Physical and mental fatigue are different, but they often occur together. Long-term physical exhaustion can also lead to mental fatigue.
According to the Centers for Disease Control and Prevention (CDC), 1 in 3 Americans say they do not get enough sleep. The National Heart, Lung, and Blood Institute (NHLBI) recommend sleeping 7 to 8 hours a day for those over 18 years.
A lack of sleep can both result from and increase the risk of a number of medical conditions.
Fatigue can prevent a person from fulfilling their usual tasks. It can make it hard to get out of bed in the morning. When it affects safety, for example, on the road, it becomes a public health concern.
Here are some key points about fatigue. More detail is in the main article.
- Fatigue can result from poor health and it can cause health problems, too.
- Causes include infections, chronic conditions, stress, and having recently given birth.
- If a health condition, such as diabetes, is diagnosed and treated, the fatigue may go away.
- A healthful diet and exercise can help reduce fatigue for many people.
Fatigue can make it hard to stay awake or to get up in the morning.
There are different types of fatigue.
Physical fatigue: A person finds it physically hard to do the things they normally do or used to do, for example, climbing stairs. It includes muscle weakness. Diagnosis may involve a strength test.
Mental fatigue It is harder to concentrate on things.The person may feel sleepy, have a decreased level of consciousness, and in some cases show signs similar to that of an intoxicated state.
Sleepiness or fatigue?
Sleepiness can happen when a person does not have enough good-quality sleep, or when there is a lack of stimulation. It can also be a symptom of a medical condition. It is more likely to be short term. Sleepiness, or drowsiness, may be solved by getting a good night's sleep.
Fatigue, especially chronic fatigue, is usually linked to a medical problem.
Drowsiness and fatigue can be life-threatening, for example, if it impairs a person when driving a vehicle or operating heavy machinery.
Fatigue is a symptom of many health conditions.
1) Mental health issues
It can result from stress, bereavement and grief, eating disorders, alcohol abuse, drug abuse, anxiety, moving home, boredom, and divorce. It can occur with clinical depression, either due to the depression itself, or because of associated problems, such as insomnia.
2) Endocrine and metabolic reasons
3) Drugs and medications
Some antidepressants, antihypertensives, statins, steroids, antihistamines, medication withdrawal, sedatives, and anti-anxiety drugs can cause drowsiness.
4) Heart and lung conditions
Pneumonia, arrhythmias, asthma, chronic obstructive pulmonary disease (COPD), valvular heart disease, coronary heart disease, and congestive heart failure, among other heart and lung diseases, can cause fatigue.
5) Sleep problems
6) Chemicals and substances
Vitamin deficiencies, mineral deficiencies, poisoning, and consuming too many caffeinated or alcoholic beverages may make it harder to get to sleep, or stay asleep, especially if these are consumed too close to bedtime.
7) Various diseases, conditions, states, and treatments
Cancer, chemotherapy, radiation therapy, chronic fatigue syndrome (CFS), fibromyalgia, systemic lupus, rheumatoid arthritis, obesity, massive blood loss, and weakened immune systems can all cause fatigue.
Fatigue can also be a sign of infection. Some infections that cause tiredness include malaria, tuberculosis (TB), infectious mononucleosis, also known as glandular fever, cytomegalovirus, HIV infection, flu, and hepatitis, among others.
8) Chronic pain
Patients with chronic pain often wake up tired, even after sleeping for a long time, especially if pain disrupts their sleep.The combination of pain and lack of sleep can cause persistent tiredness.
Some diseases and conditions where pain is the main symptom, such as fibromyalgia, are also linked to other conditions, such as sleep apnea and restless leg syndrome. These further worsen symptoms of fatigue.
9) Being overweight or underweight
Being overweight increases the risk of fatigue, for various reasons.These include having to carry more weight, and being more likely to have a condition where fatigue is a common symptom, such as diabetes and sleep apnea.
A person who is underweight may tire easily because they have less muscle strength.
10) Too much or too little activity
A person who feels tired may not exercise, and lack of exercise can cause further fatigue. Lack of exercise may eventually make it harder and more tiring to perform a physical chore.
