By Prav Prathapan
“Sleep’s the only medicine that gives ease.”—Sophocles.
Sleep is something most of us take for granted. However, increasing research indicates that it significantly improves a range of conditions. Whilst many people may understand that sleep can broadly improve mood and stress, it is increasingly understood that ‘sleep hygiene’ can significantly address brain health.
Sleeping for Brain Recovery
Sleep is not merely rest. It is an active and essential process during which the brain repairs itself. During non-rapid eye movement (NREM) sleep, the brain’s energy expenditure is about 85 percent of waking levels (1). The brain clears out metabolic waste products via the newly discovered glymphatic system and reinforces neural connections (2). For someone recovering from encephalitis (brain inflammation), for example, where inflammation might have damaged brain tissue and disrupted neural networks, this maintenance becomes critical. NREM slow-wave sleep and REM sleep serve vital functions: NREM slow-wave sleep aids memory consolidation and physical repair, while REM sleep handles emotional processing through vivid dreams (3).
Sleep and Brain Injury
Following an acquired brain injury (ABI), whether caused by encephalitis, trauma, stroke, or another condition, sleep is often one of the first things to change. Studies suggest that the majority of people living with a brain injury experience some form of sleep disturbance, with more than 50 percent of children and more than 50 percent of adults with ABI experiencing sleep-wake disturbances in the months after hospital discharge (4, 5).
Some find it hard to fall asleep at all, lying awake as a racing or foggy mind refuses to switch off. Others drift off easily but wake repeatedly through the night, then cannot get back to sleep no matter how exhausted they feel. Vivid, intense, or unsettling dreams are also common, sometimes leaving people more drained than when they went to bed (6). Overwhelming daytime fatigue and the need to nap can blur the line between day and night, pushing the body’s natural rhythms further out of step. Crucially, these changes are not a sign of weakness or of doing something wrong: they are a direct consequence of injury to the very organ that regulates sleep. Understanding this is the first step towards reclaiming rest.
Tips for improving sleep
To improve sleep after an ABI, there are several things one can do:
- Get as much exposure to daylight as possible, while following sun safety advice (such as using sunscreen).
- Engage in gentle activity during the day.
- Avoid screens late at night or just before bed. They suppress melatonin, which helps regulate sleep.
- Reduce caffeine and alcohol.
- Consciously slow down nasal breathing (four to six breaths per minute if possible).
- Keep a ‘sleep diary’ to share with your doctor.
- Consider clinical sleep interventions such as CBT-I (cognitive behavioural therapy for insomnia).
The Role of Support Networks
Family members and caregivers play a crucial role in supporting healthy sleep during recovery. They can help maintain routines, create a restful environment, and advocate for appropriate medical interventions when needed. But they must also manage their own sleep and well-being too.
Furthermore, support groups, whether in-person or online through patient organisations, can provide practical strategies from others who’ve navigated similar challenges. Sometimes knowing you’re not alone in your struggles makes them easier to bear.
A foundation for healing
Brain health, and particularly recovery from acquired brain injury (ABI), has its ups and downs. Prioritising sleep provides the foundation for recovery from this neurological condition.
The key is to take it one day at a time. If you are struggling with sleep during recovery, you are not alone. Speak with your medical team, connect with other people, and remember that sleep is one of the most important medicines for brain healing.
Prav Prathapan is Senior Medical Writer at Encephalitis International.
