New research suggests quality sleep has a healing effect on TBI.
As a sports neurologist and pain medicine specialist, I have tremendous
respect for the positive impact of quality sleep on Neurologic health
across the lifespan. Whether it's training for the next game, recovering
from injury, or healthy lifestyle maintenance, good sleep is imperative
for everyone. Recently, I came across even more compelling evidence pointing
to sleep quality as an essential recovery tool for people who have suffered
a traumatic brain injury, commonly referred to as a TBI.
Nearly 3 million cases of TBI occur in the United States each year. People
who have suffered a TBI may have specific sleep issues that need addressing,
including insomnia, hypersomnia, sleep apnea, fragmented sleep, and other
sleep disorders. New research published in the
Journal of Neurotrauma suggests that sleep is an essential factor in TBI recovery in military
veterans. A study of 56 veterans from Iraq/Afghanistan showed that poor
sleep quality correlated with reduced clearance of perivascular waste
from the brain in the study subjects. The glymphatic system is responsible
for flushing the brain of toxins and waste products (like lymphatics in
the rest of the body), and the lack of “housekeeping” appears
to be related to functional recovery. I am personally interested in ways
we can accurately measure this activity after injury
and increase or restore glymphatic activity as an approach to improving recovery
after TBI. Perhaps it’s not surprising that sleep related issues
can negatively affect recovery from TBI, considering the fact that disordered
sleep has been associated with an increasing number of health-related
conditions, significantly contributing to and/or causing disease, disability,
and death.
I believe that in addition to focus on the “facts and fear”
warnings on the dangers of poor and disordered sleep, it’s helpful
to understand the concept of sleep health, and its benefits. Sleep health
has been described as a multidimensional pattern of sleep/wakefulness
adapted to individual, social, and environmental demands, which promotes
physical and mental well-being. Good sleep is characterized by subjective
satisfaction, appropriate timing, adequate duration, high efficiency,
and sustained alertness during waking hours.
Almost every athlete I work with (whether weekend warrior, aspiring amateur,
or elite/professional) understands the beneficial effects of musculoskeletal
and cardiovascular health on performance. But many are surprised when
I tell them that sleep health and optimization of sleep efficiency may
be the most effective intervention an individual can make to optimize
performance. It’s been demonstrated that less than six hours of
sleep overnight is associated with decreased time to physical exhaustion,
reduced aerobic output, reduced peak and sustained muscle strength, impaired
metabolic capabilities, and increased injury risk. Conversely, sleep extension
has been shown to significantly improve performance related to speed,
power, accuracy, cognitive endurance, and speed of mental processing -all
critical aspects of athletic, academic, and professional performance.
Many of my patients who have suffered TBI are searching for answers on
how to restore function. Some of my clients are interested in optimizing
athletic, academic, or professional performance. Others want recommendations
on how to age successfully, maintain a high quality of life and optimize
Neurological health across the lifespan. Understanding sleep health, with
a goal of high-quality sleep is crucial for everyone.
Sources:
https://www.eurekalert.org/pub_releases/2021-03/ohs-ssr031221.php
https://www.liebertpub.com/doi/10.1089/neu.2020.7447
https://www.verywellhealth.com/sleep-traumatic-brain-injury-study-5117032