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As per this article, https://www.ncbi.nlm.nih.gov/pubmed/12499712 insomnia is a common complaint after ischemic stroke. Why does ischemic stroke leads to insomnia ?

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Sometimes, stroke may be associated with insomnia, not because of the brain tissue damage, but because of how it affects someone's life.

Insomnia is a likely long-term side effect of stroke, study finds (ScienceDaily, 2018):

Importantly researchers found that although sleep efficiency was reduced in patients, total sleep time between the groups was similar, suggesting that lesions in the brains' centres for sleep-wake regulation are unlikely to cause the insomnia. Rather researchers believe that sleep problems experienced by stroke patients are due to a number of contributory factors, such as greater psychological strain, pain and discomfort as well as reduced levels of physical activity.

The article What happens to sleep after a stroke? (Medscape) describes how different stroke locations can result in different types of insomnia:

  • A pontine stroke may be expected to affect REM sleep.
  • Particular lesion sites have been reported to cause narcolepsy, destruction of normal circadian sleep/wake patterns, and regional loss. of sleep spindles, but also loss of dream life, a peculiar bed-prone behavioral stereotypy, and visual hallucinations.
  • Subcortical strokes affecting basal ganglia may be more associated with excessive daytime sleepiness.
  • Immediately after a hemispheric stroke, REM sleep abnormalities are more common. Over a period of weeks after a hemispheric stroke, it is common to observe reduction in total sleep time, sleep efficiency, and sleep stages.
  • In one study of hemispheric strokes, one third of stroke patients slept more.
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    Interesting information, but it doesn't answer the question, which is why?
    – Carey Gregory ♦
    Commented Aug 28, 2019 at 14:52
  • This is exactly what I answered. If you don't think so, you may want to say, what do you think is missing.
    – Jan
    Commented Aug 28, 2019 at 15:20
  • Psychological strain, pain and discomfort, and reduced levels of activity are features of many illnesses that aren't known to cause insomnia. I'm not criticizing your answer. I'm simply saying I think the answer is probably "we don't know why."
    – Carey Gregory ♦
    Commented Aug 28, 2019 at 15:23
  • If you ask me, all those things can very well cause insomnia, regardless of the cause, including stroke. Anyway, I'm not sure when did you see my answer; it has two parts - the second part shows that they actually found few locations that can explain why exactly a certain damage causes insomnia. My point is that stroke can be associated with insomnia due to 1) patients' changed life or 2) directly due to brain damage.
    – Jan
    Commented Aug 28, 2019 at 15:32

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