What is fatigue and how can we combat it?

Fatigue is a common problem affecting people of all ages and backgrounds. According to a recent survey by the National Sleep Foundation, more than one-third of American adults report feeling tired or fatigued on a daily basis. As a UK GP, this statistic rings true: fatigue is a very common symptom on the surgery triage list. More importantly, fatigue can have a significant impact on our ability to function and perform daily tasks, as well as our happiness and quality of life.

But what exactly is fatigue?

The World Health Organization defines it as ‘a state of feeling very tired, exhausted, or sleepy, which can be physical, mental or a combination of both’. Fatigue can be caused by a variety of factors, including lack of sleep, stress, poor nutrition, and medical conditions such as anaemia or depression.

It’s not just about feeling bad; fatigue can negatively impact productivity, accuracy, and well-being. Studies show that sleep-deprived individuals make 37% more errors compared to those who get adequate sleep. Another study found that fatigue caused by prolonged work hours increases the risk of industrial accidents by 60%. As Vince Lombardi said, ‘fatigue makes cowards of us all’.

The most obvious cause of fatigue, and it’s very common to diagnose this as many of us are oblivious to our reality, is lack of sleep.

The National Sleep Foundation recommends that adults get at least 7-9 hours of sleep per night. However, according to a study by the Sleep Council, a non-profit organisation, nearly half of the UK population (48%) get less than the recommended 7 hours of sleep per night. Another study conducted by the Royal Society for Public Health and the Young Health Movement found that over a third of young people in the UK (35%) get less than 5 hours of sleep per night, which is considered inadequate.

Long-term sleep deprivation can lead to chronic fatigue, as well as an increased risk of other health problems such as obesity, diabetes, and heart disease.

Of course, lack of sleep is not the only cause of fatigue. Stress and poor nutrition can also contribute to feeling tired and run down. Stress can, obviously, directly affect sleep quality and quantity but in my experience, simply feeling stressed is exhausting in itself.

Meanwhile, our diets can have a huge impact on our energy levels. Modern western diets, high in carbs, are well known to cause sugar dips, for example.

As a GP, I can’t fail to mention medical conditions which can cause fatigue. There are many, including anaemia; an underactive thyroid gland; sleep apnoea; kidney, liver or heart disease, diabetes – the list goes on. If your level of fatigue is extreme, it may well be worth asking a doctor for advice.

So, what can we do to combat fatigue?

First and foremost, it’s important to prioritise getting enough sleep. Things that can help include:

• A regular bedtime and wake-up time,
• Avoiding caffeine after lunchtime,
• Abstaining from alcohol,
• Turning screens off for at least an hour before bedtime.

Creating a comfortable sleep environment, such as keeping your bedroom dark, cool, and quiet, can also help promote better sleep.

However, from my clinical work, I know that a sleep pattern is the most fragile of things; all the advice I’ve just mentioned is great until you can’t sleep when it can be infuriatingly unhelpful. Some reassurance comes from Nick Littlehales, a sleep expert working with high-performance sportspeople, who points out that virtually no one gets a reliable eight hours a night all the time and that moments of mind clearance during the day can be just as useful. There’s a great interview with him here.

“Reducing stress and/or managing stress is a key life skill”

I’ve already mentioned stress; reducing and/or managing stress is a key life skill. We might incorporate stress-reducing activities such as exercise, yoga, or meditation into our daily routines. Or we might focus on avoiding overload: practising time management techniques, setting realistic goals, and prioritising tasks can increase our feeling of control and reduce stress levels.

Eating a balanced diet that includes plenty of fruits, vegetables, whole grains, and lean proteins can also help combat fatigue. This will help ensure the body gets the nutrients it needs to function properly.

Finally, as mentioned earlier, it is prudent to consult a medical professional if you’re experiencing chronic fatigue, as it can be a symptom of an underlying health condition. A doctor can rule out any underlying medical issues and recommend treatment options if necessary. Other symptoms to look out for include breathing pauses overnight, breathlessness or unexplained and significant changes in weight.

In summary, fatigue is a common problem that various factors, including lack of sleep, stress, and poor nutrition can cause. Modern working lifestyles – staring at screens all day – arguably don’t help either. By prioritising getting enough sleep, managing stress levels, eating a balanced diet, and consulting a medical professional, you can take steps to overcome fatigue and improve your overall quality of life.

Remember, as Confucius said, ‘It does not matter how slow you go as long as you do not stop’

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