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Fatigue

Post-stroke fatigue, the invisible symptom, affects between 40 and 70 percent of stroke survivors. Fatigue is a normal condition in healthy individuals—a protective mechanism that alerts the body when it is time to rest or modify activity. This type of fatigue is usually related to one cause and is short-lived. Post-stroke fatigue is usually linked to chronic dysfunction of some kind and can significantly impair a person’s physical, cognitive and psychosocial (emotional and behavioral) functioning.

Post-stroke fatigue is often confused with “being tired.” It is not necessarily the same as tiredness, because it arrives without warning and rest does not always make it better. Post-stroke fatigue can occur days, weeks, months or even years after a stroke. It occurs differently in every individual. Fatigue can greatly impact daily life and slow down recovery. Caregivers may need to be prepared to help stroke survivors manage their fatigue.

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Types

Fatigue can make it difficult to perform daily tasks or even stay motivated. Many stroke survivors report that they feel like they’re “hitting a wall.” Types of fatigue include:

  • Physical fatigue—Motor deficits or muscle weakness and spasms
  • Cognitive fatigue—Memory loss, mental exhaustion and/or difficulty focusing.
  • Emotional fatigue—Can co-exist with mood disorders, loss of motivation

Many factors can influence a stroke survivor’s level of fatigue:

  • Mental health—Depression and other emotional issues
  • Sleep patterns—Irregular sleep cycles
  • Medications—Check the side effects
  • Physical post-stroke symptoms such as upper limb weakness, paralysis
  • Diet—Certain foods induce drowsiness
  • Pain

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Treatment

Fatigue can be subjective with different causes and experiences for each person. Often, healthcare professionals evaluate and treat the cause(s) of a patient’s fatigue.

Side effects of some medications lead to or worsen fatigue. Dosage, the time the medication is taken or the medication itself may need to be changed. Consult with a healthcare professional and watch iHOPE: Medication Adherence to learn more. Also, learn more about stroke-related medications, drug classes, adherence strategies and patient assistance programs.

Depression is commonly related to a person’s perceived fatigue. When fatigue co-occurs with depression, medication and mental health therapy can treat and improve both issues.

A disrupted sleep pattern is also a leading cause of post-stroke fatigue. Poor sleep can be a result of physical disabilities and pain.

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Management

Modifying lifestyle can reduce the burden of fatigue and promote recovery. Ideas include monitoring the fatigue patterns, pacing oneself, ensuring adequate time to rest and exercise, getting adequate sleep and maintaining good hygiene.

Communication is vital to managing fatigue—ask the stroke survivor questions and encourage him to let you know when he feels the fatigue coming on. While adjusting to post-stroke energy levels, consider the following to manage fatigue:

  • Tracking—Keep a fatigue diary to record time, place and environments when fatigue occurred.
  • Location—Visit locations first to check accessibility. For a stroke survivor with one-sided weakness, parking, entering the location and using the bathroom can be extremely challenging.
  • Logistics—Plan activities around the stroke survivor’s needs and abilities. Bring medications and necessary equipment (such as canes and walkers) and make time to rest.
  • Time—Be aware of how long an activity will take. Consider the surroundings. Outside stimulation such as crowds, music and background noise can be overwhelming for a stroke survivor. It is best to do outings involving these factors for limited amounts of time.
  • Stamina—Determine what activities have the greatest impact on energy level. Try doing activities when the stroke survivor is most energetic and alert; some people are “morning people” and some “night owls.”
  • Diet—Some foods that can help fight fatigue include:
    • Pumpkin seeds
    • Walnuts
    • Yogurt
    • Whole grains
    • Wheat bran cereal
    • Dark chocolate
    • Tea
    • Watermelon
    • Red bell peppers

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Content Updated: August 2012

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