Do Concussions Make You Tired? Exploring Post-Concussion Fatigue

Experiencing fatigue or feeling tired after a concussion is a common concern during the recovery process. While most people associate concussions with symptoms like headaches and dizziness, it’s essential to understand that fatigue can also be a significant aspect of short and long-term stages of recovery. In this comprehensive blog article, we will delve into the relationship between concussions and fatigue, explore the underlying causes, and provide insights into managing post-injury fatigue effectively.

Understanding Post-Concussion Fatigue

Post-concussion fatigue is a feeling of extreme tiredness or low energy following a concussion. It is one of the most common symptoms during the initial recovery period. The brain, as a complex organ responsible for numerous vital functions, requires significant energy to heal after sustaining a concussion. This increased energy demand can lead to physical and mental exhaustion, causing fatigue. It’s important to understand that the fatigue experienced after a concussion differs from regular tiredness and may be more severe and long-lasting.

While the standard advice is usually something to the tune of “rest until you feel normal,” sleeping too long after a concussion can be detrimental to recovery. The ideal time for sleep is in the first 7-14 days post-injury. As a rule of thumb, rest until you feel good enough to resume light activity. The most researched best practice is to begin the Buffalo Concussion Treadmill Test as soon as you can resume light activity. This will speed up recovery, prevent prolonged autonomic symptoms, and give you a clear understanding of what symptoms are holding you back.

Causes of Fatigue After Concussions

1: Increased Metabolic Activity

A brain injury can disrupt the brain’s normal functioning, leading to a rise in brain metabolic activity and an increased need for energy. This heightened demand for energy can result in individuals feeling consistently exhausted and depleted. This is considered the phase that extra sleep is important. The key is not to sleep for too long or your brain will begin to adapt to inactivity, making return to normal activities more challenging.

2: The body’s natural healing response

The natural healing response following a concussion may require increased rest and sleep, which can contribute to a sense of ongoing fatigue. The main reason concussion fatigue is so prominent early on is due to the repair of sodium/potassium channels. Healthy channels require ATP to maintain proper electrolyte balance within cells. When these channels are broke, there is no way to maintain this osmotic balance. Thus, the body shunts a lot of energy to the brain to repair these channels. Hormonal imbalances, such as disruptions in the production of neurotransmitters and changes in the hypothalamic-pituitary-adrenal axis, can also play a role. 

3: GI Health

Metabolic factors such as GI health and nutrient absorption can affect how the body uses energy. Other conditions like SIBO (small intestinal bacterial overgrowth) is common after a concussion. The stress of recovery, poor sleep, damage to vagal centers, and several other factors can all contribute to a dysfunctional microbiome which will further worsen fatigue symptoms. 

4: Sleep Wake Cycles

Concussions have the potential to disrupt the natural sleep-wake cycles, leading to fragmented or inadequate sleep. This, in turn, contributes to an ongoing sense of tiredness and lack of alertness during the day. Its often a paradox of being very tired throughout the day, but also being unable to stay asleep at night. Hormonal imbalances, damage to midline autonomic centers, and poor blood sugar control can all contribute to poor sleep post concussion.

5: Hormonal Imbalance

The occurrence of a concussion might lead to imbalances in hormonal levels, affecting the brain’s neurotransmitter production and altering the functioning of the hypothalamic-pituitary-adrenal axis, all of which can play a role in contributing to persistent fatigue. Persistent sensory mismatches between the neck, eyes, and vestibular system are a common cause of a prolonged “fight or flight” response post injury. Consult a qualified comprehensive concussion provider if you suspect your 3 primary sensory systems are not integrating.

6: Medications

Some medications prescribed for concussion symptoms, such as pain relief or anxiety management, may come with side effects like drowsiness or fatigue, further impacting an individual’s energy levels. The often effect the integrity of the gut lining, hindering nutrient absorption and perpetuating anxiety.

7: Autonomic Function

Concussions have the potential to disrupt the autonomic nervous system, which is responsible for regulating energy levels in the body, leading to a persistent sense of fatigue and diminished stamina. The body can get stuck in “fight or flight” mode, leading to an ongoing sense of fatigue. There can also be damage to the “rest and digest” response, which hinders the body’s ability to shift into recovery after prolonged stress.

8: Mental Health

The risk of developing depression or anxiety following a concussion can contribute to ongoing feelings of fatigue, impacting an individual’s mental and physical health. Prolonged recoveries, multiple unsuccessful treatments, unsupportive family members, and feelings of hopelessness can all accelerate mental health problems. Furthermore, the side effects of a lingering concussion can wind up the HPA axis, causing excessive cortisol output which to the person, feels like anxiety or a panic attack.

