A recent study, published in Neurology, found that mild brain injury may increase your likelihood of developing circadian rhythm sleep disorder (CRSD). CRSD is often misdiagnosed as insomnia, and therefore treated ineffectively. Liat Ayalon, PhD, authored of the study, says that, "as many as 40% to 65% of people with mild traumatic brain injury complain of insomnia." Sleeping problems can make brain injury symptoms worse, and CRSD is often associated with cognitive and psychological problems. Treating CRSD may improve brain injury symptoms, as well.

Circadian rhythm sleep disorder (CRSD)

CRSD is a sleep cycle disorder and causes problems with the timing of your sleep. If you have CRSD, your body is not in sync with the demands of your environment. For most people society demands that they are up and working during the day, and sleep at night, with one, roughly eight-hour sleep period. With CRSD your body refuses to comply with this schedule. The timing of your sleep is determined by the release of certain hormones which govern sleeping and wakefulness. CRSD means that the timing or volume of the release of these hormones is in conflict with your actual schedule. If you cannot change your body’s natural sleep cycle or change your schedule to accommodate, you may develop problems such as"
· Insomnia

· Lack of energy during the day

· Irritability

· Difficulty thinking and concentrating

· Headaches

· Gastrointestinal problems


Over time CRSD can lead to more serious problems including:

· Difficulty learning

· Hyperactivity

· Depression

· Addiction

· Anti-social personality

Delayed sleep phase
People with delayed sleep phase are often referred to as “night owls”. Sleep hormones are not released until late at night or even very early morning, and continue to be produced for the normal amount of time, making it difficult to wake up in the morning and often interfering with alertness during the day. You may experience increased alertness in the evening or a “second wind.” If you have delayed sleep phase CRSD, and do not have any other sleep disorders, you can get good sleep and adequate rest by simply going to bed later and getting up later.

Advanced sleep phase

The opposite of delayed sleep phase CRSD, you become sleepy in the afternoon or early evening, and wake up in the very early morning. Like delayed sleep phase, if you have no other sleep disorders, you can get good sleep and adequate rest by adjusting your schedule – going to bed early and rising early.

Non-24 hour sleep cycle

Your sleep cycle does not match a 24-hour day and is constantly shifting. This is very common in blind people because cycles of light and dark help regulate your sleep cycle.

Irregular Sleep/Wake Cycle

Your sleep cycle occurs at irregular times and often more than once a day. This can mean only brief periods of sleep at night, and extreme sleepiness during the day.

Circadian amplitude disorder

Basically your body doesn’t produce big enough doses of waking and sleeping hormones so you get poor quality sleep and/or never feel completely awake and energetic during the day.

CRSD versus insomnia

Insomnia is the inability to go to sleep or the inability to remain asleep. It can be a side effect of CRSD or can occur for other reasons. More importantly, insomnia treatment normally means taking sleeping pills. Sleeping pills do not address the release of sleep hormones and are not helpful for people with CRSD.

Properly identifying and treating CRSD may directly improve the symptoms of mild brain injury, and indirectly can speed up healing and improve quality and enjoyment of life.