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Fatigue is very common after stroke. It can last for some time and have a big effect on your life. This page looks at causes of post-stroke fatigue, what symptoms you might have and how fatigue might affect you. We also have tips for managing fatigue and returning to work.
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Aphasia friendly video on being tired after stroke
What are the symptoms of post-stroke fatigue
How long can post-stroke fatigue last?
Why do I feel so tired after my stroke?
Sleep apnoea
Aphasia friendly video on being tired after stroke
This aphasia friendly video provides information on feeling tired after stroke. Click here to return to the aphasia friendly information page.
What are the symptoms of post-stroke fatigue
Fatigue is different from normal tiredness, as it does not seem to get better with rest. It can happen after any type of stroke, big or small. It can also happen after a transient ischaemic attack (TIA, or mini-stroke).
The symptoms of fatigue vary between different people, but you may feel like you lack energy or strength and are constantly tired, physically and mentally. You might also find it harder to think clearly, which people often describe as brain fog. Post-stroke fatigue can be mild or more severe.
It’s not always caused by being more active or working harder. You might need to rest or sleep more than normal. Fatigue could make it difficult for you to take part in everyday activities. It can also affect your recovery and rehabilitation.
If you think you have fatigue, speak to your GP or therapist. They may be able to help to find out if something like a medication or infection is causing the fatigue, or if it’s more likely to be due to the stroke. They may also be able to suggest ways to manage your fatigue
You can find out how to understand the triggers for your fatigue and how to manage it. Fatigue often gets better over time. You can help to improve your recovery by getting support and trying techniques for managing fatigue.
How long can post-stroke fatigue last?
Fatigue can happen after any type of stroke or a TIA. Even if you have made a full physical recovery, or your stroke was some time ago, fatigue can still be a problem. It can start soon after a stroke or appear some time later. It’s more common in people who had fatigue before a stroke.
Many people describe fatigue as the most difficult and upsetting problem after a stroke. You may not feel able to engage fully in rehabilitation because you feel so tired. It can affect your ability to regain your independence in day-to-day life. It might be difficult to return to work or to socialise and enjoy everyday activities. It can also affect your relationships, as family and friends may not understand how genuinely exhausted you feel on a daily basis.
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Why do I feel so tired after my stroke?
There are different reasons why you might feel exhausted. Fatigue after stroke can be associated with physical and emotional changes after a stroke, as well as some other factors.
Physical effects of stroke
The physical impact of the stroke on your brain and body can trigger fatigue. In the early weeks and months after a stroke, your brain and body are healing.
The rehabilitation process can involve trying to do things in a completely new way or learning and doing exercises. This can be very tiring.
You may have lost some of your fitness and strength while in hospital or as a result of the stroke. If you’re not able to move around much, this can also lead to feelings of fatigue.
If you have muscle weakness after your stroke, walking and other movements could take up much more energy than before your stroke.
Emotional changes
Fatigue shares some of the signs of depression, such as feeling low, having anxiety, sleep problems and tiredness, but it’s not the same thing.
It is not always easy to tell apart the symptoms of fatigue from depression. People can have both at the same time and fatigue may cause low mood and anxiety.
Talk to your GP and explain what you’re going through. Discuss the treatment options available and what would work best for you. You are the expert on your own situation and you might feel sure your symptoms are due to the stroke rather than emotional changes.
You can ask if there is a local fatigue management service. There may be help available with healthy eating, being more active and increasing your fitness and strength, such as physiotherapy or a cardiac rehabilitation programme.
If you feel emotional changes play a part in your fatigue, you can ask about treatment for depression, including medication and counseling. See our emotional changes page for more information.
Other factors
Sleep changes after stroke
Sleep changes after stroke can be due to a number of reasons, including the brain injury itself, changes to daily activities, medications, pain, incontinence or mood changes such as feeling low or anxious.
Sleeping problems such as insomnia and sleep apnoea (interrupted breathing) can make you feel tired during the day.
Insomnia after stroke
Insomnia means you often have problems falling asleep, or that you wake up throughout the night, have trouble getting back to sleep, or wake too early. In some cases, sleep problems might resolve on their own. However, if you are concerned, speak to your GP or stroke nurse, who may refer you to another health professional. For some people, a treatment called cognitive behavioural therapy (CBT) might be helpful for reducing symptoms of insomnia after stroke.
You can find more tips on sleeping well here.
Sleep apnoea
Sleep apnoea is when your breathing stops and starts during sleep. Other symptoms include loud snoring and making gasping, snorting or choking sounds while asleep. You could ask someone to check for symptoms while you sleep. If it’s not treated, sleep apnoea can lead to an increased risk of stroke. Speak to your GP who may refer you for tests.
Diet
If you have trouble with swallowing or chewing, this could affect the amount of energy and nutrients you gain from your food.
Health problems
Some health conditions, such as anaemia (low levels of iron in the blood), diabetes or an underactive thyroid gland, can also make you feel tired.
Pain
If you have pain after stroke such as muscle pain or headaches, this can also affect your energy levels.
Medication side effects
Some common medications have fatigue as a possible side effect, such as beta blockers for high blood pressure, epilepsy drugs and antidepressants. If you think your medication is causing side effects, your GP or pharmacist can give advice. You may be able to try different types of medication. Do not stop taking your medication without speaking to your GP or pharmacist.