Why the Brain Wakes Up at Bedtime

Why the Injured Brain Wakes up at Bed Time


You only have to read through a few posts in any brain injury on-line support group to find someone who is wondering why they have problems with getting to sleep following a brain injury.

The extent of sleep problems can vary and many people find that just as they lay their head on the pillow, their brain suddenly decides to wake up.

This problem often follows a day of brain fog where someone hasn’t even been able to think, let alone do! It can be really irritating and sometimes people think their inner body clock has changed. Trying to fall into line with suddenly being a ‘night owl’ can exacerbate the biological problems at the root of sleep problems.

Many people experience this period as being a time when they have some really bright spark ideas and thoughts. Very often people will reach for a pen and paper and write these ideas down thinking that they have solved all their own problems, or even matters of world crisis. In the morning it is often found that whatever was written down was pretty fanciful, which is why it is better not to go on-line when you can’t sleep. 

The cause

The biochemical cascade that occurs immediately following a brain injury causes the adrenals to constantly fire due to the biological perception of stress and psychosomatic indicators. The adrenals become over-taxed and begin excreting so many stress hormones that the body begins to shut down causing feelings of exhaustion. The on-switch causing this constant firing creates a feedback loop in the body associated with the fight or flight response, which is also why PTSD and anxiety symptoms can continue unabated for years.

This is also part of the reason why people have sleep problems following a brain injury.

The adrenals are responsible for keeping cortisol and adrenaline in check as well as regulating inflammation in the body. This constant firing damages adrenal function and many people become deficient in normal levels of cortisol, again exacerbating feelings of fatigue.

When the adrenals start to struggle they no longer manufacture the right balance of hormones and initially release too much cortisol and adrenalin into the body.

Stage 1

To start with tired adrenals cause people to feel wired and tired, so although healthy adrenals usually fire more in the morning, when they are fatigued, they will instead fire at night. This leads to insomnia and problems with getting the brain to be quiet when you go to bed.

Stage 2

When adrenal tiredness isn’t addressed it can cause adrenal exhaustion. Following a brain injury the body is full of cortisol much more often because of the effects of the biochemical cascade. This can result in a boost of energy at night when you don’t need it and leaves people feeling sluggish and foggy-brained during the day.

People can not only have problems with getting to sleep but can also struggle with going back to sleep if they wake up during the night.

Stage 3

Adrenal exhaustion is a recognised second stage before reaching full adrenal burnout. Staying in a state of high-cortisol output eventually leads to cortisol levels starting to fail. Associated problems include weight gain, increased sleep problems, and a recognition that something is affecting general health.

Full adrenal burnout leaves people feeling completely burned out. By this time cortisol patterns are completely disrupted and background levels of cortisol are way below normal. Low levels of cortisol production are associated with a higher risk of thyroid and autoimmune disease and are also known to cause problems with the micro biome and absorption of nutrients.


People tend to turn to all kinds of strategies to help with getting a good night’s sleep. This might include anything from using essential oils to trying not to nap during the day, making sure screen time is reduced in the evenings, and a whole huge list of other techniques that are often suggested as a way to help normal functioning people to rest.

Whilst these strategies are really important and play a huge role in sleep management, the thing is that they don’t deal with the direct biological causes of sleep problems following a brain injury.

Good sleep is crucial to people during the healing process following a brain injury or trauma, because this is when the body is closing systems down to be able to restore them.

Managing the ‘brain wired’ feeling really starts with managing the secondary outcomes of brain injury. Getting inflammation under control helps us to better manage cortisol output and can have a huge impact on the feedback loop that the brain and body can get stuck in. In essence we need to address the biochemical cascade as soon as possible.

The best supplements that help with this are:

All of the other supplements we recommend add to these benefits and can be used for specific or multiple other symptoms.

Eating for nutrition also helps us to tackle the causes of fatigue and many of the other common symptoms at their root.

It is important to incorporate a whole body approach and to think about all bodily systems and bringing them all back to health. The cascade of negative chemicals, especially cortisol, can impact gut flora – impacting the immune system, and can cause adrenal fatigue (as discussed) – compounding the problems faced.

You can learn more about all of these, including alternative treatments, starting with ‘fixing your brain.’

You can make real changes yourself, and depending on whether you have other health problems, the length of time your sleep problems have been going on, and other factors, you may see results fairly quickly.

A boost with a really good quality vitamin B complex, specifically B6 and B12 can also really help. You doctor should be able to prescribe supplements for you and by far and away this is the best way to tackle the problem with getting to sleep, because you are directly tackling the cause. Many sleep medications are designed to help people overcome other problems that are generic life-related and normal issues. They aren’t designed to tackle the changes in physiology that follow a brain injury, which is why they often don’t work and also often cause intolerable side-effects.

Speak to your doctor. Get your bloods tested and ask for help without medication. If you can find a functional doctor who will focus on looking at a broad spectrum of your health issues. Vitamin D deficiency can also cause insomnia so please make sure you have a full screening of reserves as well.

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