9: Visual and vestibular function

Visual and vestibular dysfunction can lead to an ongoing strain of the eyes, making normal activities stressful and tiring. Places like grocery stores or large crowds quickly overwhelm these systems. When they fatigue, the resulting stress response can trigger the overwhelming need for sleep and recovery. When these systems don’t agree with one another, there is a reflexive output of stress. It’s a feeling similar to being motion sick.

Managing and Coping with Post-Concussion Fatigue

1. Rest and Sleep

Adequate rest and quality sleep are essential during the first week or 2 of recovery. Ensure you prioritize sufficient downtime and create a conducive sleeping environment to promote restorative rest. Proper sleep hygiene is essential when crafting a plan to recover from a concussion. A helpful sleep hygiene tip is the 3-2-1 rule; No food 3 hours before bed, no work 2 hours before, and no screen time 1 hour before.

2. Gradual Return to Activities

Pushing too hard too soon can worsen fatigue. Gradually reintroduce routine activities, pacing yourself and listening to your body’s signals. Be aware that cognitive exertion, such as excessive screen time or multitasking, can contribute to fatigue. Begin the Buffalo Concussion Treadmill Protocol when you can return to light activities.

3. Structured Schedules and Breaks

A structured daily routine can help manage fatigue by pacing daily activities. Incorporate regular breaks to avoid overexertion and allow your brain to recharge. Please take note of your symptoms and when they show up. A detailed list of symptoms and when they occur helps your healthcare professional better understand your triggers and location in the recovery process. Lastly, understand that hitting limits is a part of the recovery process. Staying within your current limits and gradually moving beyond them is a more effective strategy than bull-dozing through them. 

4. Mindful Nutrition

Eating a well-balanced diet that includes lean proteins, fruits, vegetables, and whole grains can provide essential nutrients for brain recovery and sustained energy. Avoiding excessive caffeine and refined sugars is also advisable, as they can lead to energy crashes. Supplements that accelerate concussion recovery include omega 3s, magnesium terminate, lion’s mane, vitamin D, B vitamins, curcumin, acetyl-l-carnitine, and antioxidants (vitamin C).

5. Stress Management Techniques

Stress can worsen fatigue levels, so implementing stress reduction techniques such as meditation, deep breathing exercises, and gentle yoga can help manage both physical and mental fatigue by supporting the vagal system. Other ways to improve this system include low-grade exercise, vagal nerve stimulators, cold exposure, and binaural beats.

6: Avoid Excessive Caffeine

During concussion recovery, it’s best to avoid caffeine, as it can worsen symptoms like headaches and fatigue. Instead, prioritize restorative sleep and a balanced diet for natural energy levels. If you absolutely need some caffeine to stay awake, opt for teas rich in antioxidants, like green tea. If you can’t live without coffee, adding some MCT oil helps prolong its benefits.

7. Consult with Healthcare Professionals

Working closely with healthcare professionals specializing in concussion management. They can offer personalized guidance, evaluate underlying conditions causing fatigue, and recommend suitable interventions. These may include physical therapy, cognitive behavioral therapy, or medication.

When to Seek Medical Attention

While fatigue is a common symptom of concussion recovery, there are cases when medical attention may be warranted. If fatigue becomes severe, persists for an extended period, or significantly impacts daily functioning, it is advisable to consult a healthcare professional. They can assess your condition, rule out other potential causes, and provide appropriate guidance and support.

Conclusion

Fatigue is a common symptom during concussion recovery, often leaving individuals feeling drained and lacking energy. Understanding the connection between concussions and fatigue is important in order to manage and cope effectively. To navigate post-concussion fatigue and support overall recovery, it’s important to prioritize rest, gradually return to activities, maintain a healthy lifestyle, manage stress, and seek professional guidance when necessary. Every journey is unique, so patience, self-care, and a multidisciplinary approach can help optimize healing and gradually restore energy levels.

Click here for a free 30-minute consultation with a Dr. at The Neural Connection if you’re dealing with unresolved concussion issues. Read our 80+ 5-star Google reviews to see how we’ve helped people with lingering post-concussion symptoms.

*Note: The information provided in this article is for educational purposes only and does not constitute a doctor-patient relationship. Patients are advised to consult their medical provider or primary care physician before trying any remedies or therapies at home.