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If you’re living with Parkinson’s disease, you may often feel run-down or low on energy. You might even feel a deep, bone-tired exhaustion that doesn’t improve with rest. These feelings of intense tiredness are known as fatigue. Fatigue is a symptom that affects up to 80 percent of those with Parkinson’s at some point in their Parkinson’s journey.
Many MyParkinsonsTeam members talk about living with fatigue. One member shared, “I have been just unbelievably tired and unable to make myself have energy for anything. I didn’t know what was happening. I have raised three kids and ran a mini farm with lots of critters. Now taking a shower is exhausting.”
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Fatigue in Parkinson’s disease can be debilitating. It may feel like physical exhaustion that leaves you completely drained. Some people describe it as a level of tiredness that makes moving feel nearly impossible. It’s not just sleepiness — it’s a deep sense of weariness, with so little energy that even getting out of bed or off the couch can feel like too much.
“I am exhausted ALL the time! I sleep at least 10 hours at night,” shared one member. “After work, I crash in my chair and don’t move until it’s time for bed. I just want some energy back!”
Fatigue can also show up as mental exhaustion. Mental fatigue makes concentrating nearly impossible and makes it difficult to remember things or follow simple directions.
Fatigue may cause excessive daytime sleepiness, no matter how much rest you get. “Just tired, always tired, no matter how many hours I sleep or how much activity during the day,” said another member.
For some people with Parkinson’s disease, fatigue is constant. For others, it comes and goes. One member shared that they are not always tired or lethargic, but rather, “it hits me for a whole day. I fall asleep often when sitting after eating, while watching TV, during quiet times, and generally ‘doze’ when I used to not do it.”
Having mental and physical fatigue can be challenging. At times, they may even feel disabling. These symptoms can make it difficult to do things you love or to participate in social activities. As one member wrote, “I can’t keep my eyes open. I can’t walk, drive, or even feel up to socializing, even by phone. I just want quiet.”
“I’m always fatigued,” another member shared. “Before Parkinson’s disease, I worked full time as an infection control nurse. I walked 4 miles a week (1 mile a day) at lunchtime and did water aerobics on Saturdays. Now, I am too tired to do most anything.”
Parkinson’s symptoms are grouped into motor symptoms, which affect movement, and nonmotor symptoms, which do not. Fatigue is considered a nonmotor symptom of Parkinson’s.
When fatigue is caused directly by a disease itself, it is called primary fatigue. When fatigue is caused by other symptoms of the disease, it’s known as secondary fatigue. In Parkinson’s disease, research suggests that fatigue is mostly primary. Many people experience fatigue before motor symptoms begin.
Fatigue often happens alongside other conditions, such as depression, apathy, sleep disorders, and anxiety. Because these conditions can also cause fatigue, it can be hard for researchers to pinpoint the exact cause.
Current studies suggest that the pathophysiology (underlying causes) of primary fatigue in people with Parkinson’s is related to inflammation and dysfunction in specific parts of the brain. This inflammation and dysfunction particularly affects the basal ganglia — the part of the brain that helps control motor function and balance important neurotransmitters, like dopamine and serotonin. Some research also suggests that fatigue in Parkinson’s might be related to dysfunction in the frontal lobe.
In simple terms, Parkinson’s disease affects specific parts of the brain in ways that can directly cause fatigue.
Researchers are still working to better understand the specific causes of fatigue in Parkinson’s disease and develop more effective treatment options. In the meantime, there are steps you and your loved ones can take to help manage fatigue caused by Parkinson’s.
If you’ve lived with Parkinson’s-related fatigue for some time, you likely have a sense of when during the day you feel the most tired and when you have a bit more energy. If any of your medications cause sleepiness as a side effect, you probably know when you take them and when you feel tired as a result.
When possible, plan tasks and activities to happen during those times when you’re more energetic or “awake.” That way, you can leave space for rest when you’ll need it most.
Pace your work when possible, too. The workday can feel long, especially if you experience Parkinson’s-related fatigue. But taking short, regular breaks throughout the day can help you stay productive without burning yourself out early on.
Doctors at Johns Hopkins recommend avoiding alcohol if you experience Parkinson’s-related fatigue. Even though alcohol can make you feel sleepy while it’s in your system, it can negatively affect your sleep cycle and overall sleep quality. Although it might help you fall asleep at first, it can leave you feeling even more tired the next day.
Talk to your doctor about all the medicines you take. Sedating medications, such as antihistamines and sleep aids, can make you feel more tired during the day, so it’s important to review them with your doctor, even if they are available over the counter.
Certain Parkinson’s medications, like pramipexole dihydrochloride, are called dopamine agonists and act like dopamine. Dopamine agonists can cause daytime sleepiness or sleep episodes, and higher doses may increase fatigue.
As one member shared, “My neurologist recently increased my daily dose of medication to see if it would help with my left-handed tremor. It doesn’t seem to help, and the fatigue has worsened, especially in the afternoons.”
Medications can be very helpful in managing Parkinson’s symptoms, but if you’re taking them and still experiencing severe fatigue, a change in dose or medication may be helpful. Always talk to your healthcare provider before adjusting the dosage of a medication you’re taking.
On the other hand, some medications may help reduce fatigue. Some research suggests that the MAO-B inhibitor rasagiline may reduce fatigue. Again, talk to your doctor about medication options for managing fatigue.
Although fatigue can make exercise feel daunting or out of reach, engaging in physical activity can give you an energy boost that can last for much of the day. It might be best to avoid vigorous exercise late in the day, but starting your day off with some yoga or a brisk walk may help increase your energy levels. Choose activities you enjoy, such as dancing to your favorite songs or gardening. Working out with another person or in a group might help motivate you. Any activity that raises your heart rate and boosts endorphins will be beneficial.
MyParkinsonsTeam members have shared their experiences using exercise to combat fatigue. “I do two hours of exercise every day,” said one member. “There are many days when I don’t feel up to it, but most of the time I get through it and feel much better.”
Another member shared some words of motivation: “It may sound strange, but exercise will make the exhaustion go away. Not immediately, but slowly over the course of your exercise,” they said. “You’re not going to go full speed right off. You start slow. Anything to get you moving will help. Walking is best. Don’t walk alone. Until you’re feeling better, you’re going to need to have someone with you.”
Exercise is great, but it’s also OK for you to rest. As one member wrote, “Breaks are essential for your mental health and well-being.”
Don’t push yourself too hard, even on “good” days. This can leave you feeling even more energy-sapped afterward.
One member shared, “I have developed a ‘do as much as you can’ plan. Then I nap. The naps are usually quite short. I feel refreshed and get back to work.”
Napping during the day may also help you get a quick energy boost when you feel fatigued. If napping makes it hard for you to sleep at night, you may want to try napping earlier in the day and taking short naps. According to scientists, taking longer naps later in the afternoon can make you feel groggy and interfere with nighttime sleep. Experiment with the length and timing of your naps to see what works best for you.
Fatigue can also be a symptom of depression, which can happen alongside fatigue in people with Parkinson’s. Get screened for depression and anxiety, and talk to your doctor about possible treatments. Pharmaceutical approaches (like antidepressants) and therapy might help ease mental health issues that make your fatigue worse.
On MyParkinsonsTeam, people share their experiences with Parkinson’s disease, get advice, and find support from others who understand.
How do you manage Parkinson’s-related fatigue? Let others know in the comments below.
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I’m trying to get my old personality back without being irritated or aggravated or angry so easily. I used to always be a glass half full person. I’m determined to not let PD change my personality.
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