Fatigue
Fatigue is a strong feeling of tiredness or exhaustion. It's common for people with Parkinson’s.
We look at Parkinson's symptoms that may contribute to fatigue and how to manage it.
Key points
- Tiredness and fatigue are different. Fatigue can happen at any time and it may not always improve with rest.
- Fatigue can be a general feeling that affects your whole body. Some people experience mental fatigue too.
- Parkinson’s itself can cause fatigue, or it can be linked to other Parkinson’s symptoms.
- Spreading out your activities, reducing stress, a balanced diet and regular physical activity can help you manage fatigue.
- If you’re working, you may be entitled to reasonable adjustments to help you manage your symptoms. This could include changing when or where you work, or taking regular breaks.
On this page
- What is fatigue?
- What causes fatigue in Parkinson’s?
- How does fatigue affect people with Parkinson’s?
- Fatigue and driving
- Parkinson’s symptoms that may add to fatigue
- Managing fatigue
- Treatments for fatigue
- Your rights if you have fatigue
- Our helpline and other useful contacts
- Get this information in other formats
What is fatigue?
Fatigue is an overwhelming and persistent feeling of tiredness.
If you’re fatigued, you may feel exhausted and not have much energy. Fatigue is more than a one-off feeling of tiredness that goes away after a good sleep.
Fatigue isn’t always easy to define because everyone feels tired sometimes. But fatigue is different from tiredness. It is more intense and can:
- last for a long time, such as much of the day, or affect you regularly
- be physical or mental
- make daily activities harder or sometimes impossible
- affect your mood.
Fatigue can be linked to other conditions, like diabetes. Visit the NHS webpage on tiredness and fatigue for more information.
You should discuss any feelings of physical or mental fatigue with your GP, specialist or Parkinson’s nurse. This will help your health professional work out the cause of your fatigue and what the best treatment could be.
What causes fatigue in Parkinson’s?
Researchers are still learning more about what causes fatigue in Parkinson’s.
Your doctor or Parkinson’s nurse will ask you about your symptoms, which can sometimes help identify a cause. Sometimes there is more than 1 cause for fatigue.
Fatigue can be a symptom of Parkinson’s itself. It can be linked to a number of factors, including:
- chemical changes and inflammation in the brain
- certain genes which make someone more likely to have fatigue.
Fatigue can also be a result of other symptoms of Parkinson’s.
Some Parkinson’s medications, including some dopamine agonists, can cause fatigue as a side effect.
How does fatigue affect people with Parkinson’s?
Up to 2 in 3 people with Parkinson’s experience fatigue at some point. You may notice fatigue before movement (motor) symptoms of Parkinson’s develop, or even before a Parkinson’s diagnosis.
The effects of fatigue in Parkinson’s vary greatly from person to person. They can change hour-to-hour, day-to-day or even build over several days.
You might have plenty of energy one day and then be too fatigued to do much the next day. This is sometimes called the boom-bust cycle.
If you’re working, you may feel especially tired after finishing work, or at certain times, such as after lunch. Once you start feeling fatigued, you might not want to do anything else.
Everyday tasks that you normally manage easily, such as household chores, can suddenly feel far more difficult.
Or, you may feel fatigue as a direct result of doing an activity. This is sometimes called performance fatigue.
Mental fatigue
As well as physical tiredness, you may feel mentally fatigued. This is sometimes called cognitive fatigue or "brain fog". It can be just as difficult to manage.
Fatigue can start or feel worse when you’re doing tasks that:
- are more complex
- need more concentration.
For example, some people find it hard to concentrate for a long time without a break. This could cause problems if you are still in work.
Fatigue and driving
Feeling fatigued or very tired can affect your driving. Speak to your GP, specialist or Parkinson’s nurse for advice if you’re worried about any aspect of Parkinson’s and driving.
If you have Parkinson’s, you must tell the Driver and Vehicle Licensing Agency (DVLA), or the Driver and Vehicle Agency (DVA) in Northern Ireland.
This is a legal requirement and should be done:
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as soon as you're diagnosed with Parkinson’s
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even if you think your symptoms will not affect your driving.
If you do not, you can be fined up to £1,000.
The DVLA or DVA will ask for more information about your condition and assess if it’s safe for you to continue driving.
Visit the GOV.UK page on Parkinson’s and driving here.
If you live in Northern Ireland, read how to tell the DVA about your medical condition here.
Parkinson’s symptoms that may add to fatigue
Sleep and night-time problems
Many people with Parkinson’s experience problems with sleep.
Tiredness from a lack of sleep is not the same as fatigue. However, getting a good night's sleep can give you more energy the next day and make fatigue easier to manage.
