If you suffer with fatigue from multiple sclerosis, you know it’s not just a matter of feeling a little tired every now and again. With this sort of extreme exhaustion, you regularly feel so wiped out you have to stop in your tracks and rest right away. You’re not alone. Fatigue is one of the most common symptoms of multiple sclerosis, and studies estimate between 75 to 90 percent of patients experience at least some of its debilitating consequences. Although you can’t completely prevent the onset of this kind of profound tiredness, there are lifestyle strategies that can help almost all MS fatigue sufferers.
Multiple sclerosis is an autoimmune disease that destroys the protective coating (myelin) around nerves in the brain and spinal cord responsible for sending signals to other areas of the body. This miscommunication can create far-ranging symptoms, from depression, sleeplessness and brain fog to muscle spasticity, tremors, visual blurriness and fatigue.
[See: 5 Rare Diseases You’ve Never Heard of (Until Now).]
“MS is a highly individualized condition. In a similar way, fatigue is not the same for all patients,” says Dr. Jaime Imitola, neurologist with the Ohio State University Wexner Medical Center. “Some MS patients can be hit with overwhelming lethargy shortly after waking in the morning, while others function well until one or two in the afternoon before their battery runs out,” he says.
No matter what time of day fatigue hits, it’s a wallop that knocks out all your energy. What’s packing the punch? It looks like one of the biggest factors is sleep disturbance. A 2012 study published in Acta Med Iran looked at the relationship between sleep problems and MS fatigue in Iranian patients and concluded that sleep difficulties had more impact on feeling totally wiped out than either depression or the severity of other MS symptoms. More recently, research published in 2015 in the journal Frontiers in Neurology found in a study of 107 individuals with MS, 61 percent reported sleep difficulty and fatigue. The researchers came to the conclusion that sleep disturbances are likely the primary factor triggering MS fatigue.
But a good night’s sleep isn’t necessarily a cure for MS fatigue, either. “Although sleep is a contributing factor, so is stress, depression, side effects from medications, as well as other influences. Damage to specific regions in the brain of MS patients is probably the primary culprit,” says Dr. Howard Weiner, co-director for the Ann Romney Center for Neurologic Diseases and director of the multiple sclerosis program at Brigham and Women’s Hospital in Boston. An MRI study reported in the June 2014 journal Radiology supports Dr. Weiner’s view. The research concluded that abnormalities in strategic brain areas were responsible for fatigue in MS patients.
Just having MS, in many instances, is cause enough to feel fatigued. “MS can be a tremendously exhausting disease. Certain symptoms such as tremors and weakness can use a lot of energy,” Imitola points out. “It’s also important to note that fatigue is a common symptom in most autoimmune diseases; MS is one of them.”
[See: 10 Seemingly Innocent Symptoms You Shouldn’t Ignore.]
So what can MS patients do to lessen their overwhelming exhaustion?
— Stay cool. “Whether it’s a hot day or you’re running a fever, heat makes fatigue worse mainly because the damaged myelin-covered nerves malfunction when exposed to temperatures above normal,” Weiner says. Following general strategies to stay chill, such as taking a cool shower before going out or staying in an air-conditioned environment, can help lessen the chances of fatigue hitting.
— Try aspirin. A 2014 study sponsored by the Mayo Clinic, in cooperation with the National Multiple Sclerosis Society, found that two regular aspirins (325 mg each) taken twice a day reduced MS-related fatigue. Before trying this yourself, be sure to discuss it with your doctor. Some people are sensitive to aspirin, and it can be dangerous if taken with certain other medications such as blood thinners.
— Exercise. “It doesn’t have to be strenuous to be effective,” Weiner says. In fact, several studies have shown that yoga can help MS patients. One of the first studies in 2004 on yoga’s impact on extreme tiredness was published in the journal Neurology. The research took place over six months among 69 MS volunteers. Subjects were divided into three groups: One-third practiced yoga, one-third performed regular aerobic exercise and one third did neither. The result? Taking a weekly yoga class, along with home practice, significantly lessened the fatigue that accompanied MS.
— Consider caffeine. “Stimulants, including black tea as well as coffee, can help,” Imitola says. “But don’t drink caffeinated beverages near bedtime because it could interfere with a good night’s sleep.”
— Schedule wisely. Another tip from Imitola: “Do all your important chores that require the most mental and physical energy when you know from experience you’ll be less likely to be struck with fatigue.”
— Take a nap. You can’t fight MS fatigue when it comes on. “Even a short nap, one as little as 10 minutes, can help perk you up,” Weiner says.
— Manage medications. “There are disease-modifying medications that can help with contributing symptoms (such as sleep disturbances or depression), as well as specific drugs that work with fatigue,” Imitola says. But the pendulum swings both ways. “Some medications have side effects that add to feelings of fatigue. That’s why it’s a good idea to go over all the drugs you’re taking with your doctor,” he says.
[See: 10 Lessons From Empowered Patients.]
There’s another reason to stay in touch with your physician. “Since fatigue is highly individualized and differs from patient-to-patient, it’s important to have a discussion with your doctor to try and discover the key factor that’s triggering your excessive exhaustion and work together to develop a personalized plan,” Weiner says.
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How to Deal With MS Fatigue originally appeared on usnews.com
