Why does this tiredness not go away with sleep?
Fatigue is one of the most troubling symptoms of lupus and rheumatoid arthritis, and it does not come only from disease activity. Knowing its other causes helps you find a better way through.
People who do not have this tiredness find it hard to understand. It is more than sleepiness. Sometimes even after a night’s sleep the body’s battery feels empty and simple tasks feel like too much. If this is you, you are not imagining it and you are not lazy.
Where does it come from?
In studies, fatigue does not depend only on disease activity. Sometimes the disease is quiet and the tiredness stays. These factors play a bigger part:
- Pain
- Low mood and anxiety
- Poor sleep
- Being overweight
- Other illnesses
The body’s inflammatory substances probably play a part too.
What should be checked first?
Your doctor needs to consider other causes as well: anaemia, which is common in rheumatoid arthritis, and any other illness that brings tiredness. So mention it at your visit, even if it seems unimportant.
What helps?
There is no magic answer, and the evidence shows each of these has a modest effect. Together they can make a difference.
- Disease control: treating the main disease usually helps a little.
- Exercise: it may sound odd, but regular gentle activity often works better than long rest.
- Pacing: split tasks up and take short rests between them. Do not overdo it on good days, or you may pay for it the next.
- Sleep: keep regular hours, and tell your doctor about sleep problems or night pain.
- Mind: cognitive behavioural therapy and mindfulness have helped in studies. If you feel low or anxious, getting help is part of treatment.
What should you tell your family?
Fatigue cannot be seen. Explain to those around you that it is part of the disease, and what they could do to help. If your work schedule can change a little, talk to your employer too.