus and energy for some people. However, if consumed too late in the day it can have a negative impact on a person’s ability to fall asleep and on their sleep quality.

One study found that participants who consumed caffeine up to six hours before bed had a significantly reduced sleep quality.

Therefore, it is best to avoid drinking coffee, tea, or large quantities of caffeinated soft drinks after lunchtime.

If you enjoy a cup of tea or coffee in the evenings, stick to decaffeinated options. You can also try herbal or fruit teas, but speak to your doctor if you are on any medications to ensure they do not interact.

Remember that a lot of fluid consumed late in the day may cause rising during the night to visit the bathroom, this is a major cause of sleep disturbance. Try to limit fluid intake in the two hours before bed.

5. Reduce napping

It can be very tempting to nap during the day, and sometimes necessary, especially if you’re living with brain injury-related fatigue.

However, if you have difficulty falling asleep at night, long daytime naps might be the problem as they can confuse your internal clock and reduce your sleep drive.

It’s important to remember however, that the effects of napping depend on the individual. Some brain injury survivors might need to nap more than others as a result of their fatigue.

If you’re concerned about how napping might be affecting your sleep, speak to your GP about your circumstances.

6. Use relaxation techniques

If you have trouble falling asleep, relaxation techniques may help. Here are just a few that might help:

• Breathing exercises – Turn your attention to your natural breathing pattern and concentrate on the air leaving and entering your nose or mouth. Visualise your breath flowing through your body.
• Guided imagery – Focus your attention on a scene, memory or story that you find calming. For example, a favourite holiday destination or a relaxing activity. Whenever you find your mind drifting onto an unrelated thought slowly let it go and turn your mind’s eye back to your relaxing story.
• Progressive muscle relaxation – This involves purposely tensing different muscle groups before relaxing them again. Hold each muscle for five seconds, if you can, and then relax. Pause for ten seconds and breathe deeply in between each muscle tension.
• Meditation - Meditation involves sitting comfortably, focusing on breathing and clearing the mind of all concern. It can take practice and can be a challenge for those with intrusive thoughts. There are many online guides and smartphone apps that can help you to meditate, and meditation classes such as ‘mindfulness’ may be available from an NHS service near you.

7. Wind down in the evenings

Relaxing and winding down before bed is an important stage in preparing the body for sleep. There are lots of ways to relax and what works will vary from person-to-person. Here are just some suggestions from our social media followers:

• A warm bath
• Soothing music
• Reading or listening to an audio book
• Light exercise, such as yoga (avoid vigorous exercise as this will have the opposite effect)
• Writing a 'to do' list for the following day can help organise and clear the mind

8. Keep a sleep diary

Keeping a sleep diary can be a useful way to help you understand why you might be having difficulty sleeping.

There are many different sleep diary templates available. You can download one example here.

9. Reduce overall levels of stress

Being stressed can make falling asleep harder and can impact upon sleep quality. Aiming to reduce your stress levels could have a positive affect on your sleep. You can find advice on coping with stress after brain injury here.

10. Speak to your doctor

These top tips are not designed to replace expert medical advice. If you’ve been having difficulty sleeping for a while you should speak with your GP to rule out any underlying sleep disorders.

Your GP will be able to recommend techniques and treatments suitable for your unique situation and may prescribe medication, such as sleeping pills, in some cases.

Advice from an expert:

We asked psychologist and Clinical Director of Sleep Unlimited, Dr David Lee, for his expert advice on getting a good night's sleep following a brain injury.