How do I reset a post-stroke sleep schedule?
My father had a severe ischemic stroke six months ago. His recovery has been going well, but recently his sleep pattern has changed: He sleeps during the day and stays awake all night. This is very difficult for my mom, who hasn't slept well since this started. What could be the cause, and what can we do to help get his sleep schedule back to normal?
Sleep disturbances after a stroke are very common. The sleep cycle disruption may start in the hospital and get gradually worse over a six-month period. It's not unusual for a stroke survivor to be extremely fatigued during recovery, and as a result, he may spend too much time sleeping during the day. It's a vicious cycle: If you sleep all day, you're naturally going to be up all night, and then you'll be exhausted during the day.
What your father needs is to get back on a normal sleep cycle. You and your mom can help him by trying the following:
Make sure he knows whether it's daytime or nighttime. A lot of stroke patients completely lose track of night and day, so you have to make a real effort to separate the two. Open all the curtains and blinds in the morning; close them at bedtime. Schedule activities and outings during the day to keep him active.
- Limit naps to certain hours. It's fine for him to take naps when he's tired, but hours and hours of napping will cause wakefulness at night. Also maintain good sleep habits: He shouldn't nap in his bed. Have him nap somewhere less comfortable, like on the living room sofa. That way he can preserve his nighttime sleep for the bedroom.
- Gradually transition to a later bedtime. Shift it 10 or 20 minutes later each day until he goes to bed at a more normal hour.
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