ALS and Fatigue

Amyotrophic lateral sclerosis (ALS) is a debilitating neurodegenerative disease that has profound effects on the human body as it progresses. There are numerous primary symptoms associated with ALS that will significantly affect the day to day living for the diagnosed individual.

Loss of muscle strength, for example, leads to loss of mobility. The individual may eventually be confined to a wheelchair and, during the later stages of the illness, be completely paralyzed. The disease also affects functions such as speech, swallowing and breathing.

One of the primary symptoms experienced by many individuals with ALS is fatigue. While we all get a little tired from time to time, for those with ALS this can range from mild tiredness to extreme, clinically significant levels of fatigue.

Here we take a closer look at the fatigue associated with ALS, what causes it and how individuals can help minimize its impact.

What is Fatigue?

Fatigue can be characterized by tiredness, lack of strength and dwindling energy. It might be caused by a whole range of issues but for most of us disappears when we have had some rest or sleep. For the individual with ALS, fatigue is often a constant issue and one which is accompanied by the gradual weakening of muscle strength.

This means that they may have slower body movements, find it difficult to speak, experience increased irritability and have a lack of focus.

How can ALS Cause Fatigue?

ALS fatigue is caused by the actual process that the disease forces on the individual but is also be influenced by psychological factors which come with coping with its progression. ALS causes neurodegeneration which means that the motor nerves serving muscles in the body gradually get destroyed.

That leads loss of muscle strength which is a huge part of this condition. Someone diagnosed with ALS may have to work extra hard just to lift their arm or swallow some food. This takes a significant toll on the body, something that gets worse as the disease progresses.

• Faulty signalling to different muscle groups often causes spasms and twitches that will quickly tire the individual.
• On top of that, there is the potential for mental health issues such as anxiety and depression which can also affect energy levels.
• Poor breathing because of reduced lung capacity may mean result in lack of sleep and the individual never feeling refreshed when they wake up each morning.

Treatment of ALS-related Fatigue

ALS fatigue is likely to be an issue at some stage during the progression of the disease. For some, it occurs at the beginning, for others, it only develops as more muscle groups are affected. It can be aggravated by lack of mobility, overexertion, certain medications and even whether the climate is too hot or too cold.

There are a number of medications that can be taken such as amantadine and pemoline which have shown to improve fatigue levels in some patients.

Dietary supplements like creatine may have an effect and promoting a healthy diet can also make a difference, particularly in the early stages of the disease.

Overall, however, fatigue is something that has to be managed.

Managing and Minimizing Fatigue

Whilst there are no real effective treatments for ALS fatigue, most of the attention is focused on how to manage it during the progression of the disease.

Anti-fatigue strategies suggested by the ALS Association include:

• Using assistive devices to help make life easier and reduce the amount of effort that has to put into daily tasks.
• It’s important to work with an occupational therapist to find solutions that can help reduce the occurrence of fatigue. That includes making living spaces as accessible as possible for daily activities.
• An individual may have to learn to pace themselves better. One key tip is to stop once they become breathless and to plan activities so they can be managed better.
• It’s important to schedule in more rest periods where possible
• Sleep is important for anyone with ALS, but getting a good night’s rest can often be difficult, especially when there are breathing issues to deal with. Finding solutions, again with the help of an occupational therapist, can help ease these kinds of issues.
• Stress can also be a contributory factor and finding ways to avoid this, working with friends and family, may have a positive impact.

Many individuals who have been diagnosed with ALS struggle with fatigue.

This is deeper and more pervasive than many people realize and has a number of causes, not least the gradual muscle wasting that accompanies the disease.

Coping mechanisms, such as regular resting should help the individual manage the issue of fatigue more successfully.