Fatigue and Asthma: My Experience

The staff at Asthma.net recently completed a survey with people who have asthma called Asthma In America. It examined a number of different factors, including asthma symptoms and their impact on quality of life and physical well-being.

Surprisingly, the most common symptom among survey respondents was not one of the four hallmark symptoms of asthma:

• Wheezing
• Chronic cough
• Shortness of breath
• Chest tightness

No, actually, it was fatigue. Not only that, but respondents said that fatigue had the highest impact on physical well-being!

Fatigue is not a symptom that is talked about a lot with asthma or even mentioned much in research, and that is surprising, given our survey results. It's also surprising, since it is so common.

Why fatigue goes with asthma

Actually, fatigue is most likely to become an issue when asthma control slips or cannot be easily achieved. There are a couple of reasons for why that happens.

• Narrowing of your airways leads to fatigue. Think about it... you're coughing, wheezing and struggling to catch your breath because of the inflammation in your airways. It's only natural that these symptoms are going to tire you out.
• Asthma symptoms are often worse at night. Because of that, they can interfere with you getting quality sleep, or going to sleep at all. Or you might wake up frequently with symptoms. I know when my asthma is acting up, a cough can wake me up out of the blue. If you don't get enough sleep, you're going to feel tired.
• Not enough oxygen is getting into your blood, muscles and other tissues.  Because of the narrowing of your airways, not enough oxygen gets into your lungs. That means not enough can be transported into the rest of your body either. Oxygen is fuel for the body. Without enough of it, it's natural to have fatigue.

Challenges of measuring fatigue

One of the problems with recognizing fatigue as a legitimate symptom of asthma is that it's so subjective. What feels like fatigue may vary from person to person. That makes it hard to measure.

However, some researchers have developed a tool called the COPD and Asthma Fatigue Scale (CAFS for short), a respiratory disease-targeted scale.  They used focus groups and individual interviews with both COPD and asthma patients to develop the tool.

Next, they used an observational study and quality of life questionnaires to assess how accurately the tool worked in measuring fatigue. Here are some other key facts about the study:

• Data used to develop the CAFS was gathered from 78 people with COPD and 84 people with asthma
• CAFS was tested with 311 COPD patients and 324 asthma patients
• In asthma patients, the CAFS scores correlated closely with the Asthma Quality of Life Questionnaire scores

Study Results: The study showed that fatigue varied significantly by disease severity, exacerbations, and health status. Overall, the new CAFS tool appears to be an accurate measure of fatigue. So, hopefully, this will be used more and more in the future to validate that fatigue is a legitimate symptom of asthma.

My Experience With Asthma-Related Fatigue

I told you at the beginning of this post that I would share my experience with fatigue. First, let me state that I have intermittent (very mild) asthma. There are times when my asthma control slips, but it doesn't happen every week, or even every month. For me, because I also have severe nasal and eye allergies, loss of asthma control is often associated with when my allergies flare. This is most likely to occur seasonally, when the pollens I am allergic to are at high levels.

When this happens, I do suffer fatigue, sometimes severe at times. I can't pin it just on asthma. Sure, all the coughing and trouble catching my breath are a factor. But so is the fact that when my eyes won't stop weeping and my nose won't stop running, it just wears me out. At those times, I tend to just cocoon in my house or even to curl up in bed early in the evening.

I can only imagine how much more of a drain on your energy it must be when you have more severe asthma symptoms!

Fighting the fatigue of asthma

So, is fatigue something you just have to live with? The answer to this question is definitely not. There are steps you can take to lessen the impact fatigue will have on your life when you have asthma. Working toward consistent asthma control is the key. Here are some reminders of how you do that:

1. Take your asthma medication as prescribed. Unless you are fortunate enough to be at the intermittent stage of asthma like me, you should be on a daily controller medicine. It only works if you take it regularly, so do that. If it doesn't control your asthma well enough, then talk to your doctor. The dose may need to be adjusted or a different medication may need to be tried out.
2. Avoid coming into contact with your known asthma and allergy triggers as much as you can. When these triggers are part of the environment, this isn't always easy. Believe me, I know. I live with a dog and two cats, all of whom shed a lot of hair. But I vacuum the hair up daily, brush them regularly and keep them out of my bedroom. During the spring, summer and fall, I try to stay indoors when pollen and mold counts are high.
3. Ask your doctor for a written Asthma Action Plan. An asthma action plan spells out what medication to take and when. It also helps you identify what level of asthma control you are at, and steps to take when control starts to slip. Finally, it helps you know when to seek out emergency care.
4. Live healthy. Keeping yourself healthy overall will also benefit your respiratory health. And when you feel healthy, you tend to have more energy too. So, make healthy food choices, stay active, get as much sleep as you can, drink your water and manage your stress.

In summary

Fatigue may be a given when you have asthma, especially when control slips. But it does not have to rule your life or be something you just accept. Be proactive and take steps to get your asthma under better control and fight fatigue.