Introduction:
Despite being a significant symptom of COPD (chronic obstructive pulmonary disease), fatigue is frequently disregarded in clinical practice and research. Developing efficient interventions to manage mild-to-severe fatigue in COPD patients needs to be improved by its understudied and, thus, contested etiology. Furthermore, it is still unknown whether and how much lung function impairment contributes to fatigue.
Previous studies on the relationship between fatigue and COPD severity came to conflicting conclusions. The importance of fatigue as a research topic is determined by input from specialists in respiratory research and care and patients with chronic lung disease. The development of pharmaceutical and nonpharmacological interventions for this symptom will be guided by improved knowledge about the onset of fatigue and its underlying causes in COPD patients.
What Are the Differences Between Normal, Mild, and Severe Fatigue?
Patients with severe fatigue had a worse disease-specific health status than subjects with normal or mild fatigue, as determined by the CAT. The groups were similar in terms of pack years, marital status, the number of patients who used oxygen therapy, self-reported comorbidities, education level, employment status, and BMI (body mass index). Patients with an underweight or obese BMI and those with an overweight or normal BMI all reported more severe fatigue.
How Does Fatigue Affect Patients With Pulmonary Disease?
Fatigue is a common concern in today's society. It is defined as the subjective feeling of tiredness or exhaustion. It is a significant and prolonged symptom of several chronic diseases, including COPD. After dyspnea, fatigue is regarded as the second most major symptom of COPD, ultimately affecting patients' functional performance and quality of life (QoL). Mild-to-severe fatigue affects 47 percent to 72 percent of COPD patients.
The characteristics of COPD patients are divided according to the level of fatigue. The most prominent factor was that patients with severe fatigue had more dyspnea (MRC grade 2) than individuals who had normal and mild fatigue (normal fatigue: 28 percent; mild fatigue: 49 percent; severe fatigue: 65 percent; p 0.001; In addition, patients with severe fatigue were slightly younger, had worse lung function, smoked more frequently, took more prescription drugs, and had more exacerbations in the previous 12 months.
Fatigue, or the subjective sensation of tiredness or exhaustion, is the second most common and distressing symptom in patients with chronic obstructive pulmonary disease patients after dyspnea (COPD). It impacts the patient's standard of living and potential for performing daily activities. Around 50 percent of patients with stable, moderate-to-severe COPD report mild-to-severe fatigue, which is noticeably higher than that of elderly, non-COPD subjects. Nevertheless, fatigue frequently goes undiagnosed, and as a result, it remains untreated despite its high prevalence and significant detrimental effects on health. This may be because fatigue-related questions must be more represented in widely used health status assessment tools.
Furthermore, few studies have focused on symptom fatigue, so little is known about the causes and maintenance of mild to severe fatigue in COPD patients. As a result, there aren't any specific COPD-related fatigue reduction interventions. It is anticipated that a number of precipitating factors contribute to the development of COPD-related fatigue. Given that COPD patients experience more fatigue than elderly control subjects, it has been hypothesized that COPD-specific characteristics are linked to fatigue. Evidence, however, indicates that fatigue is unrelated to the extent of airflow restriction. This suggests that mild to severe fatigue in COPD patients may not be primarily caused by the degree of airflow limitation. A COPD exacerbation, on the other hand, causes mild to severe fatigue. It is still unclear how much an exacerbation-related hospitalization will affect fatigue.
Along with precipitating factors, a number of physical, systemic, psychological, and behavioral factors are thought to contribute to mild to severe fatigue in COPD patients. Studies generally find significant, weak, or moderate links between fatigue and factors like health status, exercise capacity, physical activity, functional limitations, sleep quality, anxiety or depressive symptoms, and mood status. Additionally, studies show a link between systemic inflammation and COPD. However, more investigation is necessary to determine whether and how low-grade systemic inflammation is connected to fatigue.
Therefore, fatigue in COPD is a complicated symptom brought on by a mix of initiating and sustaining factors. The aforementioned factors have yet to be thoroughly evaluated in a single study with COPD patients up to this point. Additionally, it is unknown what role sleep apnea, comorbidities, medication, and exacerbation-related hospitalizations play.
What Is the Prevalence of Fatigue in Pulmonary Disease?
One-fourth of COPD patients reported mild fatigue, while half reported severe fatigue. In contrast, only 10 percent of participants with COPD reported severe fatigue, while 17 percent reported mild fatigue. These findings show that the elderly without COPD are significantly less likely to experience severe fatigue than patients with COPD (p 0.001).
As a result, the prevalence highlights the clinical importance of evaluating fatigue in COPD patients. Nonetheless, a better understanding of the factors that cause or perpetuate fatigue in COPD patients is required to develop fatigue-reducing or coping interventions for this important but often overlooked symptom.
How Is It Treated?
The symptoms of COPD, including fatigue, can be decreased with treatment, but there is currently no known cure. Managing breathlessness and facilitating easier breathing may reduce fatigue. To make breathing more accessible, a doctor may prescribe certain drugs, such as bronchodilator inhalers, which widen or expand the airways. Oxygen therapy can relieve steroid inhalers, which decreases lung inflammation and shortness of breath in those with low oxygen levels.
How to Cope With COPD Fatigue?
People with COPD can enhance their energy levels and manage their fatigue by making the following lifestyle changes:
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Practicing breathing techniques.
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Maintaining a healthy diet.
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Managing activity levels.
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Getting regular exercise.
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Treating other conditions.
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Adhering to healthy sleeping practices.
Conclusion:
In contrast to non-COPD control subjects, patients with COPD experience severe fatigue more frequently, and it is indirectly associated with the severity of airflow restriction. Furthermore, looking for the origins of fatigue in COPD is no longer required in the context of the disease's severity, clinical features, or demographics. Future studies must focus on the impact of biological, psychological, behavioral, and systemic factors that may contribute to or maintain fatigue in COPD patients.
