Understanding Fatigue After Stroke: Causes, Symptoms, & Management

Managing Fatigue After Stroke

Here are some tips that can help you cope with post-stroke fatigue:

1. Talk to your doctor

Fatigue is common during inpatient rehabilitation where you’re working hard for hours each day. But if fatigue is still affecting you after discharge, then it’s important to talk to your doctor. They can diagnose your condition and suggest methods for treatment.

2. Check your medication for side effects

Sometimes fatigue is a side effect of certain medication. Check to see if fatigue is listed as a side effect on any of your medications. If so, talk to your doctor. They may be able to switch medications, or offer other ways to improve fatigue.

Even if you’re fairly certain your medication is contributing to your fatigue, always talk with your doctor before making any medication changes.

3. Conserve your energy

An occupational therapist may be able to educate you on energy conservation strategies to use to limit post-stroke fatigue. These strategies involve simple changes that you can make to your daily routine that may help you to conserve energy and avoid fatigue.

The 4P’s  of energy conservation are:

• Prioritize which activities are most important to complete.
• Plan the best way to complete those activities (e.g. making a grocery list before shopping or cooking enough food to have leftovers).
• Pace yourself by spacing out more taxing activities throughout your day and week.
• Position (or posture). Pay attention to your positioning. Try to perform more activities while sitting, as it requires less energy than standing.

Be mindful of your rehabilitation exercises or household chores. Try not to do too much at once, otherwise you might aggravate your fatigue.

Sometimes post-stroke fatigue has delayed onset. If you push hard one day, you may experience fatigue the next day. To prevent this burnout, take breaks throughout the day and stay mindful of your energy.

4. Keep an energy journal

Keep a journal of your activity levels and energy levels. You may find patterns, like feeling fatigue the day after lots of activity. Then identify a nice balance of recovery-boosting activity and rest, and stick to it.

5. Improve your stamina

Exercise is a surprising solution for post-stroke fatigue. Even though exercise takes energy, it could help build stamina and reduce fatigue long-term.

One study suggests that treadmill training “lowers the energy cost of hemiparetic gait.” When it takes less energy to move around, it could help relieve fatigue after stroke. Start slow, and increase your duration gently.

6. Eat well

Your diet has an impact on your energy levels. For example, consuming sugary foods causes blood sugar to spike and then drop, which causes tiredness and a “crashing” feeling. To avoid diet-induced fatigue, focus on eating healthy foods for stroke recovery like vegetables and whole grains.

7. Sleep!

Neuroscientist Jill Bolte Taylor suggests sleep as her #1 recommendation for stroke survivors. When the brain is busy recovering, sleep is one of the best ways you can aid recovery. While post-stroke fatigue doesn’t always improve with sleep, it’s still good to get plenty of rest. Sleep allows the brain to recover.

8. Focus on one thing at a time

Multi-tasking is an energy drain, mentally and potentially physically as well. While some stroke patients report that they cannot multitask to begin with, it’s important to stay mindful of your attention. To reduce fatigue after stroke, it’s best to slow down and do things one at a time.

9. Manage emotional changes

Post-stroke fatigue could be a combination of physical and emotional factors. Depression and anxiety are common among stroke survivors with fatigue. Seeking treatment for mood disorders like depression can help relieve fatigue. When you spend less energy struggling with emotions, there’s more left for rehabilitation.

Getting Support for Post-Stroke Fatigue

If you struggle with post-stroke fatigue, reach out for help from your medical team.

Your doctor may be able to adjust your medication if fatigue is listed as a side effect of any current prescriptions.

If you have demanding secondary effects, like post-stroke pain or paralysis, your therapist might be able to help. For example, they can try electrical stimulation to see if it helps accelerate recovery.

Ultimately, you should experiment with as many treatments as possible until you find something that helps you. Remember to pace yourself and rest when you need it. Good luck!