Using the circadian rhythm to re-regulate your nervous system
An essential key to recovering from post-concussion syndrome and TBI
When you’re struggling to recover from a brain injury, it’s common to have problems with:
Calming down in the face of stress, especially startling stressors
Sleep
Brain fog
Inability to focus one’s attention or sustain that attention
Sensory overload
We can generalize these as problems with “down-regulating” the nervous system and “up-regulating” the nervous system. And since the brain is the centerpiece of the nervous system, a brain injury is really a nervous system injury.
If you’re like me, then you might have seen your problems with up-regulation (brain fog, attentional issues, cognitive endurance issues) as an existential threat to your ability to earn a living. Thus, I viewed that as the biggest problem I faced and largely ignored my problems with down-regulation, except when that problem was acute.
To up-regulate, I turned to the thing I had relied on for up-regulation prior to my injury: coffee. I started drinking mass quantities coffee. As you might imagine, this not only didn’t solve the fundamental problem (it masked it, and only partially), it also made down-regulation that much harder. You can imagine how well I responded to sudden stressors or to my evening in general.
Circadian rhythm to the rescue
I was so profoundly ignorant about the circadian rhythm, I thought of it as something external to myself, like the planetary rhythm of night and day, something I might deign to get in tune with, or not. I had no idea that it underpinned almost every aspect of my biology and my daily experience of life—not just when I slept, but throughout the day.
The following sources of information helped remedy that ignorance:
The Huberman Lab podcast episodes on sleep and his discussion of the circadian rhythm and Satchin Panda’s book The Circadian Code.
Matthew Walker’s Master Class on sleep.
Over time, I came to realize that the brain is a rhythmic organ (both at the neural network level, and the diurnal cycle level) and that the circadian rhythm is the foundational rhythm of other rhythms, including ultradian cycles, which are happening 24/7 in the brain and body.
Since we are a diurnal species, disconnecting from this rhythm within ourselves does real harm. The fact that we could be so out of alignment with our biology speaks volumes about modern life.
The good news is that we can do a much better job of regulating the brain and nervous system (up or down, in the moment, or at different times of day) by working with, rather than against, our own circadian rhythm.
“At night, when you turn off all the lights, there's no place that you can hide, oh no. The rhythm is gonna get'cha.” —Gloria Estefan
Key realization: If I expanded the height and depth of the “sine wave” of my day, allowing myself to relax more deeply during the relaxation trough, and be more alert during the alertness peak, I could further deepen and strengthen the overall signal. The stronger I allowed the pull of relaxation, the stronger the push of alertness could be, and vice versa.
What my day looked like before making this change
Here’s a rough sketch of my habits prior to working with the circadian rhythm rather working with little regard for it.
Wake up at X time or maybe later if I was feeling groggy, which was most days. Waking up later could be easily justified with the knowledge that I went to sleep later the night before. Have some coffee. Dick around on my phone. Do my morning routine. Struggle to track into my day. Get some work done throughout the day, throwing myself at things on my to-do list. In the evening, maybe do another work session before finally throwing in the towel. Watch a few episodes of something. Maybe get sucked into a show or an app and stay up an hour or two later than usual.
In fairness to myself, I was doing a lot of things to try and push through my day—principally by doing a lot of task switching to manage my mental or physical energy levels.
Overall, I would liken the feeling of this to piloting a sailboat, finding the wind going out of my sails, trying to do some fishing until the wind picked back up, then trying to sail again for as long as the wind held out—all in an aim to feel like I made some forward progress that day.
What my day—and night—looks like with more circadian rhythm alignment
Note: What I’m about to outline is the default routine that I aim for, but sometimes (often) life gets in the way and I have to change the sequencing of these events. “Life” could also be inspiration—being a writer means following your inspiration, sometimes first thing in the morning, before you return to the “regularly scheduled programming.” I keep a checklist on my phone (using the Notes app in iOS). At the end of each day, I take a photo of that note so I have a record of what was done or not, which keeps me accountable. One last caveat: My morning routine has evolved over the years, and I expect it to look different in the future, but this is where things stand today.
I now view “my day” as a complete diurnal cycle of day and night. Each part of the cycle supports the other within a push-pull flow.
I typically wake up naturally without at an alarm at around the exact same time every day, but as a safety net, I set my alarm for a specific time, which happens to be 7:30 AM (your time could be different, this is mine).
After I wake up, I do a session of Wim Hof breathing, in part because I want to give my body a strong and consistent cue that the day has begun.
I do the breathing before I have coffee for a practical reason. Breathing with a bellyful of coffee can be uncomfortable when you’re lying flat, but it’s especially bad if you do the WHM as I do, with my head slightly lower than the rest of my body (I’m on a slight decline plane).
After the breathing exercise, I have coffee and a small set of supplements that are best taken first thing in the morning (branched-chain amino acids, choline, and vitamin D).
Next, I take a hot shower that I steadily turn cold, usually in about two or three increments (I turn the dial to fully cold in two to three steps, acclimating for around a minute at each step before going to the next colder step).
