How To Know Its Ms Fatigue
Even though fatigue happens in most people with MS, itâs possible other things could be dragging you down.
Non-MS fatigue, also called secondary fatigue, can happen when you have another condition such as:
- Mood disorders like depression
- Thyroid issues
âIf youâre up at night because you feel like you have to empty your bladder often, or your sleep is disrupted because of loud snoring and frequent awakenings because of sleep apnea, or muscle cramps â¦ then itâs not surprising your day is hindered by fatigue,â Serra says.
You may also feel fatigued as a side effect of a medication youâre on, or from drug or alcohol use.
Most of these are issues your doctor can help you manage and treat.
Sleep Disorders In Patients With Multiple Sclerosis
Sleep disturbances are underreported and underrecognized in patients with MS and may be a contributing factor to MS-related fatigue. Reviews have shown higher incidences of sleep disturbances reported in patients with MS including prevalence of narcolepsy ranging from 0% to 1.6%, RLS from 14.4% to 57.5%, REM sleep behavior disorder from 2.22% to 3.2%, and OSA from 7.14% to 58.1%.23-29 . Referral bias, incomplete ascertainment, and other biases may influence these rates. Anxiety, reduced motivation, and mental fatigue are associated with poor sleep quality in patients with shorter MS duration, and pain, depression, and mental fatigue are associated with poor sleep quality in those with longer disease duration.26 Symptomatic narcolepsy occurs in both patients with MS and with neuromyelitis optica spectrum disorder and correlates with hypothalamic lesions seen on MRI. The International Revised Diagnostic Criteria for NMOSD includes symptomatic narcolepsy as a core clinical feature of NMOSD.30 Painful nocturnal spasms, chronic neurogenic pain, and insomnia from drugs used to combat MS-related fatigue or polypharmacy are other causes of secondary sleep disturbances in patients with MS.
In a recent survey, patients with MS reported frequent use of hypnotic medications, most frequently diphenhydramine, and frequent use of hypnotic medications correlated with daytime fatigue in these subjects.30
Do You Have Any Tips For Managing Fatigue When You Have A Young Family
Kate says: Managing fatigue with a young family can be really difficult, especially when your sleep is disturbed. Planning and prioritising what youre doing, when you can save energy and when you can do different activities can be really helpful. Its good to try and have a coordinated approach with your partner or with other family members. Try to agree with them whos going to do what childcare duties on which days and plan around the times when you might have more energy so that youre not asking them to do things when youre at the point of exhaustion. You might also want to think about getting some outside help, so perhaps getting a cleaner, especially for the heavier household chores. Maybe theres things that youre doing each week that you perhaps dont have to do at all. It can be good to think about areas where you might be able to save energy. Could you perhaps do online shopping instead of going to the supermarket? Could you buy pre-chopped or frozen vegetables? Sometimes doing batch cooking, where you cook all the meals for the week at the weekend when you have more time, can be more useful than cooking from scratch when you come home from a busy day at work.
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Ms Subtype And Disability
MS subtype and disease severity can affect the risk of fatigue. The Expanded Disability Status Score correlates with fatigue scores,,, though less strongly, perhaps, after adjusting for depression., A review of The New York State Multiple Sclerosis Consortium Database showed that fatigue consistently correlated with Expanded Disability Status Score. Fatigue appears to be more severe in patients with progressive subtypes of MS,, but this observation may in part be confounded by differences in disability levels.
A Diagnostic Approach To Fatigue
An open ended question, followed by a series of more focused inquiries will often prove to be a productive approach. This should be followed by screening for other confounding conditions such as sleep disorders or depression. A systematic approach to the assessment and treatment of fatigue in patients with MS is summarized in .
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I Remembered To Laugh
While I stand behind all of the tips on my list, and they made a big impact for me, I believe laughter is honestly one of the most important things you can do. Humor and laughter boost your energy, protect you from the damage of stress, and improves your mood. Laughter is good for your soul, its free, and lets face it, everyones happier when you laugh together.
Take Good Care Of Your Overall Health
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Fatigue Caused By Disability
MS can cause problems with mobility and muscle control. Compensating for these disabilities requires greater energy and effort than would otherwise be necessary to perform daily tasks. When some muscles cannot perform certain tasks other muscles are used instead and the extra work can tire those muscles, leading to additional fatigue.
Neurophysiotherapists and physiotherapists can demonstrate exercises to strengthen and maintain body functioning and there is a range of equipment available to help conserve energy and reduce stress on muscles and joints. Occupational therapists can suggest modifications to your home or workplace to improve your efficiency and reduce the effort involved in daily tasks. Regional MS Community Support Staff, friends, family members and other people with MS can be useful sources of practical advice on ways to reduce energy needs.
