Close this search box.

Unable to Sleep After Head Injury: How Can a Neurologist Help?

Unable to Sleep After Head Injury

If you need neuroinjury care, speak with our top neurologist in NYC today!

Are you unable to sleep after a head injury and wondering why? Head injuries cause several kinds of neurological issues, including possible sleep disruption. It’s quite normal, but if you experience any difficulties falling asleep or staying asleep after a head injury, it is important to seek the help of a neurologist right away. 

Below, Neurodiagnostics Medical P.C. shares more about what a neurologist can do for you if you’re experiencing sleep disruption after sustaining a head injury.

How Sleep Works Before Head Injury Complications

Sleep is a pivotal biological function that helps you consolidate memories, repair cells, and coordinate immune functioning, so it’s centrally important to your health. That’s why continued deprivation of sleep can cause a whole host of negative issues in the body and mind.

The specifics aren’t yet clear, but science understands that neurotransmitters, specifically melatonin, mediate sleep in the brain. Essentially, your body’s circadian rhythm monitors your day cycles and then, when it’s time to sleep, tells the pineal gland to start producing neurotransmitters, such as: 

  • Melatonin
  • Histamine
  • Orexin
  • Gamma-aminobutyric acid

Any disruptions to this production of neurotransmitters, such as a head injury, hinder this process. The results affect how easily you fall asleep. It also affects whether you can achieve the quality of sleep your body requires to function normally.

Why Don’t Sleep and Head Trauma Mix?

Sleep is a complex biological process through chemical pathways and neurotransmitters. The leading theory is that head trauma, such as a concussion or traumatic brain injury, can cause both physical and chemical changes in the brain. This process may disrupt signaling and your brain’s neurotransmitter production, which prevents the body from switching into sleep mode.

Regardless of the reasons, insomnia remains a common side effect of sustaining a head injury. About 70% of individuals with traumatic brain injuries report sleep disturbances, particularly from contact head injuries or blunt-force trauma. Other possible reasons that head trauma affects sleep include the following:

  • Pain and depression after a head injury is common. Insomnia arises from this state of mind. 
  • Medicine for treating head injuries can interfere with normal sleep patterns.
  • Patients who take up other habits after a head injury sometimes find these changes in behavior contribute to poor sleep quality. 

Common Side Effects of Insomnia

About 10% to 15% of the adult population report some kind of insomnia. Since sleep regulates bodily functions, continued sleep deprivation like this can have various negative effects, including but not limited to:

  • The inability to focus or concentrate for extended periods
  • Confusion
  • Mood swings
  • Short-term memory issues
  • Lack of inhibition or executive functioning
  • Fatigue
  • Mental distress
  • Depression

As such, long-term sleep deficiency is a serious condition linked to chronic health issues like kidney disease, heart disease, obesity, stroke, diabetes, and high blood pressure.

What Types of Sleep Issues To Expect After a Head Injury

Insomnia is just one kind of sleep problem that head trauma can cause. Below are examples of other sleep disorders associated with head trauma. 

Excessive Sleepiness

A head injury might cause excessive daytime sleepiness, causing you to fall asleep at inopportune times and always feel tired, no matter how much sleep you get. 

Unusual Dreams

People who have major changes to their sleep schedules often report unusual dreams or more vivid ones. In some cases, recurring nightmares can be a result of PTSD after a head injury event.

Poor Sleep Quality

Not everyone is unable to sleep after a head injury. For example, you may have no trouble falling asleep but experience a restless night and difficulty staying asleep because your brain cannot maintain a consistent sleep state. A brain injury can also prevent REM sleep, which sleep researchers consider essential to the sleep process.

Sleep Breathing Disorders

While sleeping, the brain controls all involuntary bodily processes, like breathing or digestion. In some cases, brain injuries cause disorders like sleep apnea, erroneously shutting off your breathing while you sleep. Sleep apnea can cause frequent wake-ups, affecting your overall sleep quality. 


Parasomnia involves performing actions while sleeping and commonly accompanies head injuries. These involuntary actions can include teeth grinding, talking while sleeping, and sleepwalking, as well as behaviors that are potentially dangerous to the sleeper or people nearby.

How a Neurologist Helps With Sleep After Head Trauma

Neurologists like the Neurodiagnostics Medical P.C. team are specialists in brain and nervous system disorders, including sleep disorders. One of the main ways a neurologist might try to manage your sleep disorder would be through cognitive behavioral therapy, which relies on a strict sleep hygiene schedule (this refers to instilling better sleeping habits).

