When recovering from stroke, many stroke survivors experience a “silent battle”: fatigue. Fatigue can impact many aspects of stroke survivors’ daily lives, creating mental and physical challenges, according to the American Stroke Association. Sometimes, post-stroke fatigue improves with time; for others, it can be a chronic problem.
The American Stroke Association reports that stroke survivors may experience fatigue as a direct result of the stroke location or from other factors related to the stroke:
- Lifestyle changes: These can include side effects of medications, changes in your diet and exercise routine and trouble sleeping.
- Emotional changes: These can include feeling sad, angry, anxious and frustrated more often. It is also common for stroke survivors to be depressed after a stroke. You may be having a hard time enjoying activities, having trouble concentrating or experiencing a lack of motivation, excitement or energy.
- Physical changes: It may be harder for stroke survivors to complete daily tasks, such as walking, talking or getting dressed. You may be using more energy in your daily life.
Fatigue Symptoms
Stroke survivors can experience many symptoms of fatigue, including:
- Problems remembering things
- Difficulty regulating and controlling emotions
- Issues with self-control
- Feeling tired even after getting the recommended amount (seven to nine hours) of sleep
- Difficulty completing tasks that require mental or physical focus
Managing Fatigue
If you are a stroke survivor experiencing fatigue, talk to your health care team. Also, let your family and friends know so they can provide support.
If you are experiencing fatigue after a stroke, here are some tips that can help manage it:
- Check the side effects of your medications. Fatigue could be a side effect. If it is, let your health care team know, as there may be a different medication that may work better for you without giving you fatigue. Do not stop taking medication without the approval of your health care team.
- Exercise and eat a balanced, nutritious diet. This can help you improve your energy level during the day.
- Schedule rest breaks throughout your day so you can take a break before you feel overly tired.
- Modify your workspace and your home so you can complete tasks more efficiently.
If you have physical therapy sessions, talk to your physical therapist about balance and coordination exercises. These exercises can help you use less energy to complete tasks.
Managing Sleeping Problems
50-70% of stroke survivors have breathing disturbances when sleeping, and 27% are excessively sleepy during the day or sleep too much at night, according to the American Stroke Association. You may need to see a sleep specialist for a sleep study to see if you have a sleep disorder.
Some patients benefit from getting a sleep study as sleep apnea is common after a stroke and can lead to feeling tired all the time. It can also increase your risk of having another stroke or heart attack.
If you are having problems sleeping, talk to your health care team. Here are some tips to help you sleep better:
- Engage in a relaxing activity before bed or when you have trouble falling asleep, such as reading or listening to soothing music.
- Limit your screen time before bed. Don’t have a computer or TV in your bedroom, if possible, and try not to look at your cell phone screen when you are getting ready for bed.
- Have a comfortable environment for sleep. Make sure your bedroom is a comfortable temperature, quiet and dark.
- Avoid alcohol, caffeine and nicotine after 3 p.m.
- Perform your exercises early in the day (20 minutes four to five times per week).
- Go to bed and wake up at the same time daily.
Bringing a Voice to the Silent Battle
During a stroke survivor support group meeting, we asked real patients to tell us their experience with fatigue after stroke. Here are some of their stories:
“I couldn’t ever imagine how I would vacuum the house again. I was so tired and, after the stroke, I felt that I was an in-house patient for another eight months while I recovered. As time went on, I began to push myself and get stronger. I walked a third of a block and felt so proud. It’s something I will always have to work on.” – Judy
“My biggest issue with fatigue was feeling disconnected from society. The world kept spinning and I stayed over here. I didn’t feel like getting out and doing things, and that led to depression, and it continues to pile up. One day I would spend sweeping the floor and I would be tired for a few days.” – Phillip
“It’s hard for someone who is always doing something to not do it anymore. It’s like your body shuts down to help you heal and we need that sometimes after a stroke as well so we can recover. My stroke gave me issues composing the words I want to say. I have to think of it and compose letters and make them into words. I am worn out after talking and the fatigue will take over. I have to prioritize my days to help limit the fatigue, so I am not tired by noon. Talking requires so much of my energy. I must plan everything now.” – Bob
“I love to walk, but after my stroke, I remember going down the steps and being afraid to go down even four steps and be afraid of falling. Thinking about walking a few houses down to something was major for me. Now I can go one or two miles a day walking through the neighborhood. I remember how long it took me to walk a short distance and it took courage, but I was easily fatigued afterwards. Now I can do it and be proud of that. It took years to build up the energy. Fear also goes along with the fatigue. Fear of physically being hurt and fear of falling as well as being tired. When you have that fear it makes you even more tired because your brain is working on being fearful and that alone will make you tired.” – Jerri
“The fatigue came on my body as anxiety to the max. I was so full of anxiety and exhausted because it took over my body. I was in flight or fight mode constantly and had to work my way out of that to recover and heal. This is a new normal, and you have to adjust to a new normal and sometimes that means you may get better than you were before.” – Doris
“Fatigue is a battle, but so is depression. Sometimes, I don’t know if I am depressed or fatigued. Both are exhausting. Hard to know the difference at times. It is the elephant in the room, and it can’t be ignored and needs to be an active part of my life and I need to actively deal with it. I embrace those times and see them as part of my life. This is my new normal and I am fortunate for many things. If I had an activity for the day, for two days after, I wouldn’t do anything extra because I would need the rest. I had to adjust that to continue to function.” – Cindy
Join UofL Health’s Stroke Support Groups
UofL Health’s stroke care doesn’t end when you leave the hospital. Many stroke survivors and their caregivers experience a range of emotions and challenges as they adjust back to normal daily activities. Our UofL Health – Brain & Spine Institute team is here to help.
Join us for our free support groups where you can enjoy talking openly with others who share similar experiences. All are welcome. To confirm the location details and RSVP, call Carrie Crockett, CSW, at 502-645-5425. Learn more about our stroke support groups.
Other Ways UofL Health Can Help
UofL Health – Frazier Rehabilitation Institute offers a Stroke Rehab Program that provides comprehensive services to individuals who have experienced a stroke and to the individuals’ families and support systems. The program serves patients of all ages, with the goal of restoring individuals to optimal levels of physical, cognitive and emotional recovery following stroke. For more information, call 502-582-7476.
Authors
Carrie Crockett, MSSW, CSW, is the stroke continuum of care program manager with UofL Health – Stroke, part of the UofL Health – Brain & Spine Institute. She received her bachelor’s degree in social work at Morehead State University and earned her master’s degree in science of social work at University of Louisville Kent School of Social Work. Carrie works with stroke survivors and caregivers to ensure each patient and family is provided support and education. She is proactive in the community, providing education and support to stroke survivors and caregivers through the stroke survivor and caregiver support groups in Kentucky (Louisville and Campbellsville) and Jasper, Indiana.
Kendra Mahan, CSW, is a stroke social worker with UofL Health – Stroke, part of the UofL Health – Brain & Spine Institute. In her role, Kendra meets with stroke patients and families at UofL Health – UofL Hospital and assesses social determinants of health in addition to providing information and referral services for patients. She also coordinates services to aid in the health-related needs of patients. This includes assessing, planning, coordinating, implementing, monitoring, educating and evaluating a patient’s care.
Kimberly Meyer, CNRN, APRN, Ph.D., is an advanced practice provider with UofL Physicians – Neurosurgery, part of the UofL Health – Brain & Spine Institute. Kimberly’s areas of interest include stroke, trauma care and vascular neurosurgery. She received her master’s degree from University of Kentucky and her doctoral degree from University of Louisville.
