Fatigue is a common and often debilitating symptom for people living with Parkinson’s disease, affecting their quality of life significantly.

Unlike ordinary tiredness, the fatigue associated with PD can be overwhelming, making it difficult for individuals to perform even simple tasks.

The Impact of Fatigue on People Living with PD

Fatigue is one of the most common non-motor symptoms of Parkinson’s Disease, with studies suggesting it affects up to 50% of individuals with PD. Fatigue may occur at any stage of Parkinson’s disease, and many people report it significantly impacts their daily routine.

This type of fatigue is not just about feeling tired; it’s a profound lack of physical and mental energy that doesn’t always improve with rest and can be more disabling than other symptoms like tremors or stiffness.

People with PD may find their fatigue significantly impacts their daily activities, social life, and overall well-being, making it a critical symptom to address.

Fatigue vs Sleepiness

Fatigue and sleepiness are not the same.

Fatigue in the context of PD refers to an overwhelming sense of exhaustion that isn’t necessarily related to physical or mental exertion. It doesn’t always resolve with sleep, indicating a more complex issue than merely feeling sleepy.

Sleepiness refers to the state or condition of feeling the need or desire to sleep. Sleepiness differs from fatigue in that it primarily signals the body’s natural need for sleep rather than a general lack of energy or motivation.

People living with PD may experience both, but management strategies differ, and sleepiness is typically more easily resolved.

Causes of Fatigue in PD

The exact cause of fatigue in PD is not fully understood and is believed to be multifaceted, involving neurological and non-neurological factors.

Possible explanations include:

• Neurological Changes 

PD involves the degeneration of dopamine-producing neurons in the brain, which plays a crucial role in regulating movement and coordination. This loss can also impact energy levels, contributing to feelings of fatigue.

• Medication Side Effects 

Medications used to manage PD symptoms can sometimes contribute to fatigue as a side effect. The very drugs helping to improve mobility and reduce tremors may affect energy levels, leading to an increased sense of tiredness and exhaustion.

• Akinesia

Akinesia, a symptom of PD, is characterized by difficulty initiating movements and demands greater physical effort for daily tasks, leading to increased fatigue.

The physical strain from overcoming muscle stiffness and joint discomfort exacerbates exhaustion. Additionally, the psychological stress from movement challenges further drains energy, intensifying the experience of fatigue.

• Mood Disorders 

Depression and anxiety, common comorbidities in PD, contribute significantly to loss of energy and fatigue.

• Sleep Disturbances 

Many people living with PD experience sleep problems, such as insomnia or sleep apnea, which can lead to daytime fatigue.

Understanding these causes is crucial for addressing fatigue effectively, as each factor may require a different approach to management.

How to Manage Fatigue with PD

Managing fatigue in PD involves a comprehensive approach addressing medical management, lifestyle changes, and supportive therapies.

It’s helpful to identify potential causes of fatigue to address this issue, so consider taking detailed notes whenever you experience fatigue to discuss with a healthcare provider and potentially identify patterns.

Here are some recommended management strategies.

Medication Review

It’s essential to work with a healthcare provider to review all current medications. Adjusting dosages or timings can sometimes reduce fatigue without compromising the management of other PD symptoms.

Regular Exercise

Although it may seem counterintuitive, engaging in regular, moderate exercise can improve energy levels. Activities such as walking, swimming, or yoga can be particularly beneficial.

Sleep Hygiene

Improving sleep quality can significantly impact fatigue levels. Establishing a regular sleep schedule, creating a comfortable sleeping environment, and addressing any sleep disorders can help.

Energy Conservation

Learning to pace activities and take regular breaks may prevent overexertion. Prioritizing tasks and using adaptive tools or devices can also reduce physical strain.

Consider requesting specific accommodations or adjustments to social settings that could help mitigate fatigue, such as sitting instead of standing, having a quieter place to talk, or taking regular breaks. Communicate your fatigue to friends and loved ones so they’re aware of this symptom and can accommodate you appropriately.

This approach not only educates others about PD but also ensures your comfort and participation in social activities.

Nutritional Support

A balanced diet with plenty of fruits, vegetables, and lean proteins can help maintain energy levels. Staying hydrated is equally important.

Mental Health Support

Since mood disorders can contribute to fatigue, addressing depression or anxiety with professional support can have a positive effect on energy levels.

Mindfulness and Relaxation Techniques

Practices like meditation, yoga, or deep-breathing exercises help manage both physical and emotional stress, potentially reducing fatigue.

Parkinson’s and Fatigue: Next Steps

Fatigue has a significant impact on the quality of life for many people living with PD.

To effectively manage fatigue, it’s imperative to understand the nature of the fatigue and its potential causes and adopt a multifaceted approach to management. Collaborating closely with healthcare providers and support networks can provide additional strategies and encouragement.

With the right approaches, it’s possible to mitigate the impact of fatigue and maintain a more active, fulfilling life despite the challenges of PD.