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What can be done about excessive sleepiness after stroke?

11 answers | Last updated: Jun 07, 2015
richard asked...

I had a stroke about 6 months ago. I'm now being treated by a doctor but I seem to be sleepy much of the time. My doctor says there is nothing I can do, but that doesn't seem reasonable. What can I do about this stroke sleepiness?


Caring.com User - James Castle, M.D.
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James Castle, M.D. is a neurologist at NorthShore University HealthSystem (affiliated with The University of Chicago) and an expert on strokes.
79% helpful
James Castle, M.D. answered...

I have found that fatigue can be a common problem after stroke. There are several reasons why you might be feeling sleepy:

See also:
American Stroke Foundation: Interview With Joan McDowd

See all 153 questions about Sleep Problems
  1. You could be suffering from sleep apnea (due to weakness in the muscles of your throat) and not getting a good night’s sleep;
  2. Your stroke could have damaged the parts of the brain involved in sleep/wake cycles;
  3. You could be uncomfortable in bed due to your disability;
  4. You could be depressed.

In my experience, sleepiness after a stroke sometimes occurs even when those reasons have been ruled out.

I would recommend a visit to a sleep specialist to examine the quality of your sleep -- there might be an easily fixable problem at work. If nothing is found, medications can be prescribed which make you feel more awake during the day. It also makes sense to have your primary doctor screen you for depression and run some basic tests to rule out an endocrine disease or infection.


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46% helpful
Crys answered...

It could also be due to certain meds. Until quite recently, my bf was on several medications. Now that he is home and has a primary physician, a different neurologist and a therapist, they have taken him off most and changed others for fewer side effects. You could see if any of your meds could be substituted for something as effective, yet have different or fewer side effects.


50% helpful
CA-Claire answered...

It can also be your brain/body signalling you that it needs more rest/repair time. Pay attention to this. Set a schedule for your nightly sleep (8 hours or more), and have a nap in the afternoon as well.

Take care!


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33% helpful
/people/142044 answered...

I had a R basal ganglia stroke on 1/17/09 (48 yr old female). I found that I have had to concentrate so much on moving my left hand/leg that it has been exhausting to get through every normal task. I also felt that my brain/body must have needed healing time and sleep is restorative... plus, I did feel my sleep time has not been as good because my left side collapses(and hurts)under my body weight and it has been much more difficult to turn over in bed, etc. I still tire more easily and it is like hitting a brick wall when I get tired... I don't seem to have ANY reserve now and therefore must take a nap immediately... the first 7 months naps were 4-5 hrs, they gradually lessened to my current 1-2 hr naps. dsh


67% helpful
oc1dean answered...

Post-stroke fatigue: a treatment protocol that is being evaluated When I found this I rejoiced, but after reading the abstract I realized they only are talking about compensation which for me is a total waste of time. I can't get any more cardiovascularily fit. I don't want the fatigue managed, I want it cured. http://www.ncbi.nlm.nih.gov/pubmed/21402652 When is someone going to look at the chemical changes in the brain and see if those are causing the fatigue? Abstract Purpose: Post-stroke fatigue is a common and debilitating complaint, which has only recently received attention in clinical rehabilitation. Until now, no evidence-based treatments have been available for the condition. Therefore, a new treatment was designed to reduce post-stroke fatigue complaints: Cognitive and Graded Activity Training (COGRAT). Rationale: Following the premise that post-stroke fatigue is primarily caused by brain damage, the treatment aims to prevent fatigue and to manage existing fatigue symptoms. The purpose of the added graded activity programme is to reduce fatigue by changing cognitions and enhancing physical fitness. Theory into practice: COGRAT consists of a cognitive treatment and graded activity programme in small groups over 12 weeks. In the cognitive treatment, patients receive education on post-stroke fatigue and register their activities and fatigue to gain insight into their daily agenda and fatigability. Patients are then taught several compensation strategies. Cognitive behavioural therapy is used to diminish anxiety, facilitate behavioural change and manage fatigue symptoms. The graded activity programme consists of walking on a treadmill, strength training and home work assignments. Maximum heart rate and strength are increased from 40% at the beginning of the training to a maximum of 70%. Considerations for future improvements: COGRAT is currently being evaluated in outpatients with severe post-stroke fatigue in a multicentre randomized controlled trial. Preliminary data suggest both positive short- and long-term effects. Adaptations for other neurological patient groups suffering from fatigue are suggested. Sorry, but you are totally on your own to find out what to do about it.


33% helpful
oldbleu answered...

As a stroke survivor I can tell you that depression is a real factor. You need to have a MD treat you for it. Also I have found "Piracetam" and "Neurocholine with Cognizin" realy helps with brain function. You can get them online in 800mg tabs. Any stroke survivor should be using these products.


25% helpful
Lady Lew answered...

I don't have a solution, but I have noted that I am sleeping 12-16 hours of good sleep at night (or whenever I choose to go to bed) with an added 1-3 hour nap every once in a while. I don't feel fatiqued, but I know I'm depressed. I just figure that's part of the territory of having brain hemorrhages, seizures (docs say no "real" strokes yet), and ageing. I live with it. Good thing I like reading in bed, with a cat sleepingon my thighs. Get lots down time and don't worry about it. Nobody seems to care about it although I've mentioned it repeatedly to my doctor.


ALM answered...

Ok Naps would be an extreme luxury for me, with working 40+ hours a week and raising a 5 year old boy, not going to happen, Any body got any other ideas, did the sleep apnea thing and nothing there. We are doing light therpy and breathing therpy, I just want to retire, but Docs don't seem to think it's neccessary. With out disability financialy it would be impossible to quit work. But man am I tired and have been since the multiple storks 2 years ago


63% helpful
Marsha L answered...

My 56 year old husband had a massive stroke on his right side in Jan, 2010. He was completely paralyzed and couldn't speak. He can now walk, has use of his arm but not hand and fingers and is working very hard to speak a word or two or three. He sleeps excessively also. He sleeps about 8 hours ea night but takes 3 hour naps during the day. Our neurologist told us that it takes 2 years for the swelling in the brain to subside and that the only way the brain can heal itself is through sleep (just like a newborn. Think about it - they sleep ALOT). So, my husband and I have decided to try and reduce the sleep to about 2 1/2 hrs hoping that his brain is working on healing and replasticizing (or whatever they call that). It is so difficult to see the change that this massive stroke has had on my husband, and our family, but he does continue to improve (even though it is definitely baby baby steps) so we are hopeful that the sleep is aiding the process. Don't know if this helps but this is what we live with.


Pattis girl answered...

Sllepiness in stroke patient: My 75 year old mother had a stroke 2 weeks ago and received on day 3 mannitol to reduce brain swelling. It was like the movie awakenings, where she became alert, sharp and talkative. When they took her off it she went into almost a coma state where it was very difficult to wake her up. Now 2 weeks into it I asked the doctor to give her manitol and it pepped her right up. The drug has not been approved for long term use but it seems that the excessive drowsiness is relieved by this drug. I hope there will be clinical trials. Email me at pattipaster@hotmail.com if you have a similar experience.


The good Dr Holiwell answered...

I'm a stroke survivor(10-8-2003) and a pediatrician. Initially for quite some time, I estimate that I was sleeping 10-15 hours a day. I just assessed that this was required for my brain to adapt and heal itself as best possible, even though I never was able to practice medicine again.