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Fatigue & Sleep

Fatigue and Low Energy

Patients who had COVID-19 often report fatigue lasting long after they are no longer infected. Fatigue can range from mild to severe. The cause of fatigue is not fully understood but there is evidence that other viruses have led to long lasting fatigue. Scientists are trying to understand relationships between fatigue and the immune system. For example, some people with chronic fatigue seem to have either an overactive or underactive immune system. Additionally, the effect of stress on body chemistry may increase the risk of chronic fatigue. Certain people may be more prone to illness due to family genetics, which can be evident when other family members are ill.

The following are signs of fatigue:

  • Unable to carry out normal daily activities
  • Very tired at times, often exhausted
  • Symptoms get worse during physical activity, trying to think too hard, or when experiencing emotional stress
  • Trouble sleeping and feeling tired after a full night’s sleep

There are additional symptoms that often accompany fatigue:

  • Brain fog, trouble thinking clearly, and memory problems
  • Feeling ill from standing up (known as orthostatic intolerance) and feeling better after lying down and elevating the feet
  • Feeling weak, dizzy, or out of balance when walking
  • Nausea, bloating, digestive discomfort, and sensitivities to certain foods
  • Discomfort in the chest and irregular heartbeat, especially when standing or walking
  • Cold hands and feet
  • Not being able to tolerate extremely hot or extremely cold temperatures
  • Sensitive to sound and light
  • Feeling feverish or like you have the flu, especially when tired
  • Pain of varied types

Seeing a Doctor for Chronic Fatigue

Currently there are no specific blood tests or diagnostic imaging tests that can diagnose chronic fatigue clearly from other chronic illnesses. A definitive diagnosis is made after 3-6 months once a medical provider completes a careful assessment of your symptoms and rules out other conditions.

Trouble Sleeping and Insomnia

Also known as sleeplessness, insomnia is a sleep disorder where people may have trouble falling asleep or staying asleep. In addition to trouble sleeping, insomnia can cause daytime sleepiness, low energy, irritability, and depressed mood. A traumatic event or stress can lead to insomnia for at least short periods of time. For those who experience insomnia lasting a month or more, this is considered chronic insomnia.

Seeing a Doctor for Trouble Sleeping and Insomnia

Talk with your doctor if your insomnia is making it challenging to function during the day. You may be referred to a sleep center for special testing. There are also a several of changes you can make to reduce insomnia:

  • Keeping a consistent sleep schedule so that your bedtime and waketime does not vary much from day to day, including weekends
  • Reduce or eliminate your caffeine and alcohol intake, and don’t use nicotine
  • Create a bedtime routine that is relaxing, such as taking a warm bath, reading, journaling, or listening to music
  • Avoid electronic screen time at least 30 minutes before going to bed
  • Avoid or reduce naps
  • Don’t eat large meals or beverages before bed
  • Use blackout blinds or materials to block light from entering your room
  • Limit the use of electronics (TV, telephones) in your bedroom

Self-Care for Fatigue and Sleep

If fatigue is one of the major symptoms you are struggling with, an important self-care tool will be “pacing” also known as “living within your energy envelope”. To learn more about pacing, visit our Self-Care Pacing Module.

Other self-care strategies that can be helpful for fatigue and sleep include: