Research shows that about 1 in 10 adults report symptoms of chronic fatigue(1), and about half of adults ‘feel sleepy’ between 3-7 days per week (2).
In this article, we’ll discuss some of the main factors of chronic fatigue and offer some action-oriented solutions that may help you feel more recharged.
What Is Chronic Fatigue?
Chronic fatigue is persistent tiredness that does not improve with adequate rest and often worsens after physical or emotional exertion. While specific symptoms may vary from person to person, some of the core symptoms of chronic fatigue include:
- persistent themes of extreme fatigue
- experiencing unrefreshed sleep even if the quantity of sleep is reasonable
- difficulty concentrating (known as brain fog)
- muscle pain or joint pain
- headaches
- sensitivity to certain textures, lights, sounds, or other sensory details
- mood swings
- digestive issues
Chronic fatigue syndrome is a general term for the medical diagnosis of myalgic encephalomyelitis chronic fatigue syndrome (ME/CFS) or systemic exertion intolerance disease (SEID). Someone with this diagnosis experiences CFS symptoms for at least 6 months or longer, and they also often experience symptoms of post-exertional malaise (PEM), meaning exertion aggravates their symptoms.
What Causes Chronic Fatigue?
Experts haven’t identified a single cause of chronic fatigue. Instead, a combination of factors probably increases someone’s likelihood of developing this condition. Other risk factors include:
Sleep Disorders
Any sleep disorder can contribute to chronic fatigue. It’s estimated that 50 million Americans have chronic sleep disorders, including insomnia, sleep apnea, narcolepsy, and restless leg syndrome(3). Sleep problems often go undiagnosed, but if you’re concerned about your quality of sleep, consider seeking a referral for a polysomnography (sleep study).
Chronic Stress
The mind and body are unquestionably connected, and chronic hyperarousal can put the body into a state of “perpetual alert,” making it hard to relax when it’s time to sleep. In addition, chronic stress is associated with increased epinephrine (adrenaline) and cortisol. These stress hormones may interrupt energy levels and overall sleep quality(4).
Nutrient Deficiencies
Research shows that iron, vitamin B12, folate, and vitamin D may impact energy and immune function. Imbalances may, therefore, contribute to fatigue(5). Consider asking your doctor for labwork to rule out potential deficiencies.
Medical Conditions
Fatigue is a common symptom of several medical conditions, including:
- Hypothyroidism: An underactive thyroid slows down the metabolism and can contribute to cognitive impairment and fatigue.
- Diabetes: Both high and low blood sugars can affect energy levels, and some diabetic medications have side effects of lethargy.
- Long Covid: Fatigue has been examined in people with long Covid, and it may coincide with sensations of dizziness, brain fog, and other sleep-related problems.
- Autoimmune conditions: People with irritable bowel syndrome, multiple sclerosis, lupus, fibromyalgia, and rheumatoid arthritis experience may oscillate between various mild and severe symptoms. Fatigue, however, is a common factor in most chronic illnesses.
- Epstein-Barr virus (EBV): This viral infection is associated with fatigue during and after infection.
How to Manage Severe Fatigue
Unfortunately, there’s no quick fix or universal strategy for treating fatigue. It’s a complex problem that may require implementing different strategies over time. Treating your symptoms generally requires improving both sleep hygiene and aiming to optimize your energy levels during the day. Here are some practical takeaways to consider:
Get a physical examination – If you haven’t had a routine physical lately, consider scheduling one. Because chronic fatigue is such a common symptom of many illnesses, it’s important to rule out possible medical conditions.
Adhere to a standard sleep routine – As much as possible, strive to go to bed and wake up around the same time each day. While this may not inherently fix unrefreshing sleep, consistency helps maintain the body’s circadian rhythms, which supports overall sleep regulation(7).
Establish a winding-down ritual – Follow the same routine before going to sleep each night. It may be helpful to simplify things by focusing on just three tasks in a row like shower, brush teeth, and moisturize or brush teeth, take medication, and read a few pages. Following this routine regularly reminds the body that you’re preparing for sleep.
Consider your physical activity – Exercise with CFS can be tricky. On the one hand, physical movement can improve your mood and promote better sleep. However, going too hard can exacerbate fatigue. It’s critical to listen to your body, respect its limits, and rest when needed. Exercise therapy may be a valuable resource to combat your fatigue.
Honor pacing – Pacing means balancing daily activity with rest to avoid post-exertional malaise symptoms. There is no perfect way to pace- it is a trial-and-error process, as everyone has unique triggers and individual limits. Even if you know your limits, they can also evolve throughout the day, week, or month. Consider tracking your heart rate to watch how certain tasks impact your activity levels.
Tend to your mental health – Chronic fatigue may coexist with certain mental health conditions like depression or anxiety. Unfortunately, symptoms of both conditions can reinforce one another. With that, it’s important to consider various lifestyle changes for managing stress (mindfulness, strengthening your support system, practicing good self-care) as well as considering professional support.
Practice self-compassion – It’s difficult to feel tired throughout the day. Engaging in self-compassion means practicing self-kindness and reminding yourself that you’re only human when you’re having a hard time. Try to talk to yourself as you’d talk to a good friend. Doing this can boost your self-worth and reduce negative thoughts.
Final Thoughts
Managing chronic fatigue is undoubtedly challenging. That said, integrative treatment that honors the mind-body connection may help improve your symptoms.
Coping with stress, taking care of your body, and honoring the need for rest can all positively impact your energy levels. But if lifestyle changes don’t improve your fatigue (or make it worse), consider consulting with your healthcare provider or a mental health professional for a more personalized treatment plan focused on your body’s specific needs.
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References:
- National Library of Medicine (2023). The demographic features of fatigue in the general population worldwide: a systematic review and meta-analysis. Retrieved from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10416797/.
- National Sleep Foundation (2020). Americans Feel Sleep 3 Days a Week, With Impacts on Activities, Mood & Activity. Retrieved from: https://www.thensf.org/wp-content/uploads/2020/03/SIA-2020-Report.pdf.
- Mayo Clinic. (2023). Chronic Fatigue Syndrome. Retrieved from https://www.mayoclinic.org.
- American Psychiatric Association (2024, March). What Are Sleep Disorders? Retrieved from: https://www.psychiatry.org/patients-families/sleep-disorders/what-are-sleep-disorders.
- National Library of Medicine (2020, January). A Review of Micronutrients and the Immune System–Working in Harmony to Reduce the Risk of Infection. Retrieved from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7019735/.
- National Library of Medicine (2018, December). The impact of stress on sleep: Pathogenic sleep reactivity as a vulnerability to insomnia and circadian disorders. Retrieved from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7045300/.
- National Library of Medicine (2020). The impact of structured sleep schedules prior to an in-laboratory study: Individual differences in sleep and circadian timing. Retrieved from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7423117/.