Treating Fatigue In Patients With Multiple Sclerosis May Significantly Improve Quality Of Life And Requires A High Index Of Suspicion For Coexisting Sleep Disorders
Jonathan L. Carter, MD
Fatigue is a ubiquitous and often under-recognized symptom in patients with multiple sclerosis . Prevalence estimates for fatigue are as high as 70% to 90% in unselected patients with MS, and it may be the leading cause of disability in patients with mild or early relapsing-remitting MS.1-3 Fatigue is a complex and multifaceted symptom that is poorly understood despite extensive study. Patients with MS may have differing definitions for fatigue. Sleep disorders are more common in patients with MS compared to the general population, including obstructive sleep apnea , central sleep apnea, and restless legs syndrome and resulting from conditions such as neuropathic pain, nocturnal leg spasms, and others. Therapy for MS-related fatigue may be partially successful, but many patients continue to have significant fatigue despite treatment. Chronic sleep deprivation can lead to worsening fatigue, depression, cognitive inefficiency, and fibromyalgia symptoms. Treatment of sleep disorders may significantly improve quality of life but requires a high index of suspicion for the presence of coexisting sleep disorders along with MS-related fatigue. In this article, we address differences between primary and secondary fatigue in patients with MS, possible physiologic mechanisms of MS-related fatigue, nonpharmacologic and pharmacologic therapy for fatigue, recognition and diagnosis of coexisting sleep disorders, and therapies to treat sleep disorders.
Any Kind Of Exercise Could Help
It seems to go against common sense to exert yourself if you experience fatigue. But there is strong evidence that exercise helps keep your body working at its best and can improve strength, fitness and mood.
Its possible to do too much exercise, so balance the exercise with rest. And keep cool while you exercise, especially if heat makes your fatigue worse.
You might want to plan your exercise and avoid long sessions to prevent overheating. Some people find water-based exercise helpful for maintaining a steady temperature.
Cooling vests may also help. A physiotherapist can help you devise a suitable exercise programme.
What Are Symptoms Of Fatigue
There are two major types of fatigue in MS. These two types of fatigue are probably separate problems related to the MS.
The first type is a general feeling of tiredness. It may feel as if one has not slept the night before. This feeling may be worse in the afternoons or after activity. People may feel that they are unable to do as many tasks without getting tired as they did before.
A second type of fatigue is muscular. In this type, there is increased weakness after repeated activity. Often, this occurs with walking. People may find that they are dragging one leg or are more unsteady.
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Respect Your Mind And Body
Respecting my bodys needs in the moment is possibly the most important skill to master when fighting fatigue. If I need a nap, I give myself permission to take a nap. If I need to gently move my joints and muscles through their full range of motion, I take the time to do so. If I need to close the computer and bring out the art supplies, puzzles, or a good book, I try to remember my own advice and take the time to enjoy myself.
These simple activities are every bit as important as staying physically active. They are important in fighting fatigue and recharging my various well-being batteries. Perhaps these activities are akin to washing my car, completing routine maintenance, and removing trash and debris from the car as well. None of these tasks change the condition of the battery, but they do help to maintain the car’s tiptop shape.
What helps you to recharge your physical, mental, and emotional batteries and keep your body in tiptop shape?
Be well my friends,
Overwhelming Disruptive And Difficult To Explain Fatigue Is The Most Common Ms Symptom
Everyone knows what it feels like to be tired. But MS fatigue is different from regular fatigue.
- It can come on suddenly, even after a good night’s sleep.
- It generally worsens over the course of the day.
- It tends to increase with heat and humidity.
Your MS fatigue is likely to feel different from anything you’ve felt before.
It may feel totally overwhelming at times, yet it remains invisible to other people. It can be one of the hardest symptoms for family, friends, and colleagues to understand.
You might find that fatigue interferes with every aspect of your life. To combat fatigue and take back control, get to know this symptom, factors that can worsen it, and ways to manage your energy.
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What Are Ms Fatigue Symptoms
Symptoms differ from person to person. Some people may experience only one symptom and then spend months or years without experiencing another. An issue may occur only once, then vanish. Within weeks or months, some peoples symptoms become worse.
Before or after an MS diagnosis, keeping track of whats going on is the best practice. It will aid in the monitoring of MS and the understanding of how well the treatment is working for the healthcare professional.
For many patients, their first encounter with MS is what physicians refer to as a clinically isolated condition . This round of neurological symptoms lasts about 24 hours on average. CIS happens when the immune system incorrectly instructs the body to attack myelin .
Tip : Regulate Your Sleep
Sleep problems are often behind the fatigue that people with MS experience.
Whether you have trouble falling asleep, staying asleep, or getting the amount and type of sleep you need to awaken feeling refreshed, the result is the same: You feel tired.
If all else fails, you can talk with your doctor about using sleep medications for a short period of time.
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Psychological Aspects Of Ms
Mood issues can be very common in MS, not just around the time of diagnosis, but at various stages of life. The most common mood disturbances are depression and anxiety which can be short or long term.
