What is fatigue, and how can I treat it?

Fatigue is a common problem which involves an extremely tired physical and mental state.

Physical and mental exhaustion is distinct, but sometimes occurs together. Physical exhaustion over a long period of time can also lead to mental fatigue.

Low sleep can lead to exhaustion if it persists and according to the Centers for Disease Control and Prevention (CDC), 1 in 3 Americans say they’re not getting enough sleep. The National Heart, Lung, and Blood Institute (NHLBI) recommends that adults over 18 years old sleep 7 to 8 hours a day.

Poor sleep is associated with a variety of medical problems and health conditions. These include:

Lack of sleep can prevent a person from performing his or her regular tasks. Getting out of bed in the morning will hurt. When it affects safety, for example, on the road, it becomes a public health issue. In extreme cases a person can show symptoms similar to an intoxicated state.

Fast facts on fatigue:

Here are some key points about fatigue. More detail is in the main article.

  • Fatigue can be due to a variety of medical conditions and health problems..
  • Some causes can include anemia, thyroid conditions, diabetes, lung and heart disease, and having recently given birth.
  • If a health condition, such as diabetes, is diagnosed and properly managed, the fatigue may go away.
  • A healthful diet and regular physical activity can help reduce fatigue for many people.

Types

Fatigue can make it hard to stay awake or to get up in the morning.
Fatigue can make it hard to stay awake or to get up in the morning.

There are various kinds of wear and tear.

Physical fatigue: For example, climbing stairs, a person finds it physically difficult to do the things he usually does or used to do. It introduces weakness in the muscle. Diagnosis may require a check for strength.

Mental fatigue: A person finds it more difficult to focus on issues and to stay on task. The person may feel tired, or may have trouble staying awake while working.

Sleepiness or fatigue?

Sleepiness may occur when a person does not sleep well enough, or when there is a lack of stimulation. It can also be a symptom of a clinical disorder that interferes with sleep, such as sleep apnea or leg syndrome of restess.

Typical sleepiness has a better chance of being short-term. Sleepiness and somnolence can also be overcome by normal, continuous sleeping.

Fatigue, in particular chronic fatigue, is typically associated with a medical condition or health problem. This can also be its own chronic illness known as myalgic encephalomyelitis (ME), or CFS.

Causes

Fatigue is associated with many health conditions.

1) Mental health issues

Stress, bereavement and loss, eating disorders, alcohol addiction, substance abuse, anxiety, moving home, depression, and divorce will result. Clinical depression may arise either because of the depression itself or because of associated problems, such as insomnia.

2) Endocrine and metabolic reasons

Conditions including pregnancy, Cushing’s disease, kidney disease, issues with electrolytes, diabetes, hypothyroidism, anemia and liver disease may all contribute to tiredness.

3) Drugs and medications

Many antidepressants, antihypertensives, statins, hormones, antihistamines, removal of narcotics, sedatives, and anti-anxiety drugs may cause tiredness. Changes in doses or drug stoppages may also be a cause.

4) Heart and lung conditions

Among many other heart, lung and digestive disorders, pneumonia, arrhythmias, asthma, chronic obstructive pulmonary disease (COPD), valvular heart disease, coronary heart disease, congestive heart failure, GERD, acid reflux and inflammatory bowel disease (IBD) may trigger fatigue.

5) Sleep problems

Early work, shift work, jet lag, sleep apnea, narcolepsy, insomnia, and esophagitis reflux can contribute to a lack of sleep and fatigue.

6) Chemicals and substances

Deficiencies in vitamins, mineral deficiencies, poisoning and drinking too many caffeinated or alcoholic beverages may interfere with normal sleep, particularly if consumed too close to bedtime.

7) Various diseases, conditions, states, and treatments

These may induce exhaustion, such as cancer, chemotherapy, myalgic encephalomyelitis (ME), radiation therapy, chronic fatigue syndrome (CFS), fibromyalgia, systemic lupus, rheumatoid arthritis, obesity, severe blood loss and impaired immune systems.

Fatigue may be a symptom of infection, too. Some diseases that cause extreme fatigue include malaria, tuberculosis (TB), infectious mononucleosis, cytomegalovirus (CMV), HIV, flu and hepatitis.

8) Chronic pain

Chronic pain patients frequently wake up during the night, sometimes. Usually they wake up exhausted and badly rested, unable to get sleep of sufficient quality. The combination of pain and lack of sleep can cause chronic fatigue and tiredness.

Many illnesses and disorders can also be related to other disorders, such as sleep apnea, where pain is the main symptom, such as fibromyalgia. It only worsens fatigue symptoms. For one fibromyalgia and sleep study, half of fbromyalgic individuals also had sleep apnea.

9) Being overweight or underweight

Getting overweight raises the risk of tiredness, for various reasons. Those involve having to bear more weight, having more risk of joint and muscle pain, and having a disease where fatigue is a common symptom, such as diabetes or sleep apnea.

Similarly, an underweight person can easily fatigue, depending on the cause of their condition. Eating disorders, cancer, chronic disease, and an overactive thyroid can all cause weight loss along with extreme exhaustion and tiredness.

10) Too much or too little activity

A person who feels exhausted may not be exercising, and lack of exercise may cause additional fatigue. Lack of exercise will gradually cause deconditioning, making performing a physical activity harder and more tiring.

