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Writer's pictureJessica Frizzell, PA-C

How Rheumatic Diseases Cause Fatigue and Insomnia



Fatigue is a common symptom with rheumatic diseases. In fact, it can be severe and debilitating for some.


Many patients also deal with insomnia, which is another life-altering symptom that comes with many rheumatic diseases.


While fatigue and insomnia are not the same condition, they tend to go hand-in-hand. They feed on each other and result in the same outcome - a sleepy, tired, overly exhausted individual.


What is Fatigue?


Words such as fatigue, sleepiness, drowsiness, and tiredness might seem like interchangeable terms, but these feelings have significant differences.


It is normal to feel tired. Life is hectic and busy, so being tired by the end of a long day is an expected part of life.


It is even normal to feel fatigued. Let’s say you complete a physically-demanding workout, you will probably feel fatigued afterward.


It is normal to feel drowsy every now and then. A feeling of excessive sleepiness can occur when running short on sleep, but drowsiness on a regular basis might be an indication of a larger health issue.


What is not normal is to feel so tired that you cannot function. It is not normal to feel such a strong desire to sleep that you cannot perform daily activities. It is not normal to feel so low on energy enough that it interferes with your ability to carry out home and work responsibilities.


And most importantly, it is not normal for these occurrences to last long term and carry on in a persistent manner day after day. A good night’s rest relieves tiredness. It does not relieve chronic fatigue.


The Correlation Between Fatigue, Insomnia, and Rheumatic Diseases


How is fatigue related to insomnia? Well, you could say it’s a symptom of insomnia. Insomnia leads to fatigue and impacts its severity.


What exactly is insomnia?


The Mayo Clinic states: “Insomnia is a common sleep disorder that can make it hard to fall asleep, hard to stay asleep, or cause you to wake up too early and not be able to get back to sleep. You may still feel tired when you wake up. Insomnia can sap not only your energy level and mood but also your health, work performance and quality of life.”


Certain medical conditions, such as rheumatic diseases, can cause insomnia. On the other hand, insomnia can actually increase the risk of developing health issues.


It’s one of those games of what comes first, the chicken or the egg. Insomnia first, then fatigue, then a rheumatic disease? Or is it the other way around?


When considering why rheumatic diseases can contribute to the development of insomnia, there is a long list of potential explanations.


Pain: Persistent pain is part of the equation with many rheumatic diseases, and naturally, pain interrupts a person’s ability to sleep. Some patients have discovered the ticket to a good night’s rest begins with managing their pain.


Inflammation: Since rheumatic diseases are inflammatory diseases, there are countless medical studies that have explored the connection between inflammation and insomnia. Research suggests inflammation affects various sleep centers in the brain and interrupts sleep cycles.


Medication: Many patients see positive results when incorporating prescribed medications into their treatment plans. Medications are not foolproof, though. Some patients might experience adverse side effects, such as insomnia.


Hormones: Oh, the dreaded hormonal changes that come with age. Furthermore, hormonal imbalances are a common occurrence with rheumatic diseases. Combine these two elements, and hormones can wreak havoc on a person’s sleep.


Vitamin Deficiencies: Just like with hormones, vitamin levels play a role in our health. Vitamin deficiencies can lead to a myriad of health problems, including sleep issues. In particular, having an iron deficiency is a known cause of insomnia.


Diet: If you really want to track how your diet affects your sleep, you need to be aware of not only what you eat, but when you eat as well. And don’t forget to account for those caffeinated drinks!


Lack of Exercise: Want to improve your sleep? Be more active. Exercising can help you sleep better at night as well as increase your energy throughout the day. Plus, regular exercise can help you achieve an optimal weight, and carrying excess weight is often linked to insomnia.


Mental Health: Stress, anxiety, and depression are three of the top leading causes of insomnia. When patients take steps to support their mental wellness, many see improvements in their sleep habits (and their rheumatic disease progression).


A Visit With Your Rheumatologist


Managing the effects of fatigue and insomnia can be all-consuming. That’s why it is important to have an open and honest conversation with your rheumatologist if you think you are experiencing these conditions in addition to your rheumatic disease.


Our healthcare team here at Paducah Rheumatology is ready to listen to your concerns and answer any questions you might have about the symptoms you are experiencing.


We are accepting new patients with a physician’s referral. Give us a call today at (270) 408-6100.

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