Poor sleep and chronic fatigue can complicate heart failure.
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Dealing with any chronic medical condition can be emotionally draining and physically taxing. Heart failure is no exception. Certain features of heart failure itself -- a condition that stems from the heart's inability to pump enough blood to meet the body's needs -- can actually contribute to a lack of energy and fatigue. In a September 2007 article in the "European Journal of Heart Failure," researchers report that people with heart failure often cite fatigue as one of their most debilitating symptoms. Fortunately, like other heart failure symptoms, fatigue can often be managed successfully.
A heart attack, viral infections, thyroid disease and substance abuse are potential heart failure causes. When the heart's ability to pump blood to the body is compromised, heart failure symptoms develop; these include difficulty breathing and swelling in the legs and feet. More subtle symptoms also arise, including low energy levels and fatigue. The authors of a January 2006 article in the journal "Heart" note that poor blood flow to the muscles may account for some degree of heart-failure-related fatigue. Additionally, diminished blood flow to the respiratory muscles makes the shortness of breath people with heart failure already experience -- from a buildup of fluid in the lungs -- more pronounced. As a result, even modest physical activity can lead to trouble breathing and a sensation of fatigue.
Heart failure can also result in shortness of breath and difficulty breathing during sleep. People with heart failure frequently experience a symptom called paroxysmal nocturnal dyspnea, or PND, which leads to intermittent trouble breathing at night. Not surprisingly, PND can be highly disruptive to normal sleep and contribute to fatigue. According to an April 2003 article in the journal "Circulation," many people with heart failure also have sleep disorders, including sleep apnea. In fact, sleep apnea -- a chronic condition that causes the airways to narrow during sleep -- is a risk factor for heart failure. People with sleep apnea often wake up still feeling tired after a full night of sleep.
Beta-blocker medications reduce strain on the heart and are a mainstay of heart failure treatment. These medications, such as atenolol (Tenormin) and metoprolol (Lopressor), have also been linked to fatigue and depressed mood. Depressed mood may further diminish energy levels and add to heart-failure-related fatigue. Nevertheless, a July 2002 review of 15 trials involving more than 35,000 study participants, published in the "Journal of the American Medical Association," found that side effects associated with beta blockers, including fatigue and depressed mood, may have been overstated by prior research.
Many people with heart failure and other chronic conditions feel that they simply have to learn to live with persistent fatigue. However, working closely with your medical team can help improve energy levels. Treatment of other medical conditions, including sleep apnea and depression, can reduce fatigue and enhance quality of life. An exercise plan approved by your doctor can also help offset heart-failure-related muscle weakness and fatigue. Even gentle stretching and other low-impact activities can boost energy and improve well-being.