An article posted in Stroke Connection Magazine, November/December 2010 issue

A stroke leaves physical and emotional damage – it can also zap energy and cause fatigue. Researchers report that up to 70 percent of survivors experience fatigue that includes overwhelming physical and/or mental tiredness or exhaustion. Symptoms can include difficulty with self control, emotions and memory. How severe and long-lasting fatigues ranges from mild and seldom to overwhelming and constant. Some report feeling tired when they perform a task requiring physical or mental focus. Most report that fatigue occurs without warning and makes it harder to do daily, routine activities as well as social or work activities.

Because research in this area is limited, we aren’t certain what causes fatigue, but there are several possible causes.

Medical conditions a survivor has, such as heart disease, diabetes, repertory disease, anemia, pre-stroke fatigue or migraines, can contribute to fatigue. That’s because the stroke or medication side affects may worsen fatigue or even mask it. Sleep apnea is also common among survivors. It is reported at high rates among those who report post-stroke fatigue, although no solid relationship has been proven.

Poor heart health may also play a part due to higher levels of exertion. Survivors expend twice as much energy just standing upright and keeping their balance.

Survivors are often concerned about doing some tasks. This stress can increase physical and mental demands and lead to fatigue. Lack of control in movement and walking appear to increase when a person is tired. Anxiety, stress and depression, which are common after stroke, are associated with lack of energy, although research has not determined their specific relationships to post-stroke fatigue.

Talk to your family and work with your healthcare team to determine the best plan of care for you. Here are some other tips:
1. Check your prescriptions for potential side effects, including fatigue.
2. Ask for treatment options if you are experiencing anxiety, depression or difficult sleeping. Family support and understanding can also help. Let your family know that post-stroke fatigue is different from fatigue they’ve experienced.
3. Maintain good health to prevent or control other medical conditions, such as heart disease or diabetes, which can affect your energy level. Currently there is no prescription specifically for tiredness, although many related symptoms can be treated.
4. Talk to your physical therapist to understand fitness balance disorders, uncoordinated movement and walking related to fatigue. He or she can create an exercise program to increase your endurance. Balance and coordination exercises will help you perform tasks with less energy, increase our confidence and decrease your anxiety.
5. Try to schedule demanding physical or mental activities throughout the day or week. That way you’ll plan to take rest breaks before you feel tired and break up the concentrated periods of time that you’re exerting yourself.
6. Consider modifying your home and work environment to make them more efficient. Use assistive technology when possible.

Physical therapists can help patients reduce post-stroke fatigue. In most states, patients can make an appointment directly with a physical therapist, without a physician referral. Learn more about conditions physical therapists can treat and find a physical therapist in your area at

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