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Posttraumatic sleep symptoms

Discussion of post-traumatic sleep symptoms

Impaired sleep is very common after TBI.  Sleep is much more than the brain shutting down for the night.  In order for deep sleep and dream sleep to occur, the brain needs to synchronize its activity, and in fact deep sleep is necessary for normal memory function, concentration, and proper metabolic activity of nerve cells in the brain.

Sleep is surprisingly complex, and the brain functions differently at each of the stages of sleep.  During wakefulness, an EEG shows fairly chaotic activity as different circuits in the brain activate in various patterns, see Figure XXX.  In drowsiness and the first stage of sleep, brain activity quiets.  In the deeper stages of sleep, something important happens.  The brain’s activity synchronizes, and slow waves appear.  This slow wave sleep is vital for memory formation and proper brain functioning.  It is thought that this synchronistic activity behavior causes the brain circuits responsible for memory to allow for the creation of long-term memories and strengthens the connections (synapses) for sustained memory.  Moreover, as discussed below, slow wave sleep allows for waste products generated during normal brain activity to be processed and removed from neurons.  There is some variability, but in general we should expect to spend XXX of our night in slow wave sleep.

Treatment for post-traumatic sleep disorder

  • Polysomnogram

  • Cognitive-behavioral therapy 

  • Start medications:

  • Melatonin 1-2 mg at night

  • Magnesium glycinate 400 mg at night

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