Stroke and Sleep

Stroke is brain damage caused by the interruption of blood supply to the brain, which can damage our brain and lead to sleepiness.

Stroke and Sleep

Benefits of Quality Sleep After Stroke

Excessive sleepiness often happens after a stroke. Stroke is brain damage caused by the interruption of blood supply to the brain, and it is one of the most common diseases for middle-aged and elderly people worldwide. So a stroke occurs when the flow of blood to the brain is blocked. It is a medical emergency because blood carries oxygen, and brain cells begin to die within a few minutes without it. Strokes can occur at any age, but stroke risk increases as you get older.【1】

A stroke may cause temporary or permanent disabilities. Stroke complications will depend on what part of the brain was affected by the stroke, and how long that area of the brain was deprived of oxygen. And common stroke complications include excessive sleepiness after stroke, paralysis or loss of muscle movement, memory loss or cognitive difficulty, trouble with talking or swallowing, pain or numbness, emotional difficulty or loss of motivation, and so on.【2】

The are many benefits of quality sleep after a stroke, including the following:

  • For people who are sick, various functions of the body can be restored during the process of sleep so as to achieve the purpose of recovery from disease.
  • A quality night’s sleep can relax and rest the body’s organs and spirit and it can promote the recovery of physical strength and energy. In this way, a good night’s sleep is not only good for physical health, but also for mental health. 
  • Quality sleep can promote our growth and development. For people in the process of growth and development, the hormones that are beneficial to growth are secreted during sleep. Thus, good sleep can promote growth and development.
  • Good sleep can promote our immune function, and improve human immunity, thereby enhancing the resistance to external viruses, bacteria, and other pathogenic microorganisms. Compared with people who sleep poorly, people who sleep well have better resistance to a number of diseases and are less likely to develop infections.

Clinically, chronic diseases of various systems are closely related to sleep, such as the digestive system and the nervous system.【3】

  • A quality night’s sleep is a kind of human instinct and the most basic requirement for maintaining normal metabolism and physiological functions. In short, sleep help us sustain our lives. 
  • Good sleep helps to improve our mental state for the next day and maintain a good mental state and a relatively comfortable mood. In this way, it can greatly improve the quality of life and work efficiency.
  • A quality night’s sleep also helps improve our memory. 

Causes of Excessive Sleeping After Stroke

Stroke is a very common disease, especially in middle-aged and elderly people. Stroke is divided into ischemic stroke and hemorrhagic stroke. And these two can all affect the function of the brain, and can also cause surrounding edema and increase intracranial pressure. In this way, it will cause sleepiness. There are many factors that may cause sleeping after a stroke, including the following reasons: 

1. Brain tissue damage

Excessive sleeping after stroke is related to brain tissue damage caused by stroke. For example, when a patient has a large-area cerebral infarction, or when a cerebral hemorrhage affects the patient’s brainstem reticular ascending activation system, the patient will experience disturbance of consciousness and then sleepiness. This sleepiness is caused by damage to brain cells after a stroke.

2. Physical cause

The elderly are physically weak, and they may take part in fewer exercises after a stroke. In this way, their body will be weaker, and they will easily sleep excessively. 

3. Increased intracranial pressure

Increased intracranial pressure can also lead to sleepiness. With the further progress and aggravation of the patient’s disease, the degree of the patient’s sleepiness will also deepen. That is, from sleepiness to coma.

4. Reduced blood circulation

Because the blood perfusion in the brain tissue of patients is relatively low, the blood circulation is relatively poor or basically. In this way, there is no blood circulation. Local brain tissue can have local necrosis with reduced blood circulation, surrounding brain tissue may lack oxygen.

The above two reasons can cause ischemia and hypoxia of nerve cells, and improve the damage to nerve cells. They will also reduce the function of local brain tissue, and cause symptoms of sleepiness in patients. Furthermore, it will aggravate the severity of a stroke and the extent of the stroke.【4】

5. Fever

Sleepiness may also be caused by fever. If the doctor says there is nothing wrong, you can just relax at home and observe your situation for a long time.

6. History of cerebrovascular disease

People who have a history of cerebrovascular disease should be alert to the recurrence of this disease if they have symptoms of sleepiness recently. You had better go to the hospital for a head CT or intracranial Doppler color ultrasound to confirm the diagnosis and treat it in time.

7. Sleep-disordered breathing

It is a chronic condition that causes partial or complete cessation of breathing throughout the night, resulting in excessive daytime sleepiness. Among them, sleep apnea is the most common type of sleep disorder that affects your breathing.

8. Reverse Robin Hood Syndrome

Reverse Robin Hood Syndrome. Excessive sleepiness is 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.)

9. Depression

Severe depression can cause excessive fatigue and drowsiness.【5】

Dangerous Signs of Excessive Sleepiness

Sleepiness can lead to many serious diseases, and these signs below are worth attracting our attention.

