#35 - Fatigue ... FFS !
Fatigue.
Weariness. Lethargy. Tired.
All these words are synonymous with fatigue.
When I began my career treating people with insomnia in 2002, the sleep community were pretty good at measuring sleep.
We’d use sleep diaries. We’d use measures of insomnia.
But a lot of people with insomnia complained that their poor sleep affected how they were during the day.
At the time, the best measure of daytime functioning was the Epworth Sleepiness Scale (ESS). Developed in 1991, it was the best self-report of how sleepy people felt during the day.
But people with insomnia didn’t score highly on the ESS.
They didn’t feel sleepy - just tired. Very tired.
In 2005, the National Institute for Health in the USA stated that better measures of the daytime feelings resulting from insomnia were needed.
Two years later, and we released the Flinders Fatigue Scale (FFS).
FFS
Before ‘FFS’ meant something to the whole world, we developed a quick questionnaire to measure fatigue in those who experienced insomnia.
We did this based on the hundreds of comments made by people who came to us to treat their insomnia.
Because the Science was lacking in this area, we needed to fill this gap with our knowledge from Clinical Practice.
And so we developed the FFS from our Clinical Practice, then it was important to test it with Science.
(by the way, these methods are known as the Scientist-Practitioner Model).
What Did We Find?
People with insomnia recorded significantly higher fatigue than good sleepers.
Fatigue did not correlate with Daytime Sleepiness
Fatigue scores decreased after we treated people with insomnia with Cognitive-Behaviour Therapy.
Besides insomnia, high levels of fatigue can be experienced due to other conditions - like Chronic Fatigue Syndrome, Cancer, and Circadian Rhythm Disorders (to name a few).
In a follow-up study of the FFS in 2017, we found high levels of fatigue in people with Chronic Fatigue Syndrome, followed by people with insomnia - and both groups reported higher fatigue than people with obstructive sleep apnea.
What about Age and Gender?
So far we haven’t found any differences between males and females.
And age has a very small influence on fatigue.
It’s not only adults who experience it - but also teenagers.
In our clinical trial where we provided Cognitive Behaviour Therapy and Bright Light Therapy to teenagers with a sleep disorder, we found the therapy was able to reduce their levels of fatigue.
What Can You Do If You’re Experiencing Fatigue?
As hinted at in this blog, reasons for fatigue can differ between people. So it’s important to first find out why?
Naturally, we’re biased, so we recommend having a good look at your own sleep.
Fatigue is related to insomnia. If you find that you’re feeling sleepy and can have the occasional nap (or 3), then you may not have insomnia, but certainly need to catch-up on your sleep.
And fatigue is related to the timing of your body clock.
If you’re a teenager reading this, you’re more inclined to have a delayed body clock. This can be a reason for fatigue. Gradually going to bed earlier each night has been shown to increase the amount of sleep.
If you’re a shift worker, then you certainly can relate to the experience of fatigue. Because there are so many variations of shift work, you really need to see a sleep specialist who can advise you on ways to minimise your sleep loss and fatigue.
What Can You Do If You Help People Who Experience Fatigue?
As we learned, it’s important to measure fatigue.
Prior to developing the FFS, we were completely blind to what our clients were experiencing.
Now we see it - because we can measure it - both before and after treatment.
And because we see it - we can show our clients.
How Do I Learn More About Fatigue?
We’ve packaged our work on fatigue in the Downloads section of the WINK website.
Have a read of our free scientific publications - one of them has the FFS at the end of the article.
We’ve also got our FFS - Bundle.
The Bundle contains the FFS in multiple languages, including administration and scoring instructions. We’ve also included clinical cut-offs so you can know whether a person’s fatigue score is a clinical issue (and then see if treatment of fatigue brings their score below these cut-offs).
Finally, we’ve bundled together 85 scientific citations that have referenced our work with fatigue - including weblinks so you can learn more.
Sleep only takes up 33% of our lives - but it dictates what happens to the other 67%.
Don’t be blind.
p.s. If you missed out on subscribing to our newsletter, then it’s a damn shame you missed out on our discount on our FFS - Bundle. It might come up again in future - like other discounts - and it takes bugger all time to join …
Prof Mike Gradisar