Lupus, chronic fatigue, and a good night sleep

For us, diagnosed with lupus SLE, the story of fatigue and cognitive dysfunction is what Dr. Melanie Harrison compares to the tale of the “chicken and egg.” 

 

Each symptom directly impacts the other and can wreak havoc upon the human body by forcing one to endure an ongoing cycle of confusion caused by exhaustion, which is caused by confusion, which is caused by exhaustion, and so on. Such a scenario is challenging for individuals to live with and tricky for physicians to diagnose. I can testify that.

 

The symptom of fatigue is real, and it is common in those with lupus. According to Dr. Harrison, those with lupus tend to experience lupus-related fatigue as “something more from inside” the human body. Though the term sounds uncertain, it lends itself to a different, and some may argue deeper, understanding the symptom in those who experience it due to lupus; fatigue is more than mere listlessness. Instead, it is when one has little trouble beginning a task, but instead tires easily and has difficulty keeping up (whether it be mentally, physically, psychologically, or otherwise).

 

Along with skin rashes and arthritis, fatigue is among the most common symptoms of lupus. Over 81 percent of those with lupus, both active and inactive, will experience troublesome fatigue that will impair their ability to live normally. Despite this high percentage, fatigue, because of the variability of the symptom and its typically subtle development, is often overlooked by both patients and physicians. Indeed, it is often only when patients first complain of fatigue that they realize that something has “been off” for quite a while. According to Dr. Harrison, this is one reason why physicians have had such trouble diagnosing it. 

 

“Because we can’t do a blood test for it, we can’t do an x-ray for it, we don’t have specific questions… it’s really difficult for us to measure it,” says Dr. Harrison. As a result, the medical community has had little chance to study fatigue. What is infinitely worse, rarely claims success in treating the ailment unless both a trigger and a continuous cause for the symptom are known.

 

Causes for fatigue can be many, and this is why narrowing down one specific cause can be so tricky. From a physical standpoint, fatigue can be the result of exertion, pain, or illnesses such as multiple sclerosis, rheumatoid arthritis, or lupus; behaviorally, it can be caused by poor sleep, substance abuse, stress, or any other type of disruption in daily activities; and psychologically, it may result from neuropsychiatric problems such as mood disorders or cognitive dysfunction itself.

 

For those with lupus, a good night of sleep is among the most worthy activities to stay healthy and avoid symptoms like fatigue and cognitive dysfunction. Unfortunately, 61 percent of those with lupus claim that they do not feel refreshed after a night of sleep. Typically, those with lupus have sleep problems that may include any or all of the following:

 

Restless sleep

Poor sleep quality

Sleep for too short of a duration

Problems falling asleep

Inability to stay asleep

Another element of sleep disorder Dr. Harrison identifies is what she calls “sleep phobia”:

 

“Lupus patients tend to lay awake and are concerned about not sleeping, but what happens when you’re thinking, ‘Oh my God, I’m not falling asleep, and I have so much to do tomorrow?'” says Dr. Harrison. “The more anxious you get, the less likely that you’ll be able to fall asleep or sleep well when you do fall asleep.”

 

As stated earlier, lack of sleep can lead to fatigue and can cause great anxiety. Still, it can also lead to feelings of depression, which can worsen the symptoms of cognitive dysfunction and make sleep more complex, creating yet another “chicken and egg” scenario where one condition furthers the other in a reciprocal motion.

 

You can read more about other causes of fatigue for those with lupus here.

 

But simply because there are questions left unanswered when dealing with lupus does not mean that physicians have no advice on limiting the effects of the disease. As most medical professionals do, that it is vital to maintain a healthy lifestyle that includes a balanced diet, sufficient sleep, and exercise. Keeping to these standards may not prevent all the disease symptoms, but in the long run, it will keep one’s body strong and well prepared to deal with whatever lupus-related conditions may arise.

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