6 Tips for Managing Chronic Fatigue With IPF

“Pulmonary fibrosis really affects your whole body, because ultimately, all systems have to work harder to maintain oxygen levels,” says Bradford C. Bemiss, MD, an associate professor of pulmonary and critical care at Northwestern University’s Feinberg School of Medicine in Evanston, Illinois. “Your heart is working harder, your muscles are working harder — your whole body is under stress and, essentially, everything is working overtime.”

Fatigue is often one of the first symptoms an individual may experience prior to a diagnosis. “It is something that may come to light even when the more overt symptoms of disease like shortness of breath, which is a more recognizable sign of disease, are absent or minimal,” says Dr. Bemiss. “Many times, we end up diagnosing IPF early because of vague symptoms like fatigue, chronic cough, or feeling like you’re getting older. One of the things I hear patients say is that they thought this was just normal aging.”

Fatigue in IPF can be managed, but you will need a multipronged approach that can be incorporated into everyday life.

• Use tools such as slow cookers, air fryers, pressure cookers, and food processors, all of which save time and effort when you prepare meals.
• Cook in batches and freeze meals. If you have time, prepare food for the upcoming week, so you don’t have to cook every day.
• Consider high quality precooked meals that you can microwave, especially when feeling very tired.
• Have a stool or high chair in the kitchen so you can sit while preparing food.

Jonathan Kropski, MD, a professor of medicine in the division of allergy, pulmonary, and critical care medicine at Vanderbilt University Medical Center in Nashville, agrees. “Be active every day,” he says. “At home, aim for regular short bursts of activity. For example, walk to the mailbox or do light resistance exercises. Doing these several times per day adds up.”

He also advises getting outside when possible. “When the weather and air quality are conducive, get some fresh air every day. Walking or sitting outside can also boost mood and improve energy,” says Dr. Kropski.

Poor sleep quality can impact your quality of life and also worsen fatigue, but there are steps you can take to help you get a good night’s sleep, explains Lederer. “Going to bed around the same time each night, waking up around the same time each morning, and avoiding TV and cell phone usage before bed are all key things to help facilitate good sleep,” she says. “When you are getting proper rest, it helps lessen fatigue.”

• Take short naps, if needed, but not too close to bedtime.
• Limit caffeine intake a few hours before bedtime.
• Exercise regularly, as tolerated.
• Eat your evening meal several hours before bedtime to allow for better digestion.
• Take some time to unwind and relax before going to bed, if possible.
• Do pursed lip breathing before bed to decrease shortness of breath and promote relaxation.

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Lederer also advises considering how much energy a specific task requires. “This can help you budget your energy throughout the day and the week,” she says.

Kropski recommends setting up your home environment to make difficult tasks easier. “A laundry basket on wheels can simplify difficult activities like lifting and carrying,” he says. “A strategically placed chair can enable you to sit while preparing meals, and a small table or even the seat of a rolling walker next to a chair can help with folding laundry.”

• If you use supplemental oxygen, consider using it while you shower or bathe, as recommended by your provider.
• Consider mobility aids if you are feeling very fatigued or breathless. These include lightweight wheelchairs (easier to fold up and put in the trunk of a car), walkers, or power scooters.
• Bathe or shower when you feel that you have sufficient energy to safely complete the task and also have some time to relax afterward. The best time of day is what works for you.
• When bathing, use assistive devices such as a handheld showerhead, shower chair, tub transfer bench, and grab bars.
• In the kitchen, keep pots, pans, utensils, and tableware that are frequently used on the counter instead of in cabinets, so you don’t have to bend to reach them.

“Everyone wants to do everything and go the extra step, but strategically conserving your energy can give you the energy for the activities you want to do,” says Lederer. “Your care team can help you strategize and identify ways to conserve your energy.”

“Patients have the opportunity to work with professionals who are able to monitor them while they are exercising, and they help them exercise more efficiently,” says Bemiss. “This can help them with breathing and fatigue. Patients usually experience less shortness of breath and increased energy [after pulmonary rehab].”

• Fatigue is a very common symptom in IPF and often one of the first symptoms that people will experience prior to their diagnosis.
• The causes of fatigue are complex but are generally attributed to breathlessness, disrupted sleep, anxiety and depression, and medications used to treat IPF.
• Fatigue can be managed with lifestyle interventions such as rest, improved sleep hygiene, exercise, a nutritious diet, and assistive or adaptive devices.
• Pulmonary rehabilitation is an important part of IPF treatment, and can help lessen fatigue and breathlessness and increase energy.