Sleep Treatments Improve Fatigue, Tiredness

It may seem like common sense, but a good night’s sleep could be the answer to getting energy back, according to a study at the University of Michigan Sleep Disorders Center.

Patients with complaints of fatigue, tiredness or lack of energy improved with nightly use of continuous positive airway pressure (CPAP) or related devices that are often prescribed for those with obstructive sleep apnea, according to the study published in this week’s issue of the Journal of Clinical Sleep Medicine.

“Many physicians and patients assume that while complaints of daytime sleepiness may indicate a sleep disorder, complaints of fatigue, tiredness or lack of energy must be caused by some other medical or psychiatric problem,” says senior author Ronald D. Chervin, M.D., M.S., Director of the U-M Sleep Disorders Center and Michael S. Aldrich Collegiate Professor of Sleep Medicine in the Department of Neurology at the U-M Medical School.

“Our new findings suggest that fatigue, tiredness, and lack of energy, in addition to sleepiness, can also be important, reversible symptoms of sleep apnea,” he says. Chervin says their findings may impact the way doctors evaluate patients with these types of complaints.

When about 300 patients with confirmed obstructive sleep apnea were quizzed about their chief complaints, it was fatigue, tiredness, or lack of energy, rather than sleepiness itself, that emerged as the most worrisome issues. Women, in particular, reported lack of energy more frequently than men.

“If we as physicians ask only ‘Are you sleepy during the day?’ we may miss an opportunity to help patients with serious sleep problems,” Chervin says. “If a patient says ‘I feel tired all day’ or ‘I just have no energy,’ rather than using the word ‘sleepiness,’ it does not rule out the possibility that sleep apnea is the underlying cause.” This would be important to know because sleep apnea is, in most cases, readily treated. The new research findings show that these other complaints – about fatigue, tiredness, and lack of energy – are about as likely to improve as sleepiness is, when sleep apnea is treated.

Sleep apnea describes a group of increasingly common sleep disorders in which a person repeatedly stops breathing during the night. In obstructive sleep apnea, the throat closes completely or partially and interrupts breathing until the person wakes up briefly, only to fall asleep again and repeat the cycle.

The good news is that CPAP or other treatments are effective for the large majority of people who have sleep apnea. A CPAP machine delivers pressurized room air through a mask to keep the throat open. Results can include improved cardiovascular health, in addition to more alertness and energy during the day.

In the U-M study, the percentage of people who reported sleepiness dropped from 39.3 percent to 23.5 percent after regular use of the machine. Tiredness fell from 52.5 percent before treatment to 32.8 percent after adherence to PAP. Patients who used their machines on average for fewer than 5 hours per night did not experience much improvement in their symptoms.

“We found that sleep apnea patients who were able to use their PAP regularly, in comparison to those who used PAP less often, had much greater success in reducing their fatigue, tiredness and sleepiness,” Chervin says. Interestingly, for reasons that remain uncertain, improvement in lack of energy did not depend as clearly on the amount that PAP was used.

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