Fatigue guide

Fatigue guide

Information on causes, symptoms and treatment

Fatigue is often caused by stress and lack of sleep. However, persistent tiredness can be a sign of a serious illness. Persistent tiredness and exhaustion are a sign of a pathologically increased need for sleep. In this case, a consultation with your family doctor is necessary.

Abstract

• Fatigue is accompanied by listlessness and reduced alertness.
• Chronic fatigue despite getting enough sleep is a symptom of deficiency symptoms, sleep problems or illness.
• Successful diagnosis and treatment are preceded by comprehensive examinations.

What is fatigue and what are the typical symptoms?

Fatigue is the body’s way of indicating that the organism needs rest. The brain controls the release of hormones and neurotransmitters. It influences the immune system through proteins and changes the body temperature.

The first noticeable symptom is a reduced ability to perform and concentrate. Prolonged sleep deprivation manifests itself in other physical and psychological impairments such as

• Perceptual disorders
• Irritability
• Lack of drive
• Visual, tactile and auditory hallucinations (hypnagogia)
• Feeling cold
• General hallucinations

After a long, strenuous day or after activities, fatigue is a normal phenomenon. Nights of stress-induced sleep deprivation result in daytime tiredness. A quiet night with sufficient sleep or a short sleep break has a revitalizing effect and creates new energy.

If the feeling of tiredness persists over a long period of time, there is a health disorder.

Possible causes of permanent fatigue

Prolonged fatigue while still getting enough sleep is a symptom of a health problem. To regulate the sleep-wake rhythm, the body needs sufficient oxygen and nutrients. It receives both through the following intact functions:

• Metabolism
• Blood circulation
• Heart function
• Hormone production
• Immune defense
• Nerve activity

If one of these functions is disturbed, sleep complaints (insomnia) or an increased need for sleep (hypersomnia) occur.

Some health conditions can trigger both sleep problems and an increased need for sleep. These include premenstrual syndrome and the menopause in women.

Causes of sleep problems

Sleep complaints mainly belong to the group of non-organic or physiological fatigue. The body needs sleep and does not get enough of it.

• Difficulty falling asleep, restless sleep and frequent awakenings during the night are usually the result of psychological stress and emotional strain. If these are not just temporary, depression may develop. Burnout, anxiety and depression are typical illnesses associated with a lack of sleep and constant tiredness.
• Sleep apnoea (heavy snoring with frequent cessation of breathing) disturbs restful sleep due to an undersupply of oxygen. The result is fatigue during the day.
• Eating disorders, an unhealthy diet and alcohol and drug abuse disrupt the sleep-wake rhythm.

Causes of an increased need for sleep

People with an increased need for sleep experience a high level of tiredness despite getting enough sleep. In this case, doctors speak of organic, pathological fatigue.

• Feeling tired can be a side effect of medication. This applies to drugs used to regulate nerve functions, brain metabolism or blood pressure.
• A lack of exercise, fluids and oxygen promotes fatigue and contributes significantly to daytime tiredness.
• Magnesium deficiency is a cause of tiredness and loss of energy.
• The lack of vitamins and minerals contributes to rapid fatigue.
• Environmental pollution caused by toxins and pollutants can increase the need for sleep.
• If the immune system defends itself against infectionsit puts a strain on the body and causes fatigue.

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Diseases as a cause of chronic fatigue

Persistent fatigue is one of the typical symptoms or side effects of certain diseases:

• Hypothyroidism
• Anemia
• Diabetes mellitus
• Cardiac arrhythmia
• Migraine
• Heart failure
• Cancer
• Chronic fatigue syndrome (CFS)
• Narcolepsy (sleep addiction)
• Multiple sclerosis
• Lung diseases
• Parkinson’s disease
• Liver and kidney damage
• Various autoimmune diseases
• High or low blood pressure
• Gastrointestinal diseases
• Rheumatic diseases
• Fibromyalgia syndrome

Fatigue – diagnosis begins with a detailed discussion

If the stressful feeling of tiredness accompanies a known illness, the doctor will quickly identify the cause. If it occurs in a previously healthy person, numerous examinations are required.

