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Sleep and TBI: Why Rest Matters at Every Age
What a New Study on Kids Tells Us About Sleep and Brain Injury
Science Corner September 2026
“Knowledge is Power”
Do you have trouble falling asleep, staying asleep, or waking up feeling rested since your brain injury? You are not alone, and it is not just in your head. A brand-new study looked at kids who had a brain injury and found that their sleep problems were connected to how they felt, how they acted, and even to their brains themselves. Here is the surprising part: what researchers found in kids matches what doctors have already been seeing in adults with TBI for years. Sleep problems after a brain injury are common at every age, and the good news is that better sleep may help your brain heal.
First, Let’s Learn Why Sleep Matters for Your Brain
Sleep is not just “downtime.” While you sleep, your brain is busy working. It sorts through the day’s memories, clears out waste, and resets chemicals that control your mood, focus, and energy. After a TBI, the parts of the brain that control sleep can get thrown off balance, which is why sleep problems are one of the most common complaints after a brain injury.
Sleep disorders are about three times more common in people with TBI than in people without one, and almost 60% of people with TBI deal with long-term sleep trouble. Other research shows that anywhere from 3 in 10 to 7 in 10 people with TBI have some kind of sleep problem after their injury.
What did the Study Find?
Researchers studied 573 children between the ages of 9 and 12 as part of a large national study on brain development. Some of the kids had a milder traumatic brain injury (like a concussion), some had a different kind of injury (like a broken bone), and some had no injury at all. The researchers checked in on each child’s sleep, behavior, and thinking skills and took brain scans twice over two years.
Here is what they found:
Kids with a TBI were more likely than the other two groups to develop new sleep problems, and more likely to have sleep problems that stuck around.
Kids whose sleep problems started after their injury were more likely to also have behavior problems, like trouble managing emotions or actions.
One specific type of sleep trouble, breathing problems during sleep, was linked to changes in the thickness of the brain’s outer layer (the cortex), the part involved in thinking and learning. This is an early finding, and researchers say more study is needed, but it hints that sleep problems may connect to real, physical changes in the brain.
Does This Apply to Adults, Too?
Yes. The doctor who wrote about this study has also studied sleep in adults with TBI. In a separate study of over 2,000 adults, followed for a full year after their injury, researchers found five different patterns of insomnia (trouble sleeping). Adults with more insomnia symptoms tended to have more mental health symptoms and more trouble with thinking and memory over time.
In other words, whether you are 9 or 90, a brain injury can disrupt sleep, and disrupted sleep can affect mood, behavior, and thinking. Sleep is not a side issue after TBI. It is connected to nearly everything else in recovery.
So What? Why Does This Matter to You?
Here is the hopeful part: sleep is something you can actually work on. Researchers call sleep a “modifiable treatment target,” which is a fancy way of saying it is a lever you can pull to help your whole recovery, not just your sleep. Improving sleep may also help improve mood, memory, and behavior after a TBI.
During the Day
- Wake up at the same time every day, including weekends.
- Get outside for some sunlight and get moving. Regular exercise is linked to fewer sleep problems after TBI.
- Keep naps under 20 minutes.
At Night
- Go to bed at the same time every night and follow a simple bedtime routine.
- Avoid caffeine, nicotine, and alcohol for several hours before bed.
- Keep your bedroom quiet, dark, and cool, and keep work, stress, and screens out of bed.
- If you are not asleep after about 30 minutes, get up and do something calm and boring until you feel sleepy.
Talk to Your Doctor If…
- Sleep problems last more than a few weeks or keep getting worse.
- Sleep trouble comes along with low mood, anxiety, or changes in behavior.
- You are thinking about trying an over-the-counter sleep aid. Many of these (including common ones with diphenhydramine) are not recommended for people with TBI because they can cause memory problems and other side effects.
- A doctor can look at the whole picture, your sleep habits, medications, mood, and pain, and help build a treatment plan that fits you, whether that is better sleep habits, counseling, or, in some cases, a referral for a sleep study.
Where Is This Information From?
This Science Corner was made using three sources:
An invited commentary published in JAMA Network Open (2026) by Dr. Emerson Wickwire, discussing a new study of sleep, behavior, and brain structure in children with mild TBI.
The Model Systems Knowledge Translation Center (MSKTC): a government-funded organization that creates health information for people with brain, spinal cord, and burn injuries. Their fact sheet on sleep and TBI explains why sleep problems happen and how to manage them.
The U.S. Department of Veterans Affairs Veterans Health Library: a health information library that explains TBI symptoms, including sleep problems, and offers tips for veterans and their families.
References
- Betz, A. K., MacLaren, H. S. R., Villagran Asiares, A. G., et al. (2026). Sleep disturbances and cognition, behavior, and brain structure in children with mTBI. JAMA Network Open, 9(5), e260229. https://doi.org/10.1001/jamanetworkopen.2026.0229
- Greenwald, B., & Bell, K. (n.d.). Sleep and traumatic brain injury [Fact sheet]. Model Systems Knowledge Translation Center (MSKTC). https://msktc.org/tbi/factsheets/sleep-and-traumatic-brain-injury
- U.S. Department of Veterans Affairs, Veterans Health Library. (2026). Improving sleep after traumatic brain injury. https://www.veteranshealthlibrary.va.gov/livingwith/traumaticbraininjury/Coping/142,41355_VA
- Wickwire, E. M. (2026). Sleep matters, at all ages, following traumatic brain injury. JAMA Network Open, 9(3), e260217. https://doi.org/10.1001/jamanetworkopen.2026.0217
- Wickwire, E. M., Albrecht, J. S., Capaldi, V. F., II, et al. (2022). Trajectories of insomnia in adults after traumatic brain injury. JAMA Network Open, 5(1), e2145310. https://doi.org/10.1001/jamanetworkopen.2021.45310
