Fatigue and Parkinson’s Disease

What is Fatigue?

Fatigue is generally thought of as extreme tiredness leading to lack of motivation for both physical and mental tasks.  It is frequently coupled with drowsiness, leading to an increased desire to sleep. Fatigue is a common complaint in adults, but is more prevalent in those diagnosed with PD ( 21.7% of the general population have fatigue, compared to 50% of those with PD).

  • Fatigue can be broken down into two categories:

    • Physical Fatigue

    • Cognitive Fatigue

Here we will be focusing on physical fatigue, what it is, what can cause it, and how to curb that feeling.

Physical Fatigue:

Physical fatigue is one of the most common non-motor PD symptoms, and often manifests prior to diagnosis of PD; however, not everyone with Parkinson’s will have fatigue. Physical fatigue can look and feel different for everyone. It is typically described as a feeling of having low energy, or low motivation to start or complete an activity. This can affect any and all daily activities and make it hard to push through the day. It can also cause you to limit your social interaction due to fear of not having the energy to be ‘ON’ during gatherings with friends or family. On the positive side, we have some tools that can help alleviate the symptoms of fatigue in your every day life.

What Causes Fatigue?

Common causes of fatigue in all adults:

  • Caffeine

    • Excessive caffeine intake can cause insomnia and rebound fatigue (a condition occurring after caffeine is depleted in your system).

  • Alcohol

    • Disruption of sleep cycles can lead to daytime fatigue.

  • Sugary and highly processed foods

    • Fast absorption of complex carbohydrates/sugars can cause an increase in insulin production which, in turn, can cause a drop in blood sugar, otherwise known as a sugar crash.

  • Medications:

    • Examples: Antidepressants, allergy medications, pain medications, etc.

  • Infections

  • Chronic disease

    • Diabetes, thyroid disease, heart disease, COPD, apnea, anemia, etc.

  • Emotions

    • Anxiety, depression, stress, etc.

  • Lack of exercise

  • Dehydration

Common causes of fatigue in PD:

  • Akinesia

    • The inability to make yourself move can lead to increased fatigue due to the physical and cognitive effort required for daily activities.

  • Tremors

    • Continuous activation of muscle can lead to fatigue.

  • Rigidity

    • Rigidity is excessive stiffness in the trunk or limbs which can limit your bodies mobility. This requires more power and effort as you move to combat the stiffness.

  • Daily Motor fluctuations

    •  Fatigue typically follows an ‘ON’ and ‘OFF’ medication cycle – therefore fatigue may be more noticeable during your ‘off’ times.

  • Depression

  • Impaired sleep cycle

  • Medication side effects

    •  Mirapex, Requip can cause fatigue

How to fight fatigue?

Where to start:

  • Take regular notes about your own fatigue.

  •  Does it relate to timing of medications? 

    • If so, which medications?

    • Do I need to discuss medication schedules/timing with my physician?

  • Does it fluctuate with my symptoms?

    • Am I less fatigued during my “ON” times?

  • Do I feel better after I exercise?

  • Do I feel more tired after I eat a heavy/unhealthy meal?

Create a healthy daily routine:

Follow a daily exercise routine:

  • Daily exercise is a proven non-medication related treatment for people with Parkinson’s disease that can help manage the PD symptoms that increase fatigue.

  • Maintaining strength and endurance through exercise can decrease muscular fatigue.

  • Flexibility exercises can help decrease your rigidity and stiffness, making daily activities less energy consuming.

  • Providing your body with adequate daily exercise has been shown to:

    •  Increase periods of time in deep sleep (Rejuvenating portion of sleep).

    • Exercise also helps to improve mood and decrease anxiety which may aid in falling asleep quicker.

Manage your sleep cycle:

First try to maintain a daily routine of sleep/wake cycle.

  • Try to minimize naps

    • If you must nap, set an alarm for 20 minutes – research from the National Sleep Foundation reports that napping in excess of 30 minute increments may lead to deeper sleep stages and cause grogginess upon waking.

  • Go to bed at the same time daily

    • Medications may affect your ability to fall asleep or stay asleep – discuss with your MD.

    • Daytime naps may also make it more difficult to fall asleep at night.

    • Regular night time routines help to manage stress and anxiety to improve your ability to fall asleep.

Evaluate your diet and fluid intake

  • Try to avoid overly processed foods, while increasing fruit and vegetable intake.

  • Increase water intake as dehydration can lead to fatigue

    • Take your body weight and divide by 2 to reach the number of fluid ounces to set your daily fluid intake goal.

 

Next week:

  • Check back next Monday for our post focusing on: Exercise Prescription.

  • Reach out if you need help developing an exercise routine, or are interested in our group classes!

 
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