Do you find fatigue to be cyclical/intermittent?

[Pistachio]

I am starting to feel the more intense fatigue again. For me, that means a good, solid 8 hours a night of sleep but still needing an afternoon nap. I went through this in the summer of 2020 and then it got better and then again in the early months of 2021 and then again last fall. I have been having a pretty good go lately with less fatigue - as in, not needing a nap. It's been a good run of about 6 months now. I DO nap sometimes just to ensure I am in tip top shape (you just never know when MS is going to slam you down again) but recently I NEED those naps again. I am tired.

It seems so cyclical. I don't notice any other changes. Is it like this for you, too?

[pennstater]

When I was working, it was chronic. Since I stopped, like you, have times where I can manage it, and others, where it is more intense again. I am also in one of the fatigue cycles now. For me, it started when the heat was really bad mid-August and I have not bounced back. I had my Tysabri infusion right after, and that didn't help either.

Trying to keep up with my exercise, as they say it is one of the best things to help with fatigue. But some days, if I do that, I am done for the day. Also like you, often nodding off mid afternoon.

I also think I may start with the light therapy, as I sometimes experience SAD. My Neuro told me best to start in September, before we have less daylight hours.

Hope yours lifts soon.

[Jules A]

Mine is chronic but I work a lot. Hopefully that will lighten like pennstater's when I reduce hours or retire.

As for light therapy I use it in the winter as I do have some degree of SAD. I just purchased a daylight clock that I plan to use on my early days when it is pitch dark to hopefully give me a softer awakening as opposed to the blood curdling alarm that I could literally throw through the window.

[KoKo]

Hey Pistachio ~

Similar to Pennstater and Jules with working, my fatigue was constant during the last few years of my employment, before retiring on disability.

Since then, I pretty much just have 'trigger' fatigue, not constant fatigue (thankfully).

The triggers that seem to bring on a bout of fatigue for me now include a night with poor sleep, overdoing physically (and sometimes mentally) and high humidity/high dew point.

Also, I have become a fairly regular, afternoon, short nap-taker, which has really helped.

[KoKo]

This info is from the brochure Fatigue, What You Should Know (A guide for people with MS) (National MS Society)


What are the types of MS-related fatigue?

∫ Fatigue related to mobility problems: With MS, mobility problems can make ordinary activities require so much physical exertion that a person is exhausted by the effort. This is especially true for people who have weakness in their arms or legs.

∫ Motor fatigue: A type of fatigue that occurs in muscles (most often in the legs or arms) that are not receiving adequate nerve impulses due to demyelination. These muscles may tire quickly with repeated use causing feelings of extreme weakness and recover following a period of rest.

∫ Fatigue related to respiratory problems: MS can sometimes affect breathing, and when it does, even simple activities can be tiring. This is especially true for people who have the most serious physical symptoms of MS.

∫ Primary MS fatigue: This is a diagnosis of elimination. After all other causes of fatigue have been ruled out or treated successfully, primary MS fatigue is what’s left

brochure-fatigue-what-you-should-know.pdf (azureedge.net)

[Pistachio]

Thanks, Koko, that was very helpful.

I honestly think my fatigue is cognitive fatigue, if that makes sense. It's like my brain is constantly working so hard to do regular things that I'm just tired. For example, there are often times that I just go get something rather than explain to another member of our household where it is. Why? Because it's just too much work to try to think of the words to explain it. Or, sometimes I have to check my attitude/temper when I have to think about explaining something to someone. Again, it's seems like so much work to do it.

It's interesting because I am still working. I work in my husband's chiropractic office so I don't have a particularly stressful job. As far as jobs go it's fairly restful. However, I also teach English (online) to kids in China. I LOVE this! I called it my paid hobby. But it gets to a point in the day (typically more as the day progresses) that I am just TIRED!

Anyway, after that long-winded explanation, I think I have a combo of chronic and acute fatigue. I am always some level of tired but, as stated in my original post, there are weeks/months that I have very acute fatigue:

∫ Chronic persistent fatigue: Activity-limiting sluggishness or lassitude that goes on for more than six weeks, more than 50% of the days, during some part of the day.

∫ Acute fatigue: Activity-limiting sluggishness that has either appeared for the first time or become noticeably worse during the previous six weeks. Acute fatigue can be an early warning that other MS symptoms are about to flare up or become worse

I sure hope this doesn't mean I am relapsing or growing lesions. I have an MRI next month so we shall see.....

[KoKo]

I honestly think my fatigue is cognitive fatigue, if that makes sense. It's like my brain is constantly working so hard to do regular things that I'm just tired. For example, there are often times that I just go get something rather than explain to another member of our household where it is. Why? Because it's just too much work to try to think of the words to explain it. Or, sometimes I have to check my attitude/temper when I have to think about explaining something to someone. Again, it's seems like so much work to do it.

Wow, I can relate with that, Pistachio. I am in Assisted Living and seem to get new assistants all the time.

It really does take alot of cognitive effort for me to explain things regarding my needs and care, over and over again.

I love it when I get a 'regular' aide that knows everything already!

It's interesting because I am still working. I work in my husband's chiropractic office so I don't have a particularly stressful job. As far as jobs go it's fairly restful. However, I also teach English (online) to kids in China. I LOVE this! I called it my paid hobby. But it gets to a point in the day (typically more as the day progresses) that I am just TIRED!

Totally get the cognitive/mental fatigue, which seems to affect the physical as well.

Anyway, after that long-winded explanation, I think I have a combo of chronic and acute fatigue. I am always some level of tired but, as stated in my original post, there are weeks/months that I have very acute fatigue:
I sure hope this doesn't mean I am relapsing or growing lesions. I have an MRI next month so we shall see.....

You may be doing too much, and not realize it? Usually we don't think we're overdoing, while we're doing!

[marti]

Fatigue for me is non-stop, but then, so is Insomnia!

[palmtree]

Fatigue? Yes. Cognitive fatigue? Yes. Physical fatigue? Yes. Overall fatigue? Yes.

i can relate to all the categories of fatigue. I’m aware of how much effort it takes to move my legs. I am aware of how much mental effort to tell my body(or somebody else) what to do. I am aware that I can have what would be considered a good nights sleep and still feel like I stayed up all night cleaning the house.

The only thing that helps me is to get extra sleep. That means more than a nap. Sometimes it means sleeping on and off for 3 days. Finally, I emerge able to move my arms and legs. If I can’t sleep lying there with my eyes closed helps a little.

Marti, I really feel for you. I’ve spent so much of my life sleep deprived. It’s no joke.

[marti]

Fatigue? Yes. Cognitive fatigue? Yes. Physical fatigue? Yes. Overall fatigue? Yes.

i can relate to all the categories of fatigue. I’m aware of how much effort it takes to move my legs. I am aware of how much mental effort to tell my body(or somebody else) what to do. I am aware that I can have what would be considered a good nights sleep and still feel like I stayed up all night cleaning the house.

The only thing that helps me is to get extra sleep. That means more than a nap. Sometimes it means sleeping on and off for 3 days. Finally, I emerge able to move my arms and legs. If I can’t sleep lying there with my eyes closed helps a little.

Marti, I really feel for you. I’ve spent so much of my life sleep deprived. It’s no joke.

It so helps to know there are others in the same boat. But I do sympathize with you!