Beat MS Fatigue

Ways to stay active and alert

Fatigue is an extremely common symptom of Multiple Sclerosis occurring in up to 95% of patients, according to one survey. There are a variety of causes of fatigue and trying to understand the cause may be helpful. In addition there are a number of ways that fatigue may be managed in patients with Multiple Sclerosis.

Fatigue may be caused by a number of problems related to MS:

1. Poor Sleep—Patients occasionally will have spasticity at night, nighttime urination or other problems that break up their sleep at night. This would then lead to daytime sleepiness. If this is the problem, then treatment of the underlying nighttime disturbance may be helpful in the controlling the daytime fatigue.

2. Depression—Depression is a common manifestation of MS and one of the symptoms of depression is fatigue and daytime sleepiness. If you have beginning symptoms of depression such as sad mood, inability to enjoy usual activities, a weight gain or loss, a sense of despair, or suicidal thoughts, discuss these with your physician and consider treatment.

3. Over-exhaustion—Often patients with MS will have muscle fatigue, particularly if they work long hours or over exhaust themselves. By carefully timing their activities, doing most of the activities in the morning when fatigue is less and taking regular naps, these symptoms may be improved.

4. MS itself—The most significant cause of fatigue in multiple sclerosis is related to the disease itself. There appears to be a direct immunological reason for the fatigue, which may relate to some of the chemicals released into the brain by the T-cells. Theses chemicals, called cytokines, are the same chemicals released in viral infections and may cause the fatigue related to such viruses. This is thus a major symptom of the disease unrelated to depression, poor sleep habits, or overwork.

Treatment of fatigue in MS

1. Exercise—A regular exercise program has been shown to improve fatigue symptoms. It will take time to develop the training effect but exercising 3 times per week for about 45 minutes has been shown to have a beneficial effect.

2. Energy conservation—It is important to parcel out efforts so that the energy is there when needed. Often people do what they need to do most in the morning when their energy level is highest. They may try to take breaks or short naps to reenergize themselves. Doing fewer optional things ina day may also help. By paying attention to energy requirements of different activities, the most necessary things can be done first.

3. Medications:

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