Coping With Brain Fatigue After a Stroke or Brain Injury

Having a brain injury or stroke can lead to many long-term effects, including chronic fatigue. This post-injury brain fatigue is a common problem that can make daily life much more challenging. Read on for tips on dealing with brain fatigue after a head injury or stroke.

What is Post-Injury Brain Fatigue?

After a moderate to severe brain injury such as a traumatic brain injury (TBI) or a stroke, it's very common to experience mental and physical exhaustion on a regular basis. This is known as post-traumatic brain injury fatigue or post-TBI fatigue. Several studies have confirmed that fatigue is one of the most common lingering symptoms after a traumatic brain injury (TBI). Up to 70% of TBI survivors experience fatigue. It differs from normal tiredness in that it is generally more severe and unrelenting. 

Brain fatigue can manifest in different ways. You may feel abnormally drained both mentally and physically. Simple cognitive tasks like reading or having a conversation may wipe you out. Physical activities can also sap your energy rapidly. This fatigue often lasts for the whole day and is not relieved by rest.

Why Does Brain Fatigue Happen? 

There are several factors that contribute to brain fatigue after injury:

  • Brain damage - Strokes and brain injuries cause damage to brain tissue and disrupt normal neural communication. Your brain has to work harder to complete tasks.

  • Sleep disturbances - Many people have trouble sleeping after a stroke or brain injury, which exacerbates fatigue.

  • Medications - Drugs prescribed post-injury like sleep aids and painkillers can cause drowsiness. 

  • Mental health - Conditions like depression and anxiety are common after a stroke or brain injury and they also induce exhaustion.

  • Hormonal imbalances - Strokes or brain injuries can disrupt hormone regulation, including testosterone and growth hormone.

Tips for Managing Post-Injury Brain Fatigue

1. Studies show that improving sleep quantity and quality can significantly reduce fatigue in people with brain injuries. Prioritize a regular sleep schedule and sleep hygiene habits. Follow your body's cues and rest when you feel tired. Take short naps if needed. Keep a regular sleep schedule.  

2.  Multiple studies have found that regular, moderate-intensity aerobic exercise like walking helps reduce fatigue and improves energy levels post-TBI. Light exercise can help boost energy levels. Avoid overexertion which can make fatigue worse. 

3. Maintain a healthy diet. Eat plenty of whole grains, proteins, fruits and vegetables to supply your brain with nutrients. Stay hydrated. 

4. Energy conservation techniques: Occupational therapy focused on pacing activities, setting priorities, and using assistive devices can help stroke survivors manage fatigue. 

5. Engage in stress reduction. Fatigue can be worsened by stress. Try relaxing activities like meditation, yoga or listening to music.

6. Communicate your needs. Let loved ones know when you need to rest. Don't over-schedule yourself.

7. Consult your doctor. Discuss any medications, supplements or lifestyle changes that could optimize your energy.

8. Treat related conditions: Addressing issues like sleep apnea, nutritional deficiencies, thyroid disorders, and medication side effects may minimize fatigue.

With time and coping strategies, many people find their post-injury fatigue improves. Be patient with yourself and listen to your mind and body. Managing fatigue takes diligence but you can regain vibrancy. Post-injury fatigue can be very disruptive but there are many ways to manage it effectively. Get plenty of rest, pace yourself, reduce stress, eat healthy and communicate your needs. With the right lifestyle strategies, you can successfully deal with post-injury exhaustion.

How Occupational Therapy Can Help 

Occupational therapy (OT) can help you explore your daily habits, roles, and routines and make simple modifications to improve your fatigue. Your occupational therapist may suggest energy conservation strategies or provide tips and tricks to improve your sleep. If you want to learn more about how occupational therapy can help with post-injury fatigue, contact us today! 

Guest Blogger: Anne Momgbet, OTS

Additional Resources:


Aaronson, L. S., Teel, C. S., Cassmeyer, V., Neuberger, G. B., Pallikkathayil, L., Pierce, J., ... & Wingate, A. (1999). Defining and measuring fatigue. Journal of Nursing scholarship, 31(1), 45-50.

Ali, A., Morfin, J., Mills, J., Pasipanodya, E. C., Maas, Y. J., Huang, E., Dirlikov, B., Englander, J., & Zedlitz, A. (2021). Fatigue after traumatic brain injury: A systematic review. Journal of Head Trauma Rehabilitation, 37(4). 

Cantor, J. B., Gordon, W., & Gumber, S. (2013). What is post TBI fatigue?. NeuroRehabilitation, 32(4), 875-883.

Cantor, J. B., Ashman, T., Gordon, W., Ginsberg, A., Engmann, C., Egan, M., ... & Flanagan, S. (2008). Fatigue after traumatic brain injury and its impact on participation and quality of life. The Journal of head trauma rehabilitation, 23(1), 41-51.

Lequerica, A.H., Botticello, A.L., Lengenfelder, J., Chiaravalloti, N., Bushnik, T., Dijkers, M.P., … Rosenthal, J. (2016): Factors associated with remission of post-traumatic brain injury fatigue in the years following traumatic brain injury (TBI): a TBI model systems module study, Neuropsychological Rehabilitation, DOI: 10.1080/09602011.2016.1231120.

Kisala, P. A., Bushnik, T., Boulton, A. J., Hanks, R. A., Kolakowsky-Hayner, S. A., & Tulsky, D. S. (2019). Measuring Fatigue in TBI. Journal of Head Trauma Rehabilitation, 34(5), 289–297. doi: 10.1097/htr.0000000000000530

Tomar, S., Sharma, A., Jain, A., Sinha, V., & Gupta, I. (2018). Study of fatigue and associated factors in traumatic brain injury and its correlation with insomnia and depression. Asian Journal of Neurosurgery, 13(04), 1061–1065.