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stroke fatigue


dreinke

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This is one of the least understood side effects of a stroke. While I was still in the hospital if I had 10 minutes between therapy appointments I would fall asleep. I was also on the general muscle relaxant, baclofen, which was supposed to lessen my spasticity. It didn't do that at all so I was left with the side effect of extreme fatigue. Finally talked my doctor into trying something else. Zanaflex, which was no better, also a general muscle relaxant.. Since there was no diagnosis on what was causing the fatigue I self-diagnosed myself that I had sleep apnea. It was proven correct after going thru a sleep study in which I would quit breathing 6 times an hour. This was a fairly mild case of sleep apnea but I did convince my doctor that I wanted to get a CPAP machine. What a mistake. With the positive air pressure going into my nose constantly, I had to actively concentrate on my breathing to make sure I could exhale against the pressure. It worked for about a week but I did not get any lessening of the fatigue. I finally quit using it during the second week when one night I spent two hours concentrating on breathing thru the mask. At that point I decided that living with the apnea was more restful than trying to use the CPAP machine. I have no idea what waterboarding feels like but that is how I would describe the feeling of breathing against the CPAP machine.

I have heard that our brain is about 2% of our body weight but uses 20% of the energy, so the speculation is that the brain is rebuilding as it recovers and needs that much extra energy.. If I want to function at work I have to have a large cup of coffee. On weekends I can sleep for 10-12 hours or take 2 hour naps during the day. Personally I think there is a chemical imbalance in the brain after a stroke and researchers just need to focus on that. Recovery could occur so much faster if we all weren't battling fatigue all the time. For myself I am still quite cardivoascularily fit, resting heart rate of 53 at age 53 puts me in the athlete category. If I am an athlete, why am I so fatigued all the time?

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Yep, fatigue, or in my husband's case massive fatigue is a feature of post-stroke living. One of the leaders of our Stroke Recovery group here on the Central Coast did a paper on that at the last Stroke Symposium, so doctors are aware of the problem but as yet have no answers for it.

 

Ray used to sleep up to 16 hours out of 24, cut back to 14 and now about twelve. It is still a major part of his day. He sleeps usually 2pm - 5pm so any activities have to be based on morning hours. I do take him out to a couple of afternoon activities as I as a long term caregiver have to have a life too but I notice he doesn't function as well the following day.

 

Sue.

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Dean: Bruce is a farmer by upbringing. He pre=stroke was in bed at sunset and up before sun rise. Just after the stroke he slept almost all day. At about one month post, just as he was being discharged, his CNA advised me he was up by 4 am and usually just watched TV so as not to disturb his roommate. She was a dear and brought him coffee from the nurses station. Over the past six months or so, he was in bed by 7:30 pm and up between 2 and 3 am with a nap only a few days a week usually on therapy days. Zanaflex zonks him, he is on a very low dose, so on PT days I only gave him 1 mg so he wouldn't fall asleep during therapy but had the benefit of the drug for therapy. He gets the bigger dose at bedtime and it lasts just about six hours. He has been through two different sleep aids, to no effect. Benadryl works, but his Neuro is dead set against it, so a no go. We have recently added 5 mg Baclofen three times a day, in preparation for the ITB trial at the end of the month. He has begun taking a good hour nap after the lunch Baclofen kicks and the bedtime dose enhances the Zanaflex for an additional hour of sleep. He recently started an antidepressant and that may also add to the added sleep.I see the effects of the antidepressant in his reconnection to the real world: he's brighter, initiates conversation, discusses his observations, asks how I am and how my time alone was. The added sleep has made him stronger; he's increased his time in the pool, can tolerate longer therapy sessions, spends more time at work. As in your case, it has taken long months and many trials to find the right mix to conquer some of his fatigue and lessen his frustration at not being able to do as much as he would like. I am hoping this will lead to renewed interested in walking again. While there may be no definitive answer as to why stroke victims require so much rest and sleep and why they suffer long bouts of fatigue, even after the smallest of activity; it is a reality and must be addressed as best an individual can.

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Hi Dean,

On this forum and others stroke survivors always mention fatigue as one of the annoying legacies of stroke and not able to be explained.

Ihad my stroke 2 years ago and have never experienced fatigue - just one more example Iguess of " all strokes are different"

Idon't sleep during day and sleep 8 hours each night

Best wishes to you

Elizabeth

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I have fatigue that is troubling. But the thing is I've had chronic fatigue for many years. so, it's not all stroke-related. I just started taking Strattera, a non-stimulant medication. My attention span sucks, anyway. My psychiatrist it watching me closely. :bouncing_off_wall:

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