The Hidden Sleep Consequences of Concussions: What Every Patient Should Know

When most people think of concussions, they picture dizziness, confusion, or a lingering headache. But there’s another side effect that often goes overlooked—and it can quietly derail recovery: sleep disruption.

At Comprehensive Sleep Medicine Associates (CSMA), we’ve seen how traumatic brain injuries (TBIs)—including mild concussions—can deeply affect sleep.

From insomnia and fatigue to hypersomnia and fragmented rest, the impact on the body’s sleep-wake cycle can be profound and long-lasting. An estimated 30–70% of concussion patients report difficulty sleeping in the first few weeks post-injury (Mosti et al., 2016). Insomnia symptoms are reported in 30% of people, and 43-73% of people report symptoms of fatigue. (Mosti et al., 2016).

In this blog, we’ll explore how concussions affect sleep, why they happen, and when to seek professional help.

What Is a Concussion—and What Is Post-Concussion Syndrome?

A concussion is a type of traumatic brain injury caused by a blow or jolt to the head–from a fall, car accident, violent shaking, or contact sports injury. While many people recover fully within a few weeks, others develop lingering symptoms lasting for months or longer. This is known as post-concussion syndrome (PCS). While not everyone experiences PCS after a concussion, it's a condition that can significantly impact daily life and quality of life. 

Symptoms of PCS can include:

• Headaches

• Dizziness

• Confusion

• Nausea or vomiting

• Mood changes

• Trouble concentrating or memory loss

• Daytime sleepiness

• Sleep disturbances

You don’t need to lose consciousness to have a concussion—and not every concussion leads to long-term symptoms. In fact, the risk of developing persistent post-concussive symptoms isn’t necessarily related to how serious the initial injury seemed. Many patients with PCS report sleep problems as one of their most disruptive symptoms.

Why Does a Concussion Disrupt Sleep?

Concussions disrupt sleep because they can damage the brain's regions responsible for regulating sleep-wake cycles, disrupt the production of sleep-regulating hormones, and can lead to post-traumatic stress or anxiety, all of which can affect sleep. 

Neuroinflammation and Circadian Rhythm Disruption

After a head injury, the brain experiences inflammation and chemical changes that can interfere with normal brain function—including how the body regulates its circadian rhythm, or internal clock. This disruption makes it harder to fall asleep, stay asleep, or feel rested even after a full night of sleep.

Melatonin and Brain Repair

Concussions can also impact the brain’s production of melatonin, the hormone that signals to your body when it’s time to sleep. When melatonin levels are thrown off, so is your ability to get restorative rest—just when your brain needs it most for healing.

Sleep isn’t just rest—it’s a critical tool for brain repair and recovery. When sleep is disrupted, recovery slows down.

Common Sleep Complaints After a Concussion

Every brain injury is different, but these are the most common sleep issues reported after a concussion:

• Insomnia – An acute or chronic condition making it difficult to fall or stay asleep

• Hypersomnia – Persistent and excessive daytime sleepiness

• Nightmares – Vivid or disturbing dreams that interfere with restful sleep

• Fragmented Sleep – Frequent awakenings or poor sleep quality

These issues don’t just make you tired. Poor sleep can worsen cognitive and emotional symptoms, making memory issues, anxiety, depression, and irritability more pronounced.

Tools for Recovery Post Concussion

Thankfully, there are effective strategies to support sleep recovery after a concussion:

1. Sleep Tracking

   Getting restorative sleep is one of the best ways to help your body heal; however, when you're dealing with a concussion, you may not always remember or notice how much sleep you are getting (or how you felt after you woke up–did you feel restful or were you still tired). Using sleep journals or apps to monitor patterns can help identify disruptions and guide treatment.

   
   

2. Cognitive Behavioral Therapy for Insomnia (CBT-I)

   This highly effective, non-drug approach allows your provider to help retrain the brain for healthy sleep and is often used in post-concussion care. It might also be combined with physical or occupational therapy.

   
   

3. Medical Evaluation or Assessment Tools

   If symptoms persist beyond a few weeks, a professional evaluation from your physician, neurologist, or sleep specialist may reveal underlying sleep disorders such as obstructive sleep apnea, circadian rhythm disorders, or REM behavior disorder—all of which can worsen after a head injury.

When to See a Sleep Specialist About a Concussion

It’s not “just in your head.” If your sleep problems continue weeks after your concussion—or if they’re affecting your mood, memory, or quality of life—it’s time to get help.

A comprehensive sleep evaluation at CSMA can help uncover:

• Undiagnosed sleep disorders

• The impact of your brain injury on sleep patterns

• Personalized treatment options to support your recovery

To Heal the Brain, You Have to Heal Sleep

Sleep is one of your brain’s most powerful healing tools—and after a concussion, it’s more important than ever. If you or someone you love is still struggling to get restful sleep weeks or months after a head injury, don’t wait.

📞 Contact CSMA today to schedule a consultation. Let’s work together to restore healthy sleep and support your recovery from the inside out.