Fatigue can also affect healthy individuals after intense mental or physical activity. Working or staying awake for long hours without a break, and especially driving, increases the risk of accidents. Statistics have shown that, among truck and bus drivers, longer hours lead to more accidents.
The main symptom of fatigue is exhaustion after a physical or mental activity. The patient does not feel refreshed after resting or sleeping. It may be hard to carry out the usual activities.
The signs and symptoms of fatigue may be physical, mental, or emotional.
Body aches can be a sign of fatigue.
- aching or sore muscles
- painful lymph nodes
- apathy and lack of motivation
- persistent tiredness
- difficulty in concentrating
- reduced hand-to-eye coordination
- impaired judgment and indecisiveness
- irritability and moodiness
- loss of appetite
- weakened immune system
- short-term memory impairment, leading to problems with organizing thoughts and finding the right words to say, known as brain fog
- sleepiness and drowsiness
- slow responses to stimuli and slower reflexes than before
- vision problems, such as blurriness
In severe cases, the person may experience hallucinations.
Symptoms get worse after exertion. They may appear some hours after activity or exercise, or possibly the next day.
Diagnosis can be difficult, because the causes and symptoms are varied and non-specific.
The doctor may ask the patient to:
- evaluate the qualities of the fatigue
- identify the patterns of their fatigue, for example, times of day when symptoms are worse or better, and whether a nap helps
- describe the quality of their sleep, their emotional state, sleep patterns and stress levels
The patient can help by keeping a record of the total hours slept each day, and how often they awaken during sleep.
The physician may carry out a physical examination to check for signs of illnesses and ask the patient which medications they are using. Other factors to consider include present or recent infections, such as glandular fever, and events that may cause fatigue, such as giving birth, having undergone surgery, a bereavement, and so on.
The doctor will also ask about lifestyle, including diet, alcohol consumption, sleep habits, and so on.
These can help diagnose an underlying cause. They may include urine tests, imaging scans, psychiatric questionnaires, and blood tests, depending on other symptoms.
Tests can help rule out physical causes, such as an infection, hormonal problems, anemia, liver problems, or kidney problems. The physician may order a sleep study to rule out a sleeping disorder.
If an illness is diagnosed, that illness will be treated. Controlling diabetes, for example, may help solve the fatigue problem.
To treat fatigue successfully, it is necessary first to find the underlying cause.
This could be:
- anemia or low iron without anemia
- sleep apnea
- poorly controlled blood sugar
- underactive thyroid
- an infection
Appropriate treatment for the condition can help alleviate fatigue.
Yoga, CBT, and mindfulness for fatigue
Researchers have found, for example, that cognitive behavioral therapy (CBT) combined with graded exercise therapy (GET) can be an effective treatment for myalgic encephalomyelitis (ME) or chronic fatigue syndrome (CFS).
It is important not to drive while sleepy. A survey carried out by the CDC found that around 1 in 25 drivers aged 18 years and above had fallen asleep while driving in the previous 30 days.
Here are some tips for overcoming fatigue.
To practice good sleep hygiene:
- Aim to go to bed and wake up at the same time each day.
- Set the bedroom temperature at a comfortable level, neither too cold nor too hot.
- 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 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.
Having a warm bath and 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 help.
Eating and drinking habits
Diet can affect how tired or energetic we feel.
Here are some tips:
- Eat three regular meals each day, at the same time each day.
- Avoid junk food and follow a well-balanced diet.
- Try to regulate your weight, either losing weight or eating more, as appropriate.
- Consume plenty of fresh fruit and vegetables.
- Avoid crash-dieting, as this can affect sleep.
- Drink alcoholic and caffeinated beverages in moderation, or not at all.
A moderate and well-balanced diet can lead to better health and better sleep.
Physical activity can help reduce fatigue. However, those who have not been physically active for some time should introduce exercise correctly and gradually. A doctor or sports therapist can help.
Regular exercise leads to better sleep better and less fatigue for most people. It may be best to exercise earlier in the day and reduce activity close to bedtime, as this may affect sleep.
Take a break from driving
The CDC urge people to know the warning signs of drowsiness on the road.
If a driver notices they are doing any of the following, they should 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
If fatigue and sleepiness are affecting your daily life, and none of these tips work, you should see a doctor.