  • Severe lacking of oxygen in the brain will not only cause memory loss, abnormal behavior, personality changes, unresponsiveness, and other behaviors, but also cause sleepiness.
  • Liver problems can cause sleepiness.
  • Diabetes. The specific manifestations are long-term fatigue and sleepiness during the day. In addition to leading to sleepiness, fatigue, and drowsiness, long-term lack of oxygen in the brain may also lead to physical fatigue and always sleepy.
  • Cerebral hemorrhage. Long-term sleepiness and drowsiness in middle-aged people can cause cerebral hemorrhage.
  • High blood pressure can cause dizziness, headache, drowsiness, weakness, and sleepiness.
  • Heart disease. Poor blood circulation in the heart and slow metabolism can cause sleepiness.
  • Ischemic stroke. If middle-aged people after stroke often have unexplained sleepiness or drowsiness, and also feel numbness in their fingers. They should be cautious for it may be a sign of ischemic stroke.
  • Hypothyroidism. Patients will have difficulty in breathing, chest tightness, sleepiness, fatigue, sluggish expression, low body temperature, poor hearing, rough, pale, or sallow skin, coarse and less shiny hair, muscle weakness, slow movement, and unresponsiveness. 
  • Liver disease. If you often feel very tired and don’t have enough sleep, your whole body is so soft, you are very weak, your skin is pretty yellow, and you even lose your appetite, you may have liver disease.
  • Heart disease. Heart disease can lead to poor blood circulation, accumulate metabolic wastes in tissues, stimulate nerve endings, and cause symptoms such as fatigue, sleepiness, and shortness of breath. 
  • Anemia. Fatigue and sleepiness are the most common symptoms of anemia, and may also be with symptoms such as dizziness, headache, inability to concentrate, pale complexion, and so on.

Symptoms of Excessive Sleepiness After Stroke

The main symptom of EDS is persistent fatigue throughout the day. Even when just waking up from a full night’s sleep, people with excessive daytime sleepiness syndrome will still feel tired. In this way, this will greatly affect people’s state and mood during the day, and even unable to live and work normally. Therefore, the harm caused by sleepiness is immeasurable.

Understanding the symptoms of sleepiness after stroke in advance is beneficial to making corresponding adjustments, and maintaining a normal state of life and lifestyle. Thus, it is also beneficial to subsequent treatment and rehabilitation. So, this section is very important.

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 a stroke, be sure to talk with your primary care physician.【6】

Stroke and Sleep
Female doctor with her senior patient with sleeping trouble, suffering from chronic headaches or migraine

Treatment of Excessive Daytime Sleepiness After Stroke

Stroke is not only fast but also powerful, so finding timely and effective treatment has become the primary goal of this field. However, the research on the changes in the brain after a stroke and the repair mechanism is still incomplete. If we can go further in this field, it will help a lot in stroke treatment.

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.【7】

  • Develop a low-salt and low-fat diet. In this way, people should avoid spicy and greasy food and eat a bland diet.
  • Be under body recovery treatment. Patients can take limb training, speaking training, and swallowing training under the guidance of physicians. At the same time, you should also pay attention to prevent the occurrence of other complications.
  • Take some medicines. Patients can take some medicines that protect brain cells and nourish nerves because stroke complications generally refer to the functional impairment left after half a year of onset in various degrees. Generally speaking, it is very difficult to recover from complications.
  • For the complications caused by cerebral infarction, patients can take anti-platelet aggregation drugs and statins for treatment. In addition, if the patient has secondary epilepsy or limb pain, he should take a targeted treatment.【8】
  • Use blood-activating drugs to improve blood supply. In this way, it can restore heart function so that the heart can function at its maximum.
  • Have physical examination regularly. Patients should often go to the hospital to check blood pressure, blood lipids, and review head CT. 

Tips to Overcome 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. Furthermore, your doctor can help you choose the best treatment for you.【9】

In addition, please pay attention to the following aspects for they can help you:

1. Choose an appropriate sleeping position.

First, general patients can choose the right lateral position. Second, the bed should be flat, soft, neat, comfortable, and clean. Third, the height and hardness of the pillow should be moderate. Moreover, the quilt should not be too thick because a soft and warm quilt is great. 

2. Well arrange your indoor environment.

The patient’s room is best facing the sun to ensure sufficient sunlight because the soft sunlight can make people feel comfortable. It is best to have heating and cooling air-conditioning equipment indoors to adjust the appropriate temperature, but also pay attention to ventilation. Furthermore, you should also pay attention to the cleanliness of the room, and disinfect the air when respiratory infectious diseases are prevalent in spring and winter. 

3. Be in a good mood.

After a healthy person has a sudden stroke, a series of mental and psychological changes will occur, especially in the elderly. They may lose confidence in life, be depressed, and even have idea of suicide. All these ideas will affect sleep. Therefore, it is necessary to communicate with other people, build up the confidence to overcome the disease and be full of love for life.

People should also actively participate in recreational activities, and actively participate in family and social activities within one’s ability. In this way, all these activities can help in treatment and recovery. 

4. Develop a reasonable diet.

Patients with a stroke often have a history of hypertension, hyperlipidemia, or hyperglycemia. Therefore, a reasonable diet can help control the primary disease, and keep the body in a relatively normal state of balance. It is also an important condition for ensuring normal sleep. All in all, people should focus on breakfast and lunch, and the amount of dinner should be small. The total daily calorie intake should be 1500-2000 kcal.

People can choose lean meat, fish, soy products, egg whites, and poultry foods that are low in cholesterol. You can cook with vegetable oil and avoid foods with high cholesterol, such as egg yolk, butter, and other animal fats. Eat more fibrous vegetables such as celery and green vegetables to stimulate bowel movements and prevent constipation. Furthermore, you should not smoke and go for a drink. Smoking has been confirmed to be one of the risk factors for cerebral infarction.