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Stroke Rehab: Management of Depression, Fatigue, and Sleep Problems


Management of depression, fatigue, and sleep problems

is an important part of stroke recovery. Sleep or emotional problems may decrease your motivation and willingness to participate in stroke rehab. This may delay or prevent your recovery from a stroke.

Contact your doctor or neurologist if:

  • You have any symptoms of depression, anxiety, or fatigue.
  • You have trouble sleeping.
  • You have thoughts of harming yourself or others.
  • You have questions or concerns about your condition or care.

Signs and symptoms of depression:

  • Extreme sadness
  • Avoidance of social interaction with family or friends
  • A lack of interest in things you once enjoyed
  • Irritability
  • Trouble sleeping
  • Low energy levels
  • A change in eating habits or sudden weight gain or loss

Signs and symptoms of anxiety:

  • Continuously feeling worried or afraid
  • Shaking, restlessness, or irritability
  • Problems focusing
  • Trouble sleeping
  • Feeling jumpy, easily startled, or dizzy
  • Rapid heartbeat or shortness of breath

Signs and symptoms of fatigue:

  • Feeling tired despite enough rest
  • Extreme weakness
  • A lack of motivation

Management of emotional problems:

Many stroke survivors experience difficulty controlling, or coping with, emotions after a stroke. This may be caused by damage to the brain. It may also be caused by the loss of body functions or independence. You may need any of the following:

  • Therapy or counseling may help you manage depression or anxiety after a stroke. Therapy or counseling may also help you control emotional outbursts or inappropriate emotions. Ask your healthcare provider how you can receive therapy or counseling.
  • Medicine may be needed to treat depression, anxiety, or problems controlling your emotions.
  • Support groups will allow you to talk about your feelings and concerns with other stroke survivors. It may be helpful to hear from others that have gone through a stroke and stroke rehab. You may learn ways to cope with your feelings and emotions.

Management of fatigue:

Managing your depression may decrease your fatigue. The following actions may also decrease your fatigue:

  • Do aerobic and strengthening exercises as directed. Talk to your healthcare provider about an exercise program that is right for you.
  • Use assistive devices to help prevent losing too much energy during an activity.
  • Schedule rest periods after exercise or other activities. Nap for 15 to 30 minutes during the day. Do not nap for longer than 1 hour at a time.
  • Take medicine as directed to help increase your energy levels. Talk to your healthcare provider if you feel fatigued after you take certain medicines. You may be able to make changes to your medicine schedule to decrease fatigue during the day.

Management of sleep problems:

Stroke survivors may develop sleep problems. This may be caused by damage to the brain or emotional problems such as depression. Treatment for sleep problems may include medicine to manage insomnia or treat depression. The following may help you manage sleep problems:

  • Create a sleep schedule. Go to bed and wake up at the same time everyday. This will help you develop healthy sleep patterns.
  • Do activities that help you relax before bed. Read a book, take a warm bath, or listen to music to help you relax.
  • Do not consume liquids or food with caffeine after dinner. This will make it easier to fall asleep.
  • Do not drink liquids for 2 hours before bed. This may decrease interruptions in sleep to use the bathroom.
  • Know and report the signs or symptoms of sleep apnea. Sleep apnea is a condition that causes you to stop breathing for 10 seconds or more while you are sleeping. It may also cause the muscles and tissues around your throat to relax and block air from passing through. Stroke survivors are at an increased risk for sleep apnea. Treatment of sleep apnea can reduce your risk for another stroke. Ask your healthcare provider about the signs and symptoms of sleep apnea. Also ask how you can be screened and treated.

Follow up with your doctor or neurologist as directed:

Write down your questions so you remember to ask them during your visits.

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The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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