According to the Sleep Foundation, about 70% of patients who practice CBT experience some measure of improvement in insomnia or disordered sleep behavior. The hygiene schedule retrains the brain for proper sleep behavior and patterns by cultivating good sleep habits, such as:

  • Exercising during the day but not at night
  • Waking up and getting out of bed at the same time every day
  • Going to sleep at the same time each night
  • Blocking out light from the bedroom while sleeping
  • Being careful to avoid caffeine or alcohol before bed
  • Setting the bedroom to the right temperature

If you are having difficulty breathing while sleeping due to a head injury, a neurologist may prescribe a CPAP machine to regulate obstructive sleep apnea. If necessary, a neurologist can also provide sleep medications to initiate and sustain sleep. However, if you go this route, you need consistent monitoring from the primary care physician who originally handled your head injury diagnosis.

What To Expect When Seeing a Neurologist for Sleep Issues After Head Injuries

Are you unable to sleep after a head injury? When you see a neurologist, they will first ask you questions about your sleep habits and the nature of your head injury, such as:

  • When did you start experiencing insomnia?
  • How long after your head injury did you start experiencing sleep problems?
  • How long does it take you to fall asleep?
  • Do you snore?
  • How have you tried to improve your sleep quality?
  • What medications are you taking?

In some cases, the neurology team might use imaging to identify potential brain problems that could contribute to or cause insomnia. 

Find a Top Neurologist | NYC

If you would like to speak to a top neurologist in NYC, contact Neurodiagnostics Medical P.C. online or call (347) 602-8530 today. Our doctors accept most insurance plans, including workers’ compensation, no-fault, and PIP (personal injury protection). Same-day appointments may also be available.

FAQs About Sleep After a Head Injury

Here are the most common questions we receive about being unable to fall asleep after head injuries and what our neurological services advise:

How Long Does It Take To Fall Sleep After a Head Injury?

How long it takes to fall asleep after a head injury depends on your injury’s location and severity. Sometimes, these insomniac episodes resolve within a week or a few weeks (chronic insomnia persists for more than 90 days). Most people fall asleep within half an hour, so taking longer than this could indicate possible neurological issues.

Is It Normal To Be Unable To Sleep After Head Injuries?

Yes, it is fairly normal to be unable to sleep after you experience a head injury. A 2012 paper by Drs. Viola-Saltzman and Watson reported sleep disturbances in around 30% to 70% of those who had sustained a traumatic brain injury. MRI imaging studies suggest that sleep disorders stem from dysfunction in the temporal lobes, thalamus, parietal cortex, and brainstem, so there’s a large scope for diagnosing sleep issues.

What Can I Do If I Cannot Sleep After a Head Injury?

There are several things to do if you cannot sleep after a head injury. Small changes might promote better sleep habits and sleep quality, such as: 

  • Avoid naps during the day. Napping makes it harder to enter full REM sleep at nighttime. 
  • Drink fewer fluids before bedtime. Waking up repeatedly to urinate affects your sleep quality.
  • Double-check your medications. Some medications cause sleeping problems, in which case you’ll have to talk to your primary care provider about a change.
  • Change your diet. Difficulties sleeping could indicate a nutrient deficiency. 
  • Quit smoking. If you are a smoker, enrolling in a quitting program could help your sleep issues. Nicotine in tobacco has a stimulative effect similar to caffeine.
  • Mentally relax before you sleep. Take a bath or read a book until you feel sleepy.

Don’t try to force yourself to sleep. If you don’t fall asleep in 30 minutes, get out of bed, do a small task, and try again later.

Can I Take Medication If I am Unable To Sleep After a Head Injury?

Generally, physicians don’t advise taking medication if you are unable to sleep after suffering a head injury. Instead of risking common medications like diazepam or lorazepam, your primary care provider may suggest seeing a sleep specialist or neurologist.

Schedule a neurologist appointment with Neurodiagnostics Medical P.C. online for convenient neuromedical services from experienced New York professionals!

About The Author

Picture of Ashwin Malhotra, M.D.

Ashwin Malhotra, M.D.

Ashwin Malhotra, M.D. is a highly respected neurologist based in New York City. With over 20 years of experience in the field of neurology, he has earned a reputation as a leading expert in the diagnosis and treatment of neurological disorders and traumatic brain injuries. In addition to his clinical work, Dr. Malhotra is also a dedicated educator and researcher. He has published numerous articles in peer-reviewed medical journals and has presented his research at national and international conferences.