: Why does stroke cause insomnia? 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.