After sustained, extreme mental or physical activity exhaustion can also affect healthy people. Working or staying awake for long hours without a break, especially while driving, increases the risk of accidents and errors. Statistics have shown that longer hours of staying awake lead to more motor vehicle accidents among truck drivers and bus drivers.

Should not drive when being asleep. A survey conducted by the CDC found that in the previous 30 days about 1 in 25 drivers aged 18 years and over had fallen asleep while driving.

Symptoms

Exhaustion of physical or emotional activity is the primary symptom of exhaustion. After rest or sleep the person doesn’t feel refreshed. Regular tasks can be difficult to carry out like work, household chores and caring for others.

The symptoms and signs of exhaustion may be physical, mental, or emotional.

Popular fatigue related signs and symptoms can include:

  • aching or sore muscles
  • apathy and lack of motivation
  • daytime drowsiness
  • difficulty in concentrating or learning new tasks
  • gastrointestinal problems such as bloating, abdominal pain, constipation, and diarrhea
  • headache
  • irritability and moodiness
  • slowed response time
  • vision problems, such as blurriness

Following exertion the symptoms tend to get worse. They can appear several hours after exercise or operation, or probably the next day.

Diagnosis

Diagnosis can be complicated, because the causes and symptoms differ and are not clear.

The doctor may ask questions relating to:

  • the quality of the fatigue
  • patterns of the fatigue, for example, times of day when symptoms are worse or better, and whether a nap helps
  • quality of sleep including emotional state, sleep patterns and stress levels

By keeping a record of the total hours spent per day, and how much they wake up during sleep, a person can benefit.

The doctor will conduct a medical exam to check for signs of illness and ask the patient what drugs they are using. Many factors to consider include current or recent illnesses and events that may cause fatigue, such as birth, surgery, or recovery from a major injury or disease.

The doctor would also inquire about lifestyle habits like diet, use of caffeine, substance use, consumption of alcohol, work patterns and sleep patterns.

Diagnostic tests

This may help to identify a cause that underlies it. Based on other symptoms, urinalysis, mri scans, mental health questionnaires and blood tests may be needed.

Tests may help to rule out physical causes such as cancer, hormone problems, anemia, liver or kidney problems. The doctor can order a sleep test to rule out a latent disorder.

If a disease is diagnosed, then the disease is treated. For example, managing diabetes can help to solve the tiredness issue.

Treatment

To successfully treat fatigue, it is important to identify the root cause first. Only a few examples may be:

  • anemia
  • sleep apnea
  • poorly controlled blood sugar
  • underactive or overactive thyroid
  • an infection
  • obesity
  • depression
  • an abnormal heart rhythm

Appropriate treatment for the condition can help alleviate fatigue.

Yoga, CBT, and mindfulness for fatigue

Participants indicated in one study that fatigue, anxiety, and depression dropped, while quality of life improved in those with multiple sclerosis (MS) who had been trained in 2 months of meditation on mindfulness.

A research on the effects of yoga has shown some change in cancer survivors ‘symptoms of exhaustion and quality of sleep. The four-week curriculum included postures, meditation, respiration, and other techniques.

A 2017 research explored the effects of cognitive behavioral therapy (CBT), mindfulness, and meditation in the treatment of breast cancer patients with sleep disturbances. Researchers found that those who engaged in CBT tended to have the greatest sleep improvement, with reduced exhaustion, depression and anxiety along with increased quality of life.

Results from carefulness and yoga studies were not as obvious, but appeared to be slightly improved or at least some gain overall.

Home treatment

Here are some tips for overcoming fatigue.

Sleep

A big part of controlling exhaustion is quality sleep. Better sleep hygiene practices:

  • Aim to go to bed and wake up at the same time each day, even on days off.
  • Set the bedroom temperature at a comfortable level. Cooler may be better. The National Sleep Foundation recommend a room temperature of 60 to 67°F.
  • Make sure the room is dark and quiet.
  • Avoid screen time an hour before sleeping, as the light and sounds from a TV or computer screen can stimulate brain activity, affecting sleep quality.
  • Avoid eating within 90 minutes or 2 hours before going to bed.
  • As bedtime approaches, physically and mentally slow down. Have a consistent routine. A warm bath or listening to some soothing music can help you clear your mind of stressful and worrying thoughts before going to sleep.

Keeping a sleep diary may also help.

Eating and drinking habits

Diet can affect how tired or energetic we feel.

Here are some tips:

  • Eat small frequent meals throughout the day.
  • Eat snacks that are low in sugar.
  • Avoid junk food and follow a well-balanced diet.
  • Consume plenty of fresh fruit and vegetables.
  • Drink alcoholic and caffeinated beverages in moderation, or not at all. Avoid caffeine in the afternoon and evening.

A moderate and well-balanced diet can lead to better health and better sleep.

Physical activity

By enhancing the sleep, regular physical activity can help to reduce fatigue. For those who have not been physically involved for some time should be slowly incorporating exercise. A physician or sports therapist may help. Exercise which is most beneficial for you during the time of day.

Take a break from driving

The CDC is advising people on the road to learn the warning signs of drowsiness.

If a driver sees any of the following they’re doing, they can pull over and take a nap or change drivers.

  • yawning and blinking
  • not remembering the last few miles they have driven
  • missing an exit
  • drifting across the lane
  • driving onto a rumble strip
  • having trouble staying focused

If your daily life is influenced by exhaustion and sleepiness and none of those tips work, you should see a doctor.

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