We all feel tired from time to time. Are you tired all the time though? Shattered? Exhausted? Drained? We live high pressured lives with a 24 -7 attitude. Lack of sleep, stress and anxiety, poor health all add to this feeling.
Workers in the UK currently work the longest hours in Europe, take the shortest lunch breaks and enjoy the fewest public holidays. Childcare is expensive and difficult to find, care for older people is of inconsistent quality and financial support during family-related leave is lower than in some other parts of Europe. (Trades Union Congress, 2014)
Some may also view sleep as wasted time. A need for sleep perhaps indicates laziness or a lack of inner strength. For many of us it is simply a luxury that we dream about as we run around like headless chickens. Pressures from work, social calendars (I wish!), children and family, we seem unable to admit sleepiness or succumb to its call. We continue to battle on, never giving in, unless we crash and burn out of course (I am speaking from experience here). The problem is we get into a vicious cycle. We feel tired so we struggle to find the energy and motivation to get out of it. This picture summarises what happens quite nicely:
Image from http://www.rcpsych.ac.uk/healthadvice/problemsdisorders/tiredness.aspx
Who suffers from fatigue?
Many of us experience short-term sleep disruption, whether it be too much booze on a Saturday night, that after dinner coffee you should have said no to, because it’s too bloomin’ hot, even with both legs hanging out the bed. Perhaps you have repeated trips to the loo through the night? Your child might be poorly or simply taking the Michael? Or maybe your mind just WILL NOT SWITCH OFF Arrrggghh! These are all common reasons many of us have a bad day, particularly flagging in the afternoon but tiredness and fatigue can affect many people in the long-term too. Then it can really start to affect an individual’s life and the people that surround them.
The Royal College of Psychiatrists (2012) report that at any given time, 1 in 5 people feel unusually tired and 1 in 10 have prolonged fatigue. Fatigue is a word often used interchangeably with tiredness (exhaustion and listlessness too) but there is a difference between fatigue and sleepiness. Sleepiness can be helped by improving the quality and length of sleep. Fatigue is characterized by very low energy levels and the need to rest frequently and is not necessarily helped by sleeping more. Some people will suffer from fatigue more than others. Women tend to suffer more than men, shift workers typically experience fatigue, as do those managing chronic disease.
What are the dangers of fatigue?
Talking about shift work, my husband (P) was one of the 3.5 million people employed as a shift worker in the UK last year (HSE, 2014). He would rotate weeks of early, late and night shifts, so never had more than 5 days to get used to going to sleep or getting up at a different time.
I also think about all my nursing colleagues and the 1000’s of nursing students I have taught over the years. Working shifts for x-years or are about to enter a lifetime of shift work. I imagine it’s very tough. The closest I have come to it is breastfeeding my son all hours of the day and night!
Research published in the British Medical Journal (BMJ 2012;345:e4800) in 2012 reported that shift work is associated with myocardial infarction (heart attack), coronary events, and stroke. It has also been recognised that shift workers are at increased risk of diarrohoea, constipation and ulcers. They are more likely to view their jobs as extremely stressful and have higher rates of substance abuse, depression and divorce (American College of Emergency Physicians, 2003).
Fundamentally, these health problems arise because the body has to battle against its own inbuilt sleep/wake cycle – the circadian rhythm that tells us to be awake when it’s light and sleep when it’s dark . Other factors that may contribute to these health problems will include having disrupted and poor quality sleep, eating at odd times such as in the middle of the night, eating more junk food and not exercising. Interestingly, it has been reported today that shift workers are also significant risk of Type 2 Diabetes. Worryingly the authors said “rotating shifts, in which people work different parts of the 24-hour cycle on a regular basis, rather than a fixed pattern, were associated with the highest risk of 42%” – read about it here and the original abstract is here
Thankfully P works days only now. It got to the point where his body clock had simply had enough and didn’t know time or day it was or what it was supposed to be doing. He used to suffer constantly from fatigue but now his and our quality of life is so much better.
Not only does fatigue limit what you can do in a day, which is debilitating in itself, it can also be dangerous.
Fatigue results in:
- slower reaction speeds
- poor coordination
- absent-mindedness
- poor memory
- decreased awareness
- lack of concentration
- underestimation of risk
- serious errors, accidents and injury
This issue becomes more alarming when you consider that shift workers are often employed in the most dangerous of jobs, such as firefighting, medical services, law enforcement and security (American College of Emergency Physicians, 2003).
Fatigue and long-term conditions
Fatigue is not a disease in itself but is often associated with many long-term conditions like rheumatoid arthritis, cancers, Parkinson’s disease, depression, Chronic Fatigue Syndrome and Multiple Sclerosis (MS). It was actually a colleague of mine who is an MS nurse specialist who asked me to write this blog about fatigue and diet to help inform her patients. I also met with a local endometriosis group recently where we discussed the fatigue they experience too. Fatigue is the key symptom of several major sleep disorders such as obstructive sleep apnoea and narcolepsy so potentially a significant proportion of the UK population are dealing with fatigue. Taking medications, having treatments or recovering from major surgery can also cause significant fatigue.
This sort of fatigue is not just ordinary tiredness; it’s an overwhelming tiredness that often occurs after very little activity. It is not just physical either, but a persistent emotional or mental exhaustion too. Fatigue can affect social relationships, feelings of well-being and sense of joy, attitude towards the future and the ability to undergo treatment. The MS Society talk about lassitude, a unique symptom associated with MS that is more severe than normal fatigue, that comes on easily and suddenly and is aggravated by heat and humidity. That you may wake up feeling as tired as you did when you went to sleep, that your limbs might feel heavy, and it becomes harder to grasp things or to write. MS-related fatigue does not seem to be directly associated with depression or the degree of physical impairment. More information can be found on this fatigue on the MS Society website.
So this is where I may be able to help. Diet can play a part in determining your levels of fatigue (or wakefulness!). It won’t necessarily make you into an athlete or compensate for medications and treatments for existing conditions. For the healthy person, it won’t compensate for the burning of the candle at both ends but it can make a difference. In addition to any treatment /medication, stress management, CBT etc. you might be having to help manage your symptoms, there are 3 key areas of your diet to look at too:
- Stabilising your blood sugars
- Ensuring you drink enough
- Ensuring you get the right vitamins, minerals and essential nutrients
So next week I will be posting 3 more blogs; each one will focus on one of the above points. I will be making suggestions to help you achieve the above and there will be lots of tips and recipe ideas to try too, so keep your eyes peeled!
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Here are the related blog posts:
- Stabilising your blood sugars – Part 2: finding the energy to fight fatigue
- Ensure you drink enough – Part 3 – drink plenty of fluids
- Part 4 – Boost your vitamins and minerals
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