Brainstorming: What is the most difficult thing about an injury to the brain?
By Colleen Butler

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Colleen Butler, author of "Concussion Recovery: Rebuilding the Injured Brain," is offering practical advice to help with the recovery from brain injury. In the first edition of Brainstorming, our questions asked are:
  • What is the most difficult issue relating to an injury to the brain?
  • Since my accident I have slept a lot and seem to always need more sleep. Is this common?
We hope you find this Q&A helpful, and we look forward to hearing from you. If you have a question or comment, we want to hear from you at

What is the most difficult thing about an injury to the brain?

Dear Hugh,

Diagnosis is the most difficult. If the injury is visible with an open wound or swelling, then it is obvious and care and caution are taken. The difficulty arises when there is no physical appearance of an injury to the brain. You go to the emergency department or the doctor and they send you home, or you take no action as there is no visible injury. Your symptoms then start appearing, such as trouble sleeping, headaches, dizziness, exhaustion, emotional outbursts or erratic behaviours. You have been to doctors, they say you are fine and still all these unusual and negative changes are occurring within you, you think you are going crazy and must be imagining things.

Your brain is the motherboard of your body, and signals may get mixed up after a fall, jolt or blow to the head. Your taste, balance, sleep and emotion may all be affected. We need to listen to our bodies.

There is no test or guideline for diagnosing a brain injury with 100 percent certainty. It feels like medical science just cannot work fast enough when "you" have the injury, however, advances are being made. Recently it has been noted that an MRI given in a vertical position will reveal 40 percent more concussions than one given in a horizontal position.

There is no magic drug or machine that will help to take your troubles with a head injury away. It takes time to heal, it is a journey and can be done with time and creating the right environment for your brain to heal.

Trust your inner voice, listen to your body.

The Brain Navigator

Since my accident I have slept a lot and seem to always need more sleep is this common?

Dear Jill,

Sleep is a very big factor in recovering from a head injury. Scientist have discovered that those experiencing a concussion/ABI/TBI have difficulty reaching the fourth level of sleep, or REM, so you do wake up feeling unrested and ready for a nap again.

This fourth level of sleep is very important to us as it is the time when our body begins the healing of our injury. Sleep is vital, especially with an injury to the brain. Not only is there a physical reaction in the brain, but also a chemical imbalance has occurred. You may find that after being overstimulated you may need some time out in a quiet room and need to have a nap.

I know during my recovery sometimes my head was so full it hurt, and I could not think or make a decision. I learned that after the nap I was much more alert, able to make better decisions and found life easier to handle. When we sleep poorly, our brains have to work much harder to help us get through our day, putting more stress and demand on a damaged brain.

Here is a little bit of information on sleep you may find interesting:
  • Sleep is the body's natural antioxidant
  • At night, growth hormones are released in the REM stage to repair and stimulate cell growth
  • Sleep deprivation creates advanced aging to the brain, neuron damage and elevated nighttime cortisol levels
  • Sleep is vital to fight infections, cancer and inflammation
  • Greater risk of death if sleeping less than six hours per night
  • Sleep deprivation is also linked to vehicle crashes and deaths
  • Elephants sleep standing up during non-REM sleep, but lie down for REM sleep.
  • 17 hours awake leads to a decrease in performance equivalent to a blood-alcohol level of 0.05 percent
  • Insomnia early in adult life is a risk factor for depression and mental health disorders
  • More calories are burned while sleeping than while watching TV
  • Long-term memories are formed while we are asleep
  • Sleep helps with learning, concentration, short- and long-term memory
  • Insomnia is a risk factor for depression and mental health disorders
The tricks I have found for securing a good nights sleep are:
  1. Exercise early in the day. This actually has a many benefits for you. The best is that the exercise is good for your physical body as well. Exercise helps to trigger the hormone serotonin (happy hormone) and melatonin (sleeping hormone). Exercising late in the day will perk you up making sleeping more difficult.

  2. Darken your room so there are no lights. Even the lights from the radio alarm clock or your cellphone can disrupt your sleep pattern

  3. Sleep mask, never leave home with out one. This is also handy for people who are having motion issues from their injury. Find a quiet place, use the mask for 15-20 minutes

  4. Warm bath 15-20 with Epsom salts is a very good relaxer and healthy. Epsom salts are really magnesium sulphate, and magnesium is the conductor of all the minerals in your body. Epsom salts help to produce serotonin, draw toxins from the body, sedate the nervous system, reduce swelling and relax muscles.

  5. Melatonin is a hormone secreted by the pineal gland at night, inducing sleep. Melatonin is found naturally in plants and algae. It is a natural hormone that can also be purchased at the local drug store. I found this to be very helpful for my sleep, and if I woke in the middle of the night, it would allow me to fall back to sleep more easily.

  6. Take control of the mind chatter by breathing in to the count of six and out to the count of six. Sometimes I simply would say "in with the good" as I inhaled and "out with the bad" as I exhaled, at the same time imagining all the good and bringing it right through my body while exhaling all the bad right through the body. The important part is to relax with your breathing.

  7. Essential oils: Lavender is a very soothing and calming essential oil.

  8. Thoughts of gratitude: Let the last thing your mind remembers be all the wonderful things in your life. No matter where you are in life and how stressed you are, there are people and places much worse than you. If you are unable to think of anything to be grateful for, have a little cheat sheet of the things that make you happy. We have 70,000 thoughts go through our subconscious daily so we might as well make the thoughts joyful and kind to start reconditioning our brains to a more pleasant situation.

  9. Routine: Keep yourself consistent with bedtimes. Try to remain within a half-hour of the hour you choose. And yes, studies have proven that we do need eight hours of sleep a night.

  10. Diet is of course important — if you are not feeding your body well, it can not perform. No junk food, keep away from sugary foods. Foods high in tryptophan, promoting sleep are turkey, bananas, figs, dates, yogurt, milk, tuna and whole grain crackers or nut butter.
The Brain Navigator

Try these tools and let me know how they work for you. If you have any questions about the path of recovery please forward your questions to:, and we will do our best to answer your questions from our experience and knowledge for the next edition.

Colleen Butler, BA, CRC, founder of Brain Navigators, is an author, international speaker and lifestyle coach. She has first-hand experience recovering from ABI. With gratitude and understanding, her mission is to provide education, tools and hope to the brain-injured and those who care for them. Colleen offers the brain injury community workshops and her workbook: "Concussion Recovery: Rebuilding the Injured Brain."