Suggest treatment for sleep disorder after ischemic stroke of left thalamus
Patient: My husband 55 years old had an ischemic stroke of the left thalamus 6 months ago. He is unable to regulate his sleep. Sleeps up to 16 hours a day, and can t wake himself though he tries in the morning with alarm clocks and phone calls he requests from his sons. He s getting frustrated with it, and knows he ll need to be able to wake himself if he is ever to return to work. His memory and motor skills are functional - the sleep is the biggest issue now. Any ideas? Doctor: Hello ! I read your question and understand your concern. In my opinion he is suffering for hyipersomnia. It is more common in thalamic stroke. Unfortunately there is not a curable therapy to this problem. I would give some advises to try to regulate his sleep cycle:  -Sleep a few hours longer at night to avoid excessive sleepiness during the day.-Exercise daily in the morning or early afternoon, if possible.-Engage in enjoyable activities that require your full attention, such as spending time with friends, writing letters, or playing with a pet.-Try to go to sleep and wake up at the same time every day.-Get out of bed and stay out of bed until bedtime.-Avoid foods that make you sleepy and heavy meals during the day.-Avoid alcohol and caffeine.I would also try Modafinil , which is a drug effective in primary hipersomnia. This drug must be prescribed under a neurologist prescription. Hope to have been helpful!Best wishes, Dr. Abaz Quka