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What you didn’t know about fatigue

We can feel tired for a number of reasons: an underlying illness, a mental health issue, or a new baby in the house. But fatigue is more than just tiredness.

Chronic fatigue syndrome (CFS) or myalgic encephalomyelitis (ME) commonly affects the nervous, gut, cardiac, endocrine and immune systems, causing a range of symptoms including aches and pains, chronic tiredness, concentration difficulties, mood instability, headaches and a susceptibility to infection.

This is what you need to know about fatigue.Credit:Shutterstock

Someone doesn’t have to be experiencing CFS/ME to feel the pain of fatigue. Sleep and respiratory physician Dr Linda Schachter said people who are chronically sleep-deprived can have similar symptoms.

“The symptoms for CFS/ME are quite similar to obstructive sleep apnoea – so we often check to see if we can treat for a sleep problem, even if it is only mild as it may be contributing to the patient’s symptoms,” Dr Schachter said.

“When treating a patient for CFS/ME, a good sleep specialist will always ask about sleep. We do know that people who have CFS/ME have poor sleep quality. When we treat the sleep problems of people with CFS/ME it doesn’t necessarily fix their fatigue, but it often helps."

Treating obstructive sleep apnoea, a condition where the upper airway partially or completely obstructs during sleep,  can have a positive effect on other medical conditions. People with chronic depression have also found relief from treating their sleep apnoea.

“I’ve had several patients with difficult to control depression. While it didn’t go away, it became much easier to control when we treated their sleep apnoea," Dr Schachter said.

“We also see results in patients with migraines and chronic headaches, as poor sleep and shallow breathing can increase your risk of headaches. By treating that and improving the sleep quality you can improve the headaches themselves.”

Obstructive sleep apnoea increases the risk of cardiac arrhythmia and stroke. The change of pressure in the chest can cause gastro-oesophageal reflux. It also presents a significant risk factor for high blood pressure.

The cause can be a genetic or anatomical component – a case of having narrow upper airways.

“About 30 per cent of my patients have obstructive sleep apnoea and they’re not overweight or obese. However we know obesity affects sleep in several ways,” said Dr Schachter.

“Firstly, it puts you at a higher risk of sleep apnoea which is a condition where people either shallow breathe or stop breathing during sleep. In response to those episodes, people wake up or go to a lighter level of sleep repetitively throughout the night. They wake up feeling tired or sleepy during the day.

“If you are obese, it can be more difficult for you to turn in bed, which means you have unrefreshing sleep – another reason you can wake feeling tired.

“And obesity is also a risk factor for shallow breathing during sleep, or not breathing deeply enough. You can wake with a headache."

Not all sleep problems are attributed to obstructive sleep apnoea – Dr Schachter also treats patients with insomnia and restless legs syndrome, whereby a person’s sleep is disturbed by their muscles twitching as they are trying to sleep.

Dr Schachter said the difference between fatigue and general tiredness is how you feel when you wake.

“If you wake in the morning and you are still tired, then it is likely there is a problem with your sleep. If you wake refreshed but you’re tired and sleepy throughout the day, there still may be something wrong with your sleep.”

For more information visit HealthShare, a joint venture with Fairfax to improve the health of regional Australians.

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