This morning I woke up at 5:00. That isn’t very early for some people, but is early for me, especially since I didn’t get to bed till midnight, and I need 7-8 hours of sleep to be fully functional. I’ve been pretty tired, lately. Needing to catch up on my sleep. But try as I might, I can’t seem to get myself to bed before midnight, and I can’t seem to sleep past 5 or 6 a.m. I do what I can to get naps in during the day, which helps, but it’s been a long time since I had 8 solid hours of good, sound sleep. That’s what I’ve traditionally needed, ever since I was a kid, but it hasn’t happened for a while.
This is really nothing new, actually. I’ve been waking up at 3 a.m., on and off, for the past three years or so. Since I fell and whacked my head at the end of 2004, I haven’t been able to really sleep the way I want to. I either can’t get to sleep before midnight/1 a.m, and/or I can’t sleep past 6 or 7 in the morning, and/or I wake up throughout the night, and/or I wake at 3 a.m. and can’t get back to sleep. All told, I’m lucky if I get 6 hours of sleep a night. I can’t remember the last time I had a full 8.
I’ve often resorted to just getting up at 3 a.m. and busying myself with things I meant to do the day before, but didn’t get around to… then hoping that I’ll wear myself out and get back to bed for an hour or so of additional sleep before my day officially starts at 8 a.m. That’s worked for me in the past, but as often as not, I find myself caught up in the little “asides” I pick up, and I don’t get back to sleep. Then I spend the rest of the day worn out and frazzled.
I’ve become increasingly accustomed to being tired all the time. It’s not such a bad thing… unless I think about the impact it may be having on my health. It certainly doesn’t help my headaches any.
Speaking of which, I have another one today. I’ve been pretty much headache-free for a few days — that is, I’ve been at a .5 or 1 level, instead of the usual 3-4 level (on a scale of 1-10). Today it feels like a 3, for starters. In the upper occipital area — back of my head, around the middle, near where my skull starts to curve around towards the top. I’m not entirely sure if the headache is due to stress and strain and thinking too much (I started doing that at 5:30 this a.m., when I realized I couldn’t get back to sleep and started fretting about things like work and jobs and paying the bills)… or maybe it’s muscular. I did go to the gym yesterday and had a good workout. I’m sore, now, including my shoulders and neck, so that could have something to do with it.
There’s a pronounced ringing in my ears, too — it tends to accompany my stronger headaches, if I’m at a 3 or higher. It’s a hollow, high-pitched, whining ringing that’s constantly in the background. If I thought about it, it would be maddening. But I’ve had most of my life to get used to it, so it’s just there…
But back to my sleeping patterns. Sleep disturbance is a common after-effect of a TBI, and when I look at my sleeping patterns in terms of my most recent injury, it all makes total sense. Although I sustained a TBI when I was 8, I don’t think that sleep disturbances weren’t a part of my life till I was injured in 2004. Even when I was 10, I was able (and eager) to go to bed by 9 or 10 p.m. and I could sleep through till 6 or 7, no problem.
After getting 8 hours of sleep a night, come hell or high water, ever since I was a kid, all of a sudden in 2004-2005, I just couldn’t manage to sleep through the night, and it made me crazy… until I resigned myself to it and just tried to adapt with afternoon naps. I’ve been an avid Saturday/Sunday afternoon napper for many years, even before my patterns were disrupted. But in the past three years, it’s become a really necessary part of my weekly routine.
Of course, three years ago, when I was waking up at 3 a.m. every night and unable to catch up on my sleep, I blamed job stress. Certainly, that could have something to do with it, but I was stressed before my injury, and I wasn’t up in the wee hours every single day. Not like I was after the fall. And after I left that job and had less stress in my life, I was still hassling with sleep disturbances.
I’ve been looking around online for resources on sleep disturbance. Over at http://www.tbihelp.org/sleep_disturbances_following_tra.htm, they say:
… It is generally accepted that sleep is usually regular and predictable. For instance, when a person is about to go to sleep, neurons within certain parts of the brain (e.g., the brainstem, thalamus, hypothalamus, and basal forebrain) become more active and prepare the person for sleep. Other areas of the brain then become involved, and seratonin is released, which facilitates the sleep process even more.
When the brain is injured (the severity of the injury does not appear to matter), the person’s sleep/wake cycle often becomes disrupted. Thus, many people who have sustained a brain injury experience difficulty getting to sleep, maintaining uninterrupted sleep, and subsequently remain quite tired during the day. Even those with mild TBI report sleeping difficulties. It has been found that when these individuals do sleep, their sleep is lighter, and less restful, where they often awake during the night. When a person is not getting enough sleep at night, they often become excessively tired during the day, and frequently experience depression. Unfortunately, while there are some studies that demonstrate particular sleep disturbances following TBI, there have not been any large studies that investigate the different ways in which such disturbances impact upon other areas of a person’s life (e.g., cognitive impairments, psychological functioning).
The article may be found at:Drake, A., & Bradshaw, D. (1999). ‘Sleep disturbances following traumatic brain injury’. Brain Injury Source, 3, Brain Injury Association: Alexandria, Virginia.
Since the article dates back to 1999, I suspect there have been larger studies about how sleep disturbances impact the lives of TBI survivors (not to mention their family members and employers).
Then again, other more recent studies report the need for more studies… Hopefully there will be more work done on this. I’ll need to check more recent brain injury research for updated information.
Other links about TBI and Sleep Disburbance:
It’s encouraging to see that researchers know this is an area that needs more exploration… and calling for more studies about sleep disturbance after tbi. As the “Sleep Disturbances after Brain Injury” site says:
Problems with sleep are another poorly understood, but absolutely central problem after brain injury. As serious of a problem as overattending fatigue can be, if the injured person doesn’t start the day refreshed, it can be debilitating.
I’ll say! When I had my fall in 2004 and went back to work A) without having a clue that I’d been injured, or to what extent I’d been affected, and B) never getting adequate sleep to keep up with not only my healing but also my day-to-day experiences in a highly stressful job, the results were personally and professional catastrophic.
Not only could I not cope with the day-to-day demands of everyday activities, like keeping up with my chores, cleaning, taking care of the house, doing yard work, etc… but I couldn’t keep up with my workplace responsibilities. I became increasingly hostile to people around me, I became insubordinate to my manager(s), I lashed out at co-workers without provocation, and I frankly scared a lot of people at work with my temper and my intensity.
Everything around me became that much more “amped up” with me, and I had a very hard time both moderating my reactions to people and regulating my pro-active behavior. Eventually I had to leave… though nobody understood exactly why I’d imploded. Least of all, me.
I’m convinced that lack of sleep exacerbated a lot of issues I had, and not only made me more difficult to deal with, but also prevented me from healing adequately. Not getting enough sleep pushes me to the point where I had ongoing difficulties navigating the social landscape at work, and my self-confidence was pretty much shot, as a result. The emotional fallout from that has been intermittently devastating, and it’s still causing me grief, trying to figure out how to integrate into the working world in a positive way — meeting the needs of my clients, as well as my own physical demands.
Yes, sleep disturbances are a huge problem for me. I’ve been plagued by them for over three years, now, and it’s a huge pain in my neck. But knowing that they can be traced back to my TBI(s) helps tremendously. Now I can explain it to myself and the people around me. Now I can put it in terms that actually make sense to other people.Now I don’t feel quite so helpless and alone anymore. And that makes all the difference in the world.
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