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Fatigue after stroke fact sheet, what new tinnitus - Review

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Over the past month there has been a period of at least two weeks when you have experienced fatigue, a lack of energy or increased need to rest every day or nearly every day. Since your stroke you have experienced fatigue, lack of energy or increased need to rest every day or nearly every day. Post-stroke fatigue can range from relatively mild to severe and the intensity of the tiredness does not seem to be related to the severity or type of stroke you have had. Even if you have made a full physical recovery, or your stroke was some time ago, fatigue can still be a constant problem. Some research studies show that women, older people and those who suffered from fatigue before their stroke are the ones most likely to experience it. Many people describe fatigue as the most difficult and upsetting problem they have to cope with after a stroke.
It can also affect your quality of life and relationships, as family and friends may not understand how genuinely exhausting the fatigue can be. It is likely that a mixture of physical and emotional factors are contributing to you experiencing fatigue after stroke, even though we don’t fully know what makes some people have fatigue when others do not. In the early weeks and months after a stroke your body is healing and the rehabilitation process takes up a lot of energy so it is very common to feel tired. You are also more likely to have lost strength and fitness whilst being in hospital or as a result of the stroke, although this does not always mean you will have post-stroke fatigue. It has also been suggested that fatigue may be associated with inflammatory cells or hormones (such as cortisol) that are disturbed by the stroke. Getting a proper diagnosis and finding out if there are any specific causes for your fatigue is the first step.
Your GP or stroke nurse can check if there are any medical conditions that could be affecting your fatigue. See our factsheet F9, Stroke in younger adults for more information about returning to work. Head of National Stroke Association, Matt Lopez, talks about his stroke and goals for 2015. While the same approach may not work for each stroke survivor, trial and error can help doctors and physical therapists figure out the best possible therapies for you.

For over 30 years we have been the trusted source for free resources and education to the stroke community. Lack of energy and frequent breaks can be a sign of fatigue which is a common post-stroke symptom. Difficulty picking up the front part of your foot, which can cause you to drag your toes along the ground when walking (foot drop or “drop foot”) is common for some people after stroke. Limited coordination and muscle movement and painful muscle spasms in your arms and legs (spasticity) can happen as a result of a stroke.
After a stroke, you may feel like you lack energy or strength and feel constantly weary or tired. However if you do ignore fatigue, you could be storing up problems for the future and you are not giving yourself the best opportunity to recover.
In one study, two years after their stroke 10 per cent of stroke survivors said they were always tired and 30 per cent said they were sometimes tired. Post-stroke fatigue is just as common after strokes caused by bleeding in the brain (haemorrhagic strokes) as those due to a blockage in a blood vessel (ischaemic strokes). However, other studies show younger people and those who were previously completely fit can also feel tired after a stroke. For example walking and completing other daily activities may well take up much more energy than they did before your stroke, making you more likely to feel tired.
For example, beta blockers for high blood pressure, drugs for epilepsy, pain and anti-depressants can all cause fatigue. If your fatigue is at least partly caused by side effects of your medication, it usually improves with time or once you start a new medication. Fatigue can be very worrying and upsetting and just knowing it is because of the stroke can help. If the fatigue means you cannot return to your old job then you may have to look at working fewer hours or changing jobs.
Learn more about sleep challenges and treatments in our latest iHOPE : Sleep Disorders in Stroke Survivors. Every stroke is different and the effects will depend on which part of your brain was damaged.

The signs of fatigue are not always obvious to other people and so they may not understand how you are feeling. Post-stroke fatigue does not always improve with rest and is not necessarily related to recent activity. In another study, at least 12 months after their stroke, 50 per cent of stroke survivors said tiredness was their main problem. We do know that you are more likely to experience fatigue after a stroke than after a transient ischaemic attack (TIA), sometimes called a mini stroke.
Other individual studies made a connection between being unemployed and having fatigue after stroke.
However, although most people with depression do feel tired, not everyone with fatigue is depressed. Show your family and friends this factsheet to help them understand what you are going through. Your local stroke team, GP or occupational therapist can help put you in touch with different types of support, for example stroke clubs, counselling, relaxation programmes, exercise groups or alternative therapies.
Make your tax-deductible donation today to support the growing needs of the stroke community. The good news is that there are things that can be done to reduce the impact of your stroke. This factsheet explains what fatigue is, what can cause fatigue after stroke and suggests ways you can help yourself and seek support in the longer term. See our factsheets F10, Depression after stroke and F36, Emotional changes after stroke for more information.

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