I spend about two to three minutes in the fully cold shower, about the length of song, typically by Tito Puente, which makes the cold shower seem like a festive event. One of the hallmarks of reaching the “minimum effective dose” of cold is the playful feeling that comes over me in the midst of the cold exposure.
Briefly, I should mention here that listening to rhythmic music is likely to be beneficial neurologically for a variety of reasons. The brain is a rhythmic organ. Different regions of the brain work together rhythmically. A neural network is a kind of band. We get a sense of that when we look at brainwave readings. Moving on…
After showering, I get dressed and go for a 30 minute walk. As with the shower, the walk serves multiple purposes, which include: helping lymphatic drainage from the brain, helping neurovascular coupling and bloodflow to the brain, creating optic flow with the attendant calming of the amygdala, and tapping into the dopaminergic activity of moving forward. While walking, I might listen to a podcast, or call a friend for a brief chat, or just enjoy the alone time.
With regard to the circadian rhythm, the walk is also serving a critically important function: light exposure. When sunlight enters your eyes in the morning, even on a cloudy day, it signals cells in your eye that, in turn, set your entire biological clock. You don’t want to miss more than a day of such light exposure.
This light exposure is critically important to maintaining synchrony with the circadian rhythm. So if I can’t get that light exposure via a walk, I will stand or sit outside for five to ten minutes to make sure my clock is set in this way. For more about the mechanism of this, see the Huberman Lab podcast about it.
Note: I used to go to a gym, but the pandemic caused its permanent closure, so now I walk to a nearby school campus where there are steps, metal bars, and other incidental structures I can use as found workout equipment. This may be the best example of how my morning routine shifts in response to life circumstance. So my walk might include this kind of workout depending on the day (I don’t workout every day).
Once I return home, I begin a set of optional treatments or training, and once these are concluded, I take a second set of supplements (which includes alpha GPC) and begin my work day (if I haven’t already).
During my work day, I take frequent brief physical recesses. While working, I might use the NeoRhythm, most likely with a setting that includes gamma waves (such as the Energy and Vitality setting). I might also use binaural beats.
In the late afternoon, around 4:30 PM, I’ll do a set of exercises the triggers my symptoms. Around 5 PM (the traditional end of the work day), I know my body and brain are shifting into the down-regulation cycle. This is when I might do a round of Wim Hof breathing (the Mood Regulation breathing in the WHM app), and a theta or Meditation Calming and Relaxation session on the NeoRhythm.
I aim to eat dinner no later than around 7:30 PM (there are social exceptions). As a general rule, I try not to eat after dark, so if I get a post-dinner urge to snack, I look outside, and if it’s dark, I’ll avoid the snack (if it’s twilight, I’ll sneak it in under the wire).
Around 10 PM I begin my wind-down to bedtime, taking magnesium bisglycinate and 200mg of L-theanine. Once in bed, I do 20 or 40 minutes of the Improve Sleep mode on the NeoRhythm, and fall asleep, typically by 11 PM.
When to schedule optional treatments
Optional treatments and training, such as syntonic light therapy, typically last for a certain time period (six months for example). My daily routine has varied depending on which treatments I was doing and where I was in the cycle of the treatment.
Before re-aligning my day according to my circadian rhythm, I would heavily front load these things in the morning. After taking the rhythm into account, I created one set of up-regulating morning activities, and another set of down-regulating evening activities.
For example, I would do a neurofeedback training session in the morning aimed at boosting my focused attention. And one in the evening for deep relaxation.
Take a look at what you’re currently doing for rehab and see how you can divide things in this way. One possible experiment: Time the physical or occupational therapy that triggers your symptoms at around 4:30 PM, then shift immediately into your down-regulating therapies and activities.
Wrapping up
Recovering from a brain injury typically involves some kind of disruption to our autonomic nervous system and our ability to either be calm when we want to be calm or be alert when we want to be alert.
Beneath this lies the bedrock of the circadian rhythm, which can offer us a way to move toward greater overall nervous system regulation, leading to better handling of individual moments of stress or relaxation.
The circadian rhythm is inside us and it hinges on our attunement both to ourselves and to our environment, in particular early morning light. Modern life has befouled this attunement and made us believe we can do any activity we want at any hour of the day we choose. So we push ourselves, often working around the clock and causing further disruptions—disruptions which are no longer tenable with a brain injury, and not even ideal for optimal performance without one.
Speaking of optimal performance, that’s what you’re working toward. You’re not necessarily working just to get back to where you where. The ceiling could be higher than that in some areas. And your re-attunement to your own rhythms can be one of those areas.
Brainwave is an informational resource for people whose symptoms haven’t resolved after a concussion or mTBI. I endeavor to present this information in a clear and concise way, spelling out what’s backed by science and what remains unknown. Nothing here is meant as a substitute for professional medical advice, diagnosis, or treatment. I am not a physician or a healthcare practitioner of any kind; I’ve simply had a lot of sports-related concussions and had to learn this stuff the hard way. If you found this information helpful or know someone who might benefit from it, please share and subscribe to Brainwave.