First of all, the GP will take a detailed medical history. During the consultation, he will ask typical questions, for example:

• Do you feel exhausted after waking up?
• When does fatigue set in?
• Does microsleep occur?
• Is your nightly sleep accompanied by snoring?
• How long and how well do you sleep at night?
• How severe is the fatigue?
• Do you have any other complaints?
• What is the family, social and professional situation?
• Are there any indications of anxiety or depression?
• Are there any known chronic illnesses?
• Have there been any major weight fluctuations recently?
• Do you take medication regularly?
• What is the alcohol consumption like?
• Is there drug use?
• Is there any known exposure to harmful environmental influences or extreme noise pollution?

The doctor uses these questions to try to determine the cause of the constant fatigue. This requires truthful answers. Intimate or unpleasant information about marital and family problems or financial difficulties also provide important clues.

Physical examinations

Following the anamnesis, the following physical examinations are carried out:

• Listening to the respiratory organs and the heart
• Checking the lung function
• Control of the lymphatic regions
• ECG (heart rate measurement)
• Blood glucose measurement
• General blood test

Depending on the medical history and the examination results, the family doctor may consult doctors.

If there are risks or particular stresses involved in performing the job, the doctor will write the patient off sick due to fatigue. Depending on the possible cause, various diagnosis codes from the ICD system are available for this purpose. This system assigns an internationally valid code to each diagnosis.

Treatment of chronic fatigue

The therapy to combat the constant feeling of fatigue depends on the diagnosis.

• If the cause lies in the patient’s life circumstances, these should be changed. Psychotherapy methods can be used for this purpose.
• If the fatigue is a side effect of another illness, the therapy is carried out with the treatment of the underlying illness.
• If it is a side effect of a medication, it will be replaced by another medication if possible.
• Harmful environmental influences as a cause should be eliminated.
• If the cause is an independent illness such as chronic fatigue syndrome or narcolepsy, treatment is carried out with medication with the support of behavioral therapy measures.

Questions and answers

Are there home remedies for fatigue?

Home remedies only help against tiredness that is not caused by mental or organic illnesses. If the amount of sleep is insufficient or if stress is the cause, a longer period of sleep and relaxation techniques are helpful.

Exercise in the fresh air, a low-fat and vitamin-rich diet and sufficient fluid intake can prevent rapid fatigue.

Who is mainly affected by fatigue?

In 2017, the IGES Institute in Berlin compiled figures on sleep complaints among working people on behalf of the DAK. According to the study, 9.4 percent of male respondents suffer from daytime tiredness and exhaustion. Among women, the proportion is 11 percent.

When is a visit to the doctor necessary?

A visit to the doctor should be made if the fatigue is a burden and lasts longer than three months.

Sources

• https://www.patienten-information.de/kurzinformationen/narkolepsie#
• https://www.berlin.de/special/gesundheit-und-beauty/gesundheit/psychologie/1327443-2260865-chronisches-erschoepfungssyndrom-muedigk.html
• https://www.apotheken-umschau.de/Muedigkeit
• https://www.aerzteblatt.de/archiv/46725/Chronic-Fatigue-Syndrom-Mit-Psychotherapie-gegen-die-Muedigkeit
• https://www.aerzteblatt.de/archiv/47249/Chronische-Muedigkeit-Trainingsplaene-kontraproduktiv
• https://www.aerzteblatt.de/archiv/80276/Muedigkeit-und-erhoehte-Leberwerte
• https://www.apotheken.de/symptome/12271-muedigkeit-und-abgeschlagenheit-anhaltend
• https://www.dak.de/dak/bundesthemen/muedes-deutschland-schlafstoerungen-steigen-deutlich-an-2108960.html#/
• https://www.deutsche-apotheker-zeitung.de/daz-az/2009/daz-38-2009/was-steckt-eigentlich-hinter-abnormer-muedigkeit
• https://www.dgsm.de/downloads/fachinformationen/rki-bericht/schlafstoerung.pdf
• https://www.medical-tribune.de/medizin-und-forschung/artikel/immer-erschoepft-wachsam-sein-bei-mueden-patienten-und-keine-pseudodiagnosen-stellen/
• https://www.laekh.de/heftarchiv/ausgabe/artikel/2020/oktober-2020/hypersomnie-und-insomni