In addition to the rheumatoid arthritis disease processes and medications, there are a number of lifestyle and comorbid factors that can cause, contribute to, and/or exacerbate chronic fatigue.

    Depression and other mood disorders. Just as fatigue can cause depression, depression can cause fatigue. People who are depressed may feel sluggish and want to avoid work, chores, and social activities. Anxiety is another mood disorder commonly correlated with rheumatoid arthritis that can potentially lead to or contribute to chronic fatigue.

    Low quality sleep. Many experts describe chronic fatigue as a problem that is not directly related to sleep, but people suffering from fatigue should not overlook this factor. As many as half of rheumatoid arthritis patients report sleep problems.8 They may not get enough sleep because of joint pain, depression, sleep apnea, or other factors.

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    Lack of exercise. While this notion may seem counterintuitive, regular exercise can alleviate fatigue. Evidence shows exercise seems to improve quality of sleep and reduce fatigue.9 Of course, those with RA may be less inclined to exercise due to pain and often the patient's pain needs to be adequately treated prior to starting to exercise.

    Other health conditions. People with rheumatoid arthritis are more prone to other medical conditions, such as fibromyalgia, hypertension, and diabetes, which are associated with fatigue.

    See Characteristic Symptoms of Fibromyalgia

If doctors and patients can identify the root cause of fatigue, they may be able to come up with a plan to lessen or alleviate it. It may be that one or more of these factors cause fatigue, or it may be another factor(s) at play.

The bottom line is that the more information patients supply to their doctors concerning their specific fatigue symptoms, the better chance fatigue can be evaluated and addressed.

References:

  1. Abad VC, Sarinas PS, Guilleminault C. Sleep and rheumatologic disorders. Sleep Med Rev. 2008; 12:211–228. [PubMed: 18486034]
  2. Durcan L, Wilson F, Cunnane G. The effect of exercise on sleep and fatigue in rheumatoid arthritis: a randomized controlled study. J Rheumatol. 2014 Oct;41(10):1966-73. doi: 10.3899/jrheum.131282. Epub 2014 Aug 15. PubMed PMID: 25128510.
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