The Exhaustion of Headaches

The Skinny on Fatigue

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Do Your Headaches Cause Fatigue?. Jan Stromme/Getty Images

Fatigue is a common symptom in many diseases such as fibromyalgia, lupus, multiple sclerosis, HIV, depression, thyroid disease, and sleep apnea.

It's also common for patients who suffer from headaches. One study found fatigue in 70% of headache sufferers, and another study found fatigue in 84% of chronic migraine sufferers.

Individuals with chronic fatigue syndrome — a medical condition characterized by fatigue lasting at least 6 months plus other symptoms like a sore throat, headache, and poor concentration – also have a higher prevalence of migraine with and without aura.

Do you suffer from fatigue in addition to your headache disorder? Let's take a closer look at this unique relationship.

What is Fatigue?

Fatigue is difficult to define, even within the medical profession. Fatigue can be physical – meaning an individual has difficulty initiating activity or maintaining activity. Fatigue can also be mental – in which an individual has difficulty with concentration, memory, and/or emotional stability.

Many people use terms interchangeably to describe fatigue like sleepiness, muscle weakness, loss of strength, lack of energy, and loss of interest. Unfortunately, there is little data on what actually causes fatigue – making it challenging to treat.

Who Gets Fatigue?

About two-thirds of people with chronic fatigue—defined as fatigue occurring for more than six months— have an underlying medical or psychiatric condition. Less than 10 percent of individuals with fatigue have chronic fatigue syndrome (CFS)

How is Fatigue Evaluated?

If you do suffer from fatigue, it's important to see your doctor for a proper evaluation. They will determine the source of your fatigue. For instance, Is your fatigue related to your headache disorder? Another medical or psychiatric condition? Or  "idiopathic, " meaning no known cause?

Your doctor will ask you questions to better understand what "fatigue" means to you like:

  • How would you describe your fatigue?
  • When did your fatigue start?
  • With treatment of your headaches, is your fatigue improving?
  • How long does your fatigue last? Does it occur daily?
  • What makes your fatigue better or worse?
  • How does your fatigue affect your job or your interpersonal relationships?

Your doctor will also inquire about sleep hygiene and any medications or supplements you are taking, as they could be causing or exacerbating your fatigue.

To rule out an underlying medical cause for your fatigue, like cancer or an autoimmune disease, your doctor will perform a thorough physical examination and order laboratory studies.

Finally, to examine the potential role of a psychiatric illness in your fatigue, your doctor will screen you for disorders like depression, anxiety, and substance abuse.

How is Fatigue Treated?

If fatigue is secondary to a psychiatric or medical condition, your doctor will focus on treating that underlying illness.

That being said, fatigue can still persist, and there are therapies that can help minimize it.

Cognitive-Behavioral Therapy: This intervention involves multiple sessions designed to reorient an individual's beliefs surrounding their fatigue, alter behaviors that will help the individual gain control over their fatigue, and help the individual achieve various physical and personal health goals.

Graded Exercise Therapy: This intervention involves engaging in physical activity slowly and increasing the level of activity gradually over time. Avoiding extremes and stopping before fatigue sets in is critical.

Other therapeutic interventions include:

  • antidepressants
  • referral to support groups
  • counseling on sleep hygiene (e.g. avoiding over-sleeping)

Take Home Message

Fatigue can be a debilitating symptom, either on its own or as a result of another underlying disease process. Try not to be discouraged by it. Speak with your doctor, seek out resources, and stay proactive in your health care. You may not be able to completely eliminate fatigue from your life, but you can strive to gain control.

Sources

Fosnocht KM & Ende J. Approach to the adult patient with fatigue.I n: UpToDate, Basow DS (Ed), UpToDate, Waltham, MA, 2014.

Peres MF, Zukerman E, Young WB, Silberstein SD. Fatigue in chronic migraine patients. Cephalalgia. 2002 Nov;22(9):720-4.

Ravindran MK, Zheng Y, Timbol C, Merck SJ, Baraniuk JN.Migraine headaches in chronic fatigue syndrome (CFS): comparison of two prospective cross-sectional studies.BMC Neurol. 2011 Mar 5;11:30.

Solomon S, Lipton RB, Newman LC. Clinical features of chronic daily headache. Headache 1992; 32:325–9.

Spierings EL, van Hoof MJ. Fatigue and sleep in chronic headache sufferers: an age- and sex- controlled questionnaire study. Headache. 1997; 37:549–52.

DISCLAIMER: The information in this site is for educational purposes only. It should not be used as a substitute for personal care by a licensed physician. Please see your doctor for diagnosis and treatment of any concerning symptoms or medical condition.

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