Tiredness: Information for patients and carers

Fatigue is a feeling of extreme tiredness or lack of energy that doesn’t always go away with rest. People often describe it as feeling drained, heavy, or like their body won’t do what they want it to.

Fatigue can affect:

• The ability to move around or do daily tasks
• Concentration and memory
• Mood and motivation
• Social interaction

• The illness itself (e.g. cancer, heart failure, lung disease)
• Side effects of treatments like chemotherapy or medication
• Pain or other symptoms interfering with sleep
• Anxiety or depression
• Poor nutrition or dehydration
• Moving about less
• In the final weeks of a long term illness fatigue can be very severe

Fatigue often has more than one cause.

• If you feel low, anxious, or unable to cope with the change in energy levels
• If fatigue is new or has changed significantly as there may be a treatable medical cause such as low blood count (anaemia) or medication side effects
• There are some medications (such as steroids) that may help with a boost of energy for a short period of time

• Prioritise: Focus on what matters most each day
• Plan ahead: Spread tasks throughout the day or week
• Pace yourself: Take regular breaks and rest when needed

There is evidence that gentle movement or light exercise (such as walking or stretching) can surprisingly help increase energy and reduce fatigue.

• Try to keep a regular calm sleep routine at night
• In the final days and weeks of life people may sleep a lot more in the day which often makes night time sleep difficult. 

• Try to eat small, regular meals as calories are essential for energy. Small volume high calorie foods (e.g. full fat yoghurt) can help
• If appetite is very poor and calories need increasing food can be fortified e.g. with powdered skimmed milk added to hot chocolate or coffee, +/- a spoon of cream or ice cream
• Drink plenty of fluids as hydration is also key
• If towards the end of life please see this information on eating and drinking 

It is important to talk about how someone is feeling. People often don't realise that high anxiety levels can cause overwhelming tiredness. Sometimes specific concerns once expressed can be worked through more easily. Medication for depression may help.