Do you or a loved one with Parkinson’s disease (PD) feel physically or mentally exhausted? This could be fatigue ― a feeling of deep tiredness that does not improve with rest. About half of people with PD report fatigue is a major problem and a third say it is their most disabling symptom.
Fatigue is different from sleepiness. A person who is fatigued feels exhausted, however, does not necessarily feel like sleeping.
Fatigue is common early in the course of PD, but can occur at any point and can happen whether movement symptoms are mild or severe. It is sometimes confused with other symptoms that can make a person sleepy or tired, like sleep disturbances or pain. Fatigue is also a symptom of depression, but a person can be fatigued without being depressed. Stress can make fatigue worse.
No specific cause has been shown to cause fatigue in PD. It is possible that motor symptoms like tremor and stiffness contribute to making muscles tired. But fatigue can have causes outside of Parkinson’s, too. It is important to identify and treat illnesses or medications not related to PD that cause fatigue.
The extreme exhaustion that comes with fatigue can lead people to reduce hours at work or retire, or avoid social activities. Understanding fatigue as a symptom of PD and finding ways to cope with it are essential to maintaining a good quality of life.
- Physical fatigue: feeling deeply tired or weary; may worsen with “off” fluctuations.
- Mental fatigue: mental tiredness that makes it difficult to concentrate.
- Few therapies have been tested for fatigue in PD. None have been proven effective against fatigue on its own. Therapies for movement symptoms do not seem to help fatigue.
- When fatigue is mixed with other symptoms, treating those symptoms may help people feel more energetic. For example, treating sleep disturbances can help a person sleep soundly through the night and treating depression may also help.
- Some therapies for motor symptoms may contribute to fatigue or make you sleepy. Adjusting doses of these medications may help solve the problem.
- Talk to your doctor about medications you take that are not for PD — these also may contribute to fatigue.
- Although little research has been done to evaluate stimulants like amphetamine salts, your physician may recommend trying a low dose.
- Work with your doctor to identify and treat any medical causes of fatigue besides PD, such as anemia.
- Talk with your doctor before taking any vitamins or supplements. These may interact with medications for PD or other disorders.
- In addition to your neurological appointments, have regular check-ups with your primary care doctor. Ask him or her to test for nutritional deficiencies such as vitamin B, potassium and more.
Tips for Coping with Fatigue
- Eat well.
- Stay hydrated.
- Exercise. Walk, do Tai Chi, dance, cycle, swim, do yoga or chair yoga — whatever you enjoy. Fatigue may make it hard to start exercising, but it may make you feel more energetic afterward. If you find it difficult to get going, consider exercising with another person or a group.
- Keep a regular sleep schedule. If you have difficulty sleeping because of tremor or stiffness, trouble rolling over or needing to use the bathroom, talk to your doctor about these issues.
- Take a short nap (10 to 30 minutes) after lunch. Avoid frequent naps or napping after 3:00 p.m.
- Stay socially connected.
- Pace yourself: plan your day so that you are active at times when you feel most energetic and have a chance to rest when you need to.
- Do something fun: visit with an upbeat friend or pursue a hobby.
- At work, take regular short breaks.
Note: Fatigue has been identified by the PD community as an unmet need. More research to understand and solve fatigue in PD is underway.
Page reviewed by Dr. Chauncey Spears, Movement Disorders Fellow at the University of Florida, a Parkinson’s Foundation Center of Excellence.