Fatigue, sometimes described as overwhelming tiredness or physical malaise, is a common symptom of pulmonary fibrosis (PF) patients. Generally, fatigue is characterized by a lack of energy that does not improve after rest or normally sufficient amounts of sleep. People who struggle with fatigue describe the symptom as unrelenting exhaustion that inhibits daily activities and negatively affects their quality of life.
Pulmonary fibrosis, like sarcoidosis and scleroderma, is one of several autoimmune diseases that belong to a group of interstitial lung diseases. Autoimmune diseases feature a wide range of symptoms, but fatigue tends to be common across all patient groups.
In a survey conducted by the American Autoimmune Related Diseases Association, 98% of autoimmune disease patients said they suffer from fatigue. In the same study, 89% admitted that fatigue is a “major issue” and 59% said it is “probably the most debilitating symptom” of their disease.
What causes fatigue in pulmonary fibrosis?
The direct cause of fatigue in autoimmune diseases is not fully understood by researchers. In PF, it could be a byproduct of poor sleeping patterns caused by breathing difficulties and decreased oxygen intake.
A 2008 research project, led by pulmonologist Dr. Sonye Danoff of Johns Hopkins University School of Medicine, demonstrated that fatigue in PF patients is associated with up to 25% loss in body-rejuvenating REM sleep. The study found that 18 of 22 pulmonary fibrosis patients surveyed experienced fast, shallow breathing while sleeping. Shallow breathing in PF often prompts patients to breathe twice as fast to keep up with oxygen demands. Because rapid breathing in PF causes patients to wake frequently, they get less REM sleep.
How is fatigue treated?
Because fatigue negatively impacts a patient’s life nearly every day, the symptom needs to be addressed.
“Physicians should strongly consider monitoring people with this scarring lung disease for sleep disorders as part of their standard care, because poor sleep has a profound effect on their quality of life,” Danoff said in a news release.
Though fatigue itself can be difficult to treat, treating underlying issues that contribute to fatigue may help improve sleep quality and lead to higher energy levels. Oxygen therapy is commonly used to address shallow breathing and dyspnea in PF because it increases the concentration of oxygen in the lungs that oxygenates blood.
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