Fatigue

Everyone has probably suffered from fatigue at some point in his or her life. It can be caused by stress, by work pressure, if you are kept awake at night, for example by your newborn or because you just went to bed late. If it cannot be solved with a few nights of good sleep, then it becomes a different story and something really needs to be done about it. 

What is fatigue? 

Fatigue is a lack of energy. You do not feel fit enough to do your daily activities anymore, and you want to go to sleep. Everything is more difficult due to the feeling of exhaustion, and it can even happen that you fall asleep during your work. If this is the case for a long time, then it becomes a real problem. 

What are the causes of fatigue? 

The causes of fatigue can be broadly divided into three groups: 

  • Lifestyle factors: by this we mean the amount of exercise you get, your BMI, your eating habits (which, for example, deprives you of important nutrients), intake of caffeinated drinks, a lot of screen work. 
  • Psychological factors: pychological factors take up a lot of energy, and can cause you to get exhausted and feel tired. Some psychological factors of which fatigue is a consequence or symptom are: 
    • If you experience a lot of emotional or work-related stress. 
    • If you have a mental illness such as a depression or anxiety disorder. 
    • If you have suffered a loss recently. 
    • If you worry a lot. 
    • If you have experienced a major life event (move, change of job, divorce or a new relationship). 
  • Medical factors: finally, there may be medical reasons for fatigue. If you do not see a clear cause, and changes in your lifestyle do not deliver results, it would be a good idea to talk to a doctor about this.  

Some medical conditions are: sleep apnea, narcolepsy, anaemia or you have a rheumatic condition, of which fatigue is a known side effect. You may also suffer from a slow thyroid gland or diabetes. Chronic fatigue syndrome, COPD, asthma, and other chronic illnesses also take so much energy that you become exhausted and need help to sustain yourself. 

Finally, it is possible that you have an illness among those that have not (yet) been diagnosed. 

What forms of fatigue are there? 

Fatigue complaints can be divided into four groups. 

  • Short-term fatigue, after going to bed late a few times or a busy time. 
  • Fatigue due to chronic sleep deprivation, usually due to lifestyle factors. 
  • Fatigue due to medical causes and/or use of medication. 
  • Fatigue caused by psychological factors. 

 

How can you recognise fatigue? 

In addition to the normal symptoms of fatigue, lethargy and yawning, there are also symptoms that indicate that it is not about a 'night of bad sleep'. These are, for example: 

  • Dark shadows, bags and circles under your eyes. 
  • Pale vision (with pale skin, the skin can sometimes become bluish around the mouth). 
  • Dropping off suddenly, for example when doing paperwork, watching a program or working on your computer. 
  • Being languid, not getting started. 
  • Headaches, especially around the eyes. 
  • Getting dizzy when moving quickly, stumbling easily. 
  • Less control over your actions, dropping things. 
  • Being stimulated or irritated, crying quickly and getting angry quickly (the 'short fuse'). 
  • Poor ability to concentrate. This, together with the falling asleep, is a great and real danger in traffic. 

 

Is there anything I can do myself about fatigue? 

This is very much to blame for the fatigue. If fatigue has a medical cause, it is often a matter of accepting your limits and adapting your way of life accordingly. It may also be a side effect of your medicines, in which case you should discuss with your doctor whether another medicine or a different dose is possible. 

If that is not possible, then there are a number of possibilities. 

  • The first step you can take in the fight against fatigue is to take a closer look at your lifestyle. Take a critical look at your eating and drinking habits, make sure you get enough daily exercise, take a critical look at your bedroom and evening rituals and make changes where necessary. 
  • The average person needs seven to nine hours of sleep per night. Keep a sleep diary for a while to see if you are getting enough sleep. 
  • Determine for yourself whether there have been any recent major changes, both positive and negative, such as relocations, job changes or changes in the family composition. And see objectively if you are experiencing a heavy workload. You can change circumstances, or you can realise that it is a temporary situation. After a major change, you will need time to process it and adapt to the new situation. It is normal for this to cost you more energy than before. 

If all of this is not the case, and nothing changes in your fatigue, then it is wise to talk to your doctor. 

What are the forms of treatment? 

Medication 

Fatigue is mostly caused by insomnia. Insomnia is only treated with medication in serious cases, because these medications are often addictive and have many side effects. 

Should it nevertheless be necessary to support the treatment of insomnia with medication, this should preferably be done for a short period of time. Preference is given to a short-acting benzodiazepine agonist: lormetazepam, temazepam, zolpidem or zopiclon. There is ample experience with these products and when used in low doses there is little chance of after-effects the next day. 