The most important thing to remember is to talk to your MS healthcare team as soon as you start to notice symptoms, so that you can access appropriate help, to improve your quality of life.
A Little More Strength To Carry The Weight
In my experience, it’s not like you take a pill and, just like that, no more fatigue until the pill wears off. When I take my medication, the fatigue is still there, but it becomes easier to work through it kind of like how cold medication doesn’t eliminate a cold, but it may help reduce the symptoms of one. If you think of fatigue like the weight of a huge boulder on your back that you have to walk around with, I would say that these medications don’t really remove the weight of the boulder but instead give you a little more strength to carry it. The heaviness in my body caused by my fatigue is always there, but these medications make it a little less difficult to not be crushed by it. At least that how it feels to me.
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Look At Your Personal Situation
Evaluate your level of energy. Think of your personal energy stores as a bank. Deposits and withdrawals have to be made over the course of the day or the week to balance energy gained and spent. Keep a diary for 1 week to identify the time of day when you are either most fatigued or have the most energy. Note what you think affects your fatigue.
Be alert to your personal warning signs of fatigue. Fatigue warning signs may include tired eyes, tired legs, whole-body tiredness, stiff shoulders, decreased energy or a lack of energy, inability to concentrate, weakness or malaise, boredom or lack of motivation, sleepiness, increased irritability, nervousness, anxiety, or impatience.
Muscle Spasms And Stiffness
Muscle spasms and stiffness can be improved with physiotherapy.
Techniques like stretching exercises can help if your movement is restricted.
If your muscle spasms are more severe, you may be prescribed a medicine that can relax your muscles.
This will usually be either baclofen or gabapentin, although there are alternative medicines, such as tizanidine, diazepam, clonazepam and dantrolene.
These medicines all have side effects, such as dizziness, weakness, nausea and diarrhoea, so discuss which of these would be best for you with your specialist MS nurse or GP.
If these medicines are not effective, you may be offered a 4-week trial of nabiximols . This is a cannabis-based medicine sprayed into the mouth. Read about medical cannabis.
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How To Treat It
If youre experiencing fatigue, make an appointment with your doctor to discuss possible treatment options. A doctor will likely want to run some tests to find out more about what may be causing your fatigue.
Based on the results of these tests, your doctor may prescribe medications or recommend counseling, physical therapy, and occupational therapy.
Exercise Can Boost Energy
Certain types of easy exercise, such as gardening and yoga , have been shown to boost energy levels, reduce stress, improve joint range of motion, help manage spasticity, and increase strength. Because of its natural buoyancy, water allows many men and women with MS to perform exercises they cannot do outside of the pool. Water exercise helps increase flexibility, strengthen the upper and lower extremities and trunk, improve ambulatory skills, increase coordination and balance, and condition the overall body to raise endurance levels and lessen fatigue.
For more information on the benefits of aquatic therapy and aquatic exercise for individuals with MS, please see the Health and Wellness column from the Summer/Fall 2012 issue of The Motivator. This may be found on MSAAs website at mymsaa.org/publications/motivator/summer-fall12/health
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Organise Your Living And Work Spaces
You might find there are practical changes that can be made to the places you work and live. Maybe re-organising desks or cupboards, or adjusting the temperature or lighting to suit you better.
Sometimes, the simplest of changes can make the workplace or home more energy efficient for you.
An occupational therapist can help you assess the spaces you use at work and at home – and may suggest adaptations or equipment that could help. For more information about the support that occupational therapists can offer, and how to find one, download or order our leaflet Occupational therapy and MS.
Cocoa May Help Curb Fatigue Typically Associated With Multiple Sclerosis
May offer easy, safe approach to persistent symptom, if confirmed in larger studies, suggest researchers
Cocoa may help curb the fatigue that is typically associated with multiple sclerosis , suggest the results of a small feasibility trial, published online in the Journal of Neurology Neurosurgery & Psychiatry.
Cocoa, like dark chocolate, is rich in flavonoidssubstances found abundantly in fruit and vegetables and associated with anti-inflammatory properties.
If the findings are confirmed in larger studies, it may offer a simple dietary approach to a persistent and hard to treat symptom, which affects nine out of 10 people with MS, suggest the researchers.
The causes of mental and physical fatigue experienced by people with MS are complex, and likely to include neural, inflammatory, metabolic, and psychological factors. None of the currently available approaches offers long term relief, say the researchers.
Previous research suggests that dark chocolate, containing between 70 and 85 per cent cocoa solids, is associated with an improvement in subjectively assessed fatigue in people with chronic fatigue syndrome .
This prompted the researchers to see if it might also be worth exploring its potential in helping to tackle the fatigue associated with MS.
Participants were instructed to wait 30 minutes before taking any prescribed medication or eating or drinking anything else, but otherwise to stick to their usual diet.
Journal: Journal of Neurology Neurosurgery & Psychiatry
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