Poststroke Hypersomnia

Hypersomnia, defined as excessive sleepiness or sleep-like behavior, can reflect insufficient arousal following disruption of the arousal systems or increased production of sleep. Poststroke hypersomnia affects about 20% of patients with stroke. Severe and persistent hypersomnia is suggestive of a bilateral paramedian thalamic or mesencephalic stroke and large hemispheric strokes with mass effect. Poststroke hypersomnia can be documented by actigraphy, whereas the correlation with wake and sleep EEG is relatively poor. Persistent poststroke hypersomnia can occasionally be improved with stimulants or dopaminergic drugs.