In some cases, melatonin is not or not sufficiently produced, for example as a result of neck damage caused by an accident. In those cases, a supplement with melatonin is a good solution. Doctors rarely or never prescribe this because the efficacy of melatonin is limited, and less than that of zolpidem. Moreover, it is only useful for patients who have a demonstrably disturbed function of the pineal gland, which produces the melatonin. In all other cases, it is useless. 

Alternative treatments 

Without having to resort directly to medication, there are also other, alternative treatments available to help you regain or strengthen your sleep rhythm. 

  • Meditation and yoga can bring your body and mind to rest, creating the optimal conditions for a peaceful sleep. 
  • Use aromatherapy with soothing essential oils such as lavender (Lavandula angustifolia), lemon balm (Melissa officinalis), geranium (Pelargonium Asperum) and chamomile (Matricaria recutita). Make sure that you buy essential oil from a good brand. You can apply these oils in a diffuser, or with a carrier oil in the bath, or, again, with a carrier oil such as almond oil on your skin. A relaxing aromatic massage could also be an option. Essential oils are very powerful. It is therefore wise to use a professional aromatherapist for this purpose. 
  • Have a glass of herbal tea before bedtime. For example, chamomile, valerian, orange blossom and lemon balm. If you normally take sugar in your tea, consider using honey as a sweetener. Fast-acting sugars such as granulated sugar can also have a stimulating effect. 
  • Your melatonin production may be disturbed. Melatonin is a hormone that your body produces itself. It helps with falling asleep, the depth of the sleep and the duration of the sleep. It also protects against free radicals.  

The production of this hormone is influenced by a number of factors; the amount of light is one of the most important, but also the availability of a number of vitamins and minerals. These are: zinc, magnesium, calcium, vitamins B3, B5, B6 and C. A shortage of these vitamins and minerals can be solved with a vitamin supplement. Please note that it is better not to take them in the evening, as they often have a slightly stimulating effect. 

Lifestyle changes 

Changes in lifestyle are recommended in various areas. We describe them briefly below. 

  • Bedroom furnishings; Make sure you sleep enough hours and go to bed on time. Make sure your bedroom is cool and well aerated, and keep the decor soothing and sober. Make sure your window cover is well-darkened. A lot of people cannot sleep well if it is still light outside. Above all, keep electronic equipment such as televisions, laptops, phones and tablets outside the bedroom. 
  • Bedtime activities; it is wise not to watch TV the last hour before you go to bed and to turn off your mobile phone, laptop or tablet. Instead, you can quietly read a book or magazine and turn on quiet music, for example, to prepare your brain for a restful, deep sleep. 
  • Make sure you do enough exercise. Play sports, take a brisk evening walk. Start with relaxing activities such as dancing lessons, yoga, meditation. 
  • Do not overload your agenda. Keep space free to relax and unwind in between. Do this for your professional life, but also for your social life. Build in sufficient moments of rest. 
  • Avoid alcohol and caffeinated drinks in the evening. This includes energy drinks and black tea. Also reduce the number of cups of coffee during the day. Caffeine delays the production of melatonin (a hormone produced by your body that controls your wake/sleep rhythm) and stimulates brain activity. This is not convenient if you want to sleep. Also avoid using cannabis and other (soft) drugs, for the same reasons. 
  • Make sure you take on enough fluid. You may experience both physical and mental fatigue if your body is not properly hydrated. A well hydrated body can dispose of waste products quickly and well, which promotes a good night's sleep. 
  • Stop smoking. Smoking reduces the blood flow to tissues and organs, and this causes toxins to enter the blood. 
  • Make sure you are a good weight. Obesity causes extra fatigue in several ways. 
  • Adapt your eating habits. Certain foods such as fatty meats, chips, mayonnaise, crisps, sweets and cakes require a lot of energy to process and therefore cause fatigue. Eat enough fruit and vegetables, so that you also get enough vitamins and minerals. Eating late at night and going to bed on a full stomach can greatly disturb your sleep. 

 

 

References

Pieter Polman (2017), Why am I so tired? Causes of fatigue, consulted on 14 April 2019, at https://www.slaapinfo.nl/vermoeidheid/oorzaken-van-vermoeidheid/ 

Tartuffel (2016-2019), Fatigue or fatigue: symptoms, cause and treatment, consulted on 14 April 2019, at https://mens-en-gezondheid.infonu.nl/diversen/173073-moeheid-of-vermoeidheid-symptomen-oorzaak-en-behandeling.html 

Dutch Care Institute (s.j.) insomnia, consulted on 14 April 2019, at https://www.farmacotherapeutischkompas.nl/bladeren/indicatieteksten/slapeloosheid 

Ralph Moorman (s.a.) Solving sleeping problems | 12 valuable tips! consulted on 14 April 2019, at https://www.dehormoonfactor.nl/slaapproblemen 

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