Symptoms – Fatigue

Approximately 75% of people with Parkinson’s disease (PD) experience fatigue or excessive daytime sleepiness. Fatigue is a sense of tiredness, weakness, and lack of energy that is not relieved by sleep. Fatigue can be a debilitating symptom of PD and can be caused by both physical and mental factors. It can be difficult for people with PD to describe fatigue, and it is a difficult symptom to measure.1

Causes of fatigue in Parkinson’s disease

Many of the symptoms of PD, including slow movement, muscle stiffness, depression, and changes to sleep quality can cause or worsen the symptom of fatigue.

  • Akinesia – Fatigue may be caused by akinesia (the difficulty starting a movement). People experiencing akinesia find it challenging to accomplish simple tasks, requiring significantly more energy to get through the daily activities.
  • Muscle fatigue – Many of the symptoms of PD that affect the muscles, like stiffness, cramping, tremor, and difficulty starting movement, put extra stress on the muscles, causing fatigue. In addition, some people with PD experience muscle atrophy, in which the muscles shrink and weaken due to lack of use. Muscle atrophy decreases a person’s stamina and endurance, contributing to the sense of fatigue.
  • Depression – Depression is another common non-motor symptom of PD, occurring in approximately 40% of people with PD. Depression can cause fatigue, adding to a sense of low energy or lack of motivation.
  • Sleep disturbance – PD often causes changes in sleep cycles, which can add to a sense of fatigue during the day.
  • Medications – Some of the medications used to treat PD, including dopamine agonists, can cause fatigue as a side effect. Others may cause insomnia as a side effect, leading to daytime fatigue.1,2

Assessing fatigue in Parkinson’s disease

There is no single standard for assessing fatigue. As a subjective experience, like the symptom of pain, the person experiencing fatigue can best describe the impact it is having on their life. Fatigue is generally discussed during a physical exam and health history. Patients experiencing fatigue should talk to their doctor about their experience of fatigue, including what times of day symptoms are worse, how long fatigue symptoms last, and how fatigue is impacting their life. The physician can discuss treatments for depression or difficulties sleeping. In addition, the physician may ask for a sleep study to analyze problems with sleep.1

Treating fatigue in Parkinson’s disease

There are currently few treatments available that directly alleviate fatigue, which can make it difficult to treat. However, people with PD who experience fatigue should talk to their doctor as changes in their current medications may help relieve fatigue. Complementary therapies, such as acupuncture or massage, may help improve symptoms of fatigue. In addition, there are several lifestyle approaches that can help manage fatigue, including:

  • Eating a healthy, balanced diet. Good food provides the body with fuel that is important to maintaining energy.
  • Getting regular exercise. Fatigue is improved with regular physical exercise, and people with PD benefit from exercise that includes aerobic activity, such as walking and stretching.
  • Practicing good sleep habits. Some tips to get a good night sleep include a regular bedtime, avoiding too many naps or naps late in the day, decreasing caffeine and alcohol intake, and avoiding stimulating activity in the evening.
  • Scheduling activity for times when movement is easier. Many people with PD find that activity is easier when their medications are working well, and their activity is more difficult as a dosage wears off.
  • Budgeting personal energy. Recognizing the limits of personal energy and not pushing to do too much can help manage fatigue.
  • Reducing stress. Stress worsens fatigue, so find activities that lower stress levels, such as meditating, exercising, or spending time with friends.
  • Stimulating your mind. Boredom can increase the severity of fatigue.1,2
Written by: Emily Downward | Last reviewed: March 2017
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