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Date issued: June 2022

Review date: June 2024 

Ref: C-496

PDF:  Fatigue final June 2022.pdf [pdf] 930KB

What is Fatigue?

Fatigue is a personal experience which can affect you both physically and mentally. It is different from the typical tiredness that we all experience as fatigue may not improve with rest.

You may feel:

• Exhausted or “sleepy”
• Physically and/or mentally weak
• Lacking in motivation
• Irritable, frustrated, overwhelmed

The impacts of fatigue can be severe. It can make daily tasks a challenge, hinder recovery, contribute to people becoming socially isolated, and make other physical and psychological difficulties. It is important to manage fatigue well.

Causes

Research studies have shown that a number of factors can make people vulnerable to experiencing fatigue.

Fatigue is like a battery

Like a battery, humans only have so much energy. Some factors mean our battery isn’t as big as it used to be (e.g. poor sleep), or that it drains more quickly (e.g. some medications, or being de-conditioned).

If the battery gets too empty, we stop working, and it takes a long time to recharge. This is like fatigue.

If you stop and recharge before the battery is empty, it is much easier to top-up the energy levels.

Recognising my Fatigue

The first step to managing fatigue is being able to recognise the signs. Everyone experiences fatigue differently, common signs of fatigue include:

• Yawning

• Eyes feeling heavy or blurred vision

• Loss of concentration

• Experiencing a headache or body/stomach ache

• Fidgeting or feeling irritable

What are your signs of fatigue? Do you start to think, feel, or behave differently when you are fatigued? It may be useful to ask a close friend or family member if they notice any signs that you may be feeling fatigued.

Recognising my Triggers

It is likely that you will find some tasks more fatiguing than others. These tasks are known as triggers. As with signs of fatigue, triggers are different for everyone. 

Some triggers may include:

• Doing too much, overexertion

• Doing too little, under exertion

• Being in a busy environment

• A bad night’s sleep

• An emotionally demanding event

It may be helpful to write a list of everyday activities and make a note of how tired you feel before and after doing them on a scale of 1-10. This will allow you to identify which tasks use more energy.

Boom and Bust

As your fatigue levels will vary, you may be able to do more on some days than you can on others.  During the times when you feel you have more energy, you may notice the temptation to do as much as you possibly can. This is a ‘boom’. However, this is not sustainable, and can lead to periods of severe fatigue. This is a ’bust’. After spending a long time recovering to regain energy, it is common to want to repeat the pattern. This is known as the boom and bust cycle. An alternative that avoids the difficult side effects of fatigue, is pacing.

Pacing

One way to manage energy levels is through pacing. This involves spreading out activities and taking regular breaks. It is important to take breaks before you even notice the signs of fatigue, so that your body can rest and recharge effectively. This helps avoid the boom and bust cycle so that you can get more done over a longer period of time. For example, if you need to clean the house, take a break in between each room, rather than trying to do it all in one go.

Top tips for pacing include:

• Schedule rest breaks into your daily routine.
• Set regular alarms to remind you to have a rest. For example, use a timer on your phone after starting an activity.
• It is important to find activities that you find help you to relax and recharge. Even things that seem relaxing can be draining for some people (e.g. watching television).
• Practicing relaxation techniques may be a beneficial way of giving you focus and allowing yourself to recharge.

Prioritising

Prioritising involves thinking about all the different tasks you usually do on a daily basis and a weekly basis. Ask yourself the following for each task:

• If I do this task, will it impact on my fatigue so that I cannot function?
• Is this job essential or important?
• Can I delegate this task to someone else, or ask   someone else for help with it?
• Can I adapt this task to be less tiring?
• Do I enjoy doing this task?
• Can I do this task less often or eliminate it all together?

Planning

Planning your day is essential to completing the tasks you set out to do and managing your fatigue. Plan your days around the times when you think you are more likely to have energy. If you are able to anticipate the tasks that will fatigue you through planning, then you can schedule time to rest and recharge.

Using a daily or weekly planner to schedule activities and rest breaks maybe useful.

Tips for resting: Plan the exact times that you will take a rest and what you will do during this period.  For example, going somewhere quiet to sit or lie-down, practice mindfulness, listening to calming music, or reading an easy book. The important thing is that you feel like you can recharge.

Fatigue and lifestyle 

Sleep

Establishing a healthy sleep routine is crucial for getting a good night’s sleep and feeling more alert during the day.

Try to…

• Go to bed and get up at the same time every day.

• Use your bed for sleeping only.

• Develop sleep rituals   before going to bed e.g. having a bath.

• Create a calming bedroom e.g. dark and quiet.

• Practice relaxation and mindfulness.

• Keep a ‘worry journal’ next to the bed

Try NOT to…

• Use caffeine, nicotine, or alcohol in the hours before sleep.

• Eat heavy meals before bedtime.

• Exercise within 3 hours of going to sleep.

• Nap after 4pm.

• Look at the time if you wake up in the night.

• Avoid bright lights, or looking at your phone before bed.

Diet

Some types of food and drink can make us feel energised, while others can make us feel more tired and slowed. To manage   fatigue, it is important to consider what kinds of foods you are eating and at what times.

Foods like sweets, white bread, and sugary cereals are fast-releasing carbohydrates. This means that they may cause an  initial release of energy, but this does not last long and is followed by a period of decreased energy.

Foods like fruits, vegetables, wholegrain pasta, and brown rice are slow-releasing carbohydrates. These foods contain fibre which slows down the release of sugar and, in turn, maintains energy levels for a longer period of time.

It is important to have a balanced diet of slow-releasing carbohydrates and proteins, such as meat, fish, and dairy, to  remain healthy and alert.

Mood

You may be finding that your fatigue is getting in the way of things you used to do, such as taking part in activities that are important to you. This can often lead to negative, unhelpful thoughts- “I SHOULD be able to do this”, and negative feelings, such as frustration and hopelessness. This may cause you to avoid activities or over-exert yourself.

It is important to recognise the link between your thoughts, feelings, and behaviours, and when your fatigue is becoming overwhelming. This combined with other factors in this leaflet will allow you to manage your fatigue better. 

Try to:

• Acknowledge that you may not be able to do as much as you did before. Focus on what you can do.

• Do not dwell on things you were unable to do or  finish. Do what you can do that is in line with your values. For example, you might not be able to do the shopping, but you might be able arrange an online shop.

• Do not dwell on unhelpful thoughts and feelings. What would you say to a close friend or relative who was in your position? What can you do? 

• Plan time to do activities that you enjoy.

• Recognise and celebrate when you have done something well.