What is fatigue?

Fatigue is a common and often debilitating symptom experienced by people with Parkinson’s disease. It is characterised by an overwhelming sense of tiredness that is not necessarily relieved by sleep or rest and can significantly impact your daily activities. The exact causes of fatigue in Parkinson’s are unknown, but it may be related to motor symptoms like tremor and stiffness, sleep disturbances, pain, depression, medication side effects and stress.

Fatigue fast facts

  • About half of people living with Parkinson’s experience fatigue.
  • There are two main types of fatigue: physical fatigue (feeling deeply tired or weary) and mental fatigue (difficulty concentrating).
  • Fatigue can occur early in Parkinson’s and can happen whether movement symptoms are mild or severe.
  • Fatigue can lead to avoiding social activities, reducing work hours, or even retiring early.
  • High levels of stress, being in poor physical condition and having poor mental health can increase fatigue.

Managing fatigue

Managing fatigue in Parkinson’s involves a combination of medical treatment, lifestyle changes, and support from your care team. It’s important to work closely with your care team to find the best strategies for your needs. Here are some starting points to think about:

  • Optimise medications and work with your doctor to adjust those with any side effects you may be experiencing, as some may contribute to fatigue.
  • Exercise and engage in regular physical activity, such as walking, cycling or yoga, to boost energy levels.
  • Have a nap if you need to, but not after 3 pm and not for more than 30 minutes so it doesn’t interfere with your overnight sleep.
  • Practice good sleep hygiene, ensure you get enough rest.
  • Address any sleep issues, such as insomnia or sleep apnea, with professional support.
  • Pace yourself by spreading out physical and mental activities throughout the day to avoid overexertion.
  • Eat a balanced diet with low glycemic index foods to provide longer-lasting energy.
  • A diet with plenty leafy greens, fruits, whole grains, and healthy fats found in fish, nuts, and seeds may help lessen the effects of fatigue.
  • Address any underlying depression or anxiety, as these can exacerbate fatigue.
  • Lower your stress through mindfulness and meditation.
  • Stay well hydrated.
  • Try to avoid having alcoholic drinks in the evening. It may make you feel sleepy at first, but alcohol is known to cause poor sleep quality.

 

References

Haß U, Herpich C, Norman K. Anti-Inflammatory Diets and Fatigue. Nutrients. 2019 Sep 30;11(10):2315. doi: 10.3390/nu11102315. PMID: 31574939; PMCID: PMC6835556.

John Hopkins, How to Fight Parkinson’s Disease-Related Fatigue

Kluger, B. M., Pedersen, K. F., Tysnes, O. B., Ongre, S. O., Øygarden, B., and Herlofson, K. (2017). Is fatigue associated with cognitive dysfunction in early Parkinson’s disease? Parkinsonism Relat. Disord. 37, 87–91. doi: 10.1016/j.parkreldis.2017.02.005

Siciliano, M., Trojano, L., Santangelo, G., De Micco, R., Tedeschi, G., and Tessitore, A. (2018). Fatigue in Parkinson’s disease: a systematic review and meta-analysis. Mov. Disord. 33, 1712–1723. doi: 10.1002/mds.27461

Stocchi, F., Abbruzzese, G., Ceravolo, R., Cortelli, P., D’Amelio, M., De Pandis, M. F., et al. (2014). Prevalence of fatigue in Parkinson disease and its clinical correlates. Neurology 83, 215–220. doi: 10.1212/wnl.0000000000000587Stocchi et al., 2014

Toolkit for sleep, Andrew Huberman Lab 

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