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Understanding Excessive Sleeping After Stroke: Why It Happens & How It’s Treated

Old man napping on couch with dog because he has excessive sleepiness after stroke

Fatigue and excessive sleepiness after stroke may fall under a condition known as excessive daytime sleepiness (EDS). People with EDS often feel overcome by the need for sleep during the day.

While sleep is crucial for promoting a healthy recovery, excessive sleepiness can be a sign of more serious underlying problems.

This article will discuss why a stroke can cause excessive sleepiness, and explain when to seek medical attention.

Use the links below to jump straight to any section:

Benefits of Quality Sleep After Stroke

Before we look at the causes of excessive sleeping after stroke, it’s important to note that drowsiness is a normal part of the early post-stroke phase of recovery.

During this period, your brain will devote most of its resources toward healing the damage it incurred. While the brain normally uses 20% of your total energy, that percentage increases during stroke recovery. This means the brain has less energy left to keep you alert and awake.

Aside from helping the brain heal, deep sleep also offers other, fantastic benefits to stroke survivors.

For example, REM sleep – the deep sleep that occurs at intervals throughout the night – helps your brain process motor information. When your brain achieves REM sleep, there are spikes of neural activities that occur, known as sleep spikes. During these neural spikes, the brain transfers short-term memories about muscle movement to the temporal lobe where they become long-term memories.

Therefore, quality sleep can actually help stroke survivors regain proper muscle movement and strength. Since most stroke patients struggle with mobility problems, this is an incentive for stroke patients to focus on getting enough sleep.

But how can you tell when sleep becomes excessive? We’ll discuss that in the sections below.

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Causes of Excessive Sleeping After Stroke

Although sleep is a crucial part of stroke recovery, many patients develop a problem known as excessive daytime sleepiness (EDS). Excessive daytime sleeping usually decreases after a few weeks. However, in about 30 percent of stroke patients, EDS can last for over six months.

If your sleepiness lasts for several months and prevents you from practicing your stroke rehab exercises, talk to your doctor, who can help you find effective treatments.

In addition, there are several factors that can worsen excessive daytime sleepiness after stroke, such as: 

  • Sleep-disordered breathing: A chronic condition that causes partial or complete cessation of breathing throughout the night, resulting in excessive daytime sleepiness. Sleep apnea is the most common type of sleep disorder that affects your breathing.
  • Reverse Robin Hood Syndrome. Excessive sleepiness caused when the brain attempts to redirect blood flow from damaged areas to non-damaged ones. (The brain robs the poor to feed the rich.)
  • Depression. Severe depression can cause excessive fatigue and drowsiness.

These medical complications can prevent you from getting quality sleep and, as a result, limit your recovery. Therefore, it’s important to identify and treat them as soon as possible.

Symptoms of Excessive Sleepiness After Stroke

senior woman napping on couch because she has excessive sleeping after stroke

The primary symptom of EDS is constant fatigue throughout the day. Even after just waking up from a full night’s sleep, a person with excessive daytime sleepiness syndrome would still feel exhausted.

Other symptoms of excessive daytime sleepiness after stroke can include:

  • Irritability
  • Anxiety
  • Decreased appetite
  • Slowed cognition or speech
  • Memory problems
  • Restlessness

To find an effective treatment for these symptoms, it is critical to receive a thorough diagnosis. If you struggle with excessive sleepiness after stroke, be sure to talk with your primary care physician.

Treating Excessive Daytime Sleepiness After Stroke

doctor discussing treatment with elderly patient

As mentioned above, excessive sleep is not always a bad thing, especially in the beginning of stroke recovery. However, as time passes, drowsiness might impair your recovery by preventing you from engaging in therapy.

If your quality of life is being impacted by excessive daytime sleepiness after stroke, do not worry. There are effective treatments available. Some approaches your doctor might recommend include the following:

Address Underlying Conditions

The first step doctors might take is to address any underlying conditions causing your excessive drowsiness.

For example, if sleep apnea is disturbing your ability to achieve REM sleep, treatment may involve the use of a C-PAP machine. With a C-PAP, you wear a mask over your nose or mouth while you sleep. The mask is then hooked up to a machine that blows a continuous stream of air. This ensures you get enough oxygen throughout the night, which can reduce daytime drowsiness.

Sometimes excessive daytime sleepiness is caused by a poor night’s rest for other reasons, such as depression. If emotional changes after stroke are affecting your sleep and quality of life, talk to your doctor. You can explore psychological care such as talk therapy or medication like antidepressants.

Stimulants and Diet Changes

If nothing else works, there are stimulant medications that doctors can prescribe to treat excess sleepiness. These include modafinil, amphetamines, and ritalin.

Always consult your doctor before starting or stopping these medications (which are only available with a prescription).

Finally, some natural remedies that can help you stay awake include coffee and tea, but be sure and check with your doctor on caffeine use as well. Your doctor might also encourage you to follow a high-nutrition diet to maintain energy. (See: top 9 foods for stroke recovery)

Overcoming Excessive Sleep After Stroke

Excessive sleeping after stroke is common during the early stages of recovery as the brain works hard to heal itself. However, excessive daytime sleepiness could signify other problems that deserve a conversation with your doctor.

If your daytime sleepiness is caused by depression, sleep apnea, or other problems, treating these conditions can help decrease your sleepiness. Otherwise, certain medications such as modafinil can increase alertness. Your doctor can help you choose the best treatment for you.

We hope this information on excessive daytime sleepiness can help you find ways to boost your energy and continue your recovery from stroke.

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