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    Includes Expert Content
    Stroke victim always sleeping
    caregiverbart posted:
    I have a client who has suffered a couple of strokes. His cognitive ability is somewhat in question. I always rehab a client (no matter what the problem) with expectations of a full recovery. I realize this is not always going to be the case but I feel aim for the stars and you might make it to the moon.

    Throughout the different therapy's Speech, PT, OT, etc my biggest challenge is to keep him awake. Has any one here ever dealt with this issue? Any suggestions how I can combat this? It is real hard to rehab him when I cannot keep him awake.
    Richard C Senelick, MD responded:
    Fatigue is a very common complaint after a stroke or brain injury. It is important to rule out medical conditions that can be contributing to this and may be treatable. Sleep apnea is more common in stroke survivors. Do you know if your client has excessive snoring that might indicate he has sleep apnea? Someone needs to review his medications to see if they might be the problem. A routine blood panel should rule out the common causes. If everything comes back normal, low dose of amphetamine, like methylphenidate, can make a big difference in improving the level of alertness after a stroke or brain injury. It can increase the blood pressure and that should be monitored. You will need a physician who is comfortable with that approach, but many of us who treat stroke survivors find it very helpful. Good Luck
    After your stroke you may be experiencing a new normal, but remember what George Eliot said- It is never too late to be what you might have been. You still can achieve new goals.
    caregiverbart replied to Richard C Senelick, MD's response:
    Thank you Richard. We are treating him for sleep apnea and he is on no mess that cause drowsiness. His condition almost seems to be like narcolepsy, after a full night sleep he will pass out and it takes shaking and yelling to wake him, then within a minute he will be out again. I feel if I could wake him a I could help him. As it is it is hard to even get him Physical Or Speed Therapy Because We cannot keep him awake. The man was an accomplished dentists and I hope to find a way to break through. By the way, to complicate matters he and his wife are of the 7th day church and are vegan vegetarian so not sure how an amphetamine treatment would fly.

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