Your sleep may be interrupted by:
- stiffness (rigidity)
- times where your medication stops working ("off periods")
- acting out your dreams, sometimes caused by REM (rapid eye movement) sleep behaviour disorder, which some people with Parkinson's experience
- getting up to urinate (wee) at night.
Treating the causes of any sleep or night-time problems can help you feel better during the day.
Depression and mood changes
Parkinson’s can affect your mood and you may have feelings of depression.
Depression is more than simply feeling "down". It can involve a range of symptoms that last for weeks or months. Visit the NHS website page on depression here.
Depression can cause feelings of fatigue.
Having fatigue can also make feelings of depression more likely.
However, not everyone with fatigue feels depressed.
Depending on how severe your depression symptoms are, your doctor may recommend:
- self-help strategies, such as regular exercise
- talking therapies
- medication.
Apathy
Apathy is a lack of enthusiasm and curiosity for everyday activities. It’s a common Parkinson’s symptom. Apathy can feel like depression or fatigue, but it isn’t the same. Unlike depression, apathy doesn’t always come with feelings of sadness or hopelessness. You may simply lose interest in activities you once enjoyed. Or you may feel indifferent or unconcerned about things that used to matter to you.
People with Parkinson’s who have fatigue are more likely to develop feelings of apathy. This works both ways, as fatigue is more likely if you have apathy.
It’s important to recognise apathy so that it can be treated. Talk to your GP, Parkinson’s nurse or specialist if you think you may be experiencing apathy.
Managing fatigue
Once you know what’s causing your fatigue, and what can trigger it day to day, you and your health professional can make a plan to manage it.
If your fatigue is more severe, you may need to make changes to your lifestyle and daily routine. But there are plenty of things you can try to help you manage fatigue and keep doing the things that are important to you.
It may help to:
- spread out your activities. Fatigue can get worse if you do too little or try to do too much. Pacing yourself can help you avoid trying to fit everything into a short period of time. Some people avoid activity to stop themselves becoming fatigued, but this also seems to make fatigue worse over time. It may help to schedule a day at home after a day out visiting family and friends, for example. How you pace your activities depends on your symptoms and preferences. Your Parkinson’s nurse or an occupational therapist can help you plan your time
- manage stress. Stress can make fatigue worse, so finding ways to reduce this may help
- keep up good sleep habits. We have lots of tips to help you sleep well here.
It could help to think about managing fatigue in different situations.
If you’re working, try to:
- take regular breaks. Having a cup of tea, a chat with a colleague or even sitting back for a few moments with your eyes closed can help. Even if you can’t rearrange your daily tasks, regular breaks can help your concentration and help reduce fatigue building up
- keep up good posture. If you work at a desk, getting up regularly and walking a few steps can help adjust your posture. Give your body and mind a short rest by walking around for a minute if you can
- if you work, consider asking for reasonable adjustments. Reasonable adjustments are changes an employer must make to help employees with physical or mental health conditions to do their jobs
- make use of workplace support. Your workplace may, for example, have a wellbeing room, where you can have a short rest.
Read more about work and Parkinson’s.
At home and in daily life it may help to:
- rest when you need to. Try to do as much of your daily routine as you can by yourself. But take a rest or get help when you think you need it
- be kind to yourself. Fatigue can be frustrating. Some people can feel upset or even guilty if they can’t do things as easily as they used to because of their fatigue. Fatigue isn’t anyone’s fault, so try not to be too hard on yourself or blame yourself if you feel fatigued
- divide up household tasks, if you live with someone. So that you do the jobs you can manage more easily
- let people close to you know about your fatigue. Telling family and friends about your fatigue can help them understand your symptoms. For example, you may prefer to meet up with friends when you tend to have more energy, such as during the daytime instead of the evening
- remember that fatigue fluctuates (changes over the day, and day by day). Keep in mind that you will have days when you feel you have more energy than others
- plan ahead. Remember, fatigue won’t go away immediately or completely. But with time you should be able to recognise what you can do and when you might find things difficult. You can then plan your time around when your fatigue feels more manageable.
Exercise is good for people with Parkinson’s and can help you manage fatigue.
But fatigue can trigger a cycle in which you become less and less active. This can happen if your daily activities or physical activity make you feel tired. But the less you do, the weaker your muscles become, and the more fatigued you may feel over time.
This is why it’s important to try to work out what might be causing your fatigue and any other barriers to physical activity.
A physiotherapist can help you work out the right level and type of physical activity for you.
Exercise can:
- help you manage your fatigue
- boost your mood
- help you sleep well.
Some people don't find that exercise helps their fatigue. However, exercise is still important for your health generally, especially if you have Parkinson’s.
Any exercise you do can help. Start with some gentle exercises. This could be chair based exercises if you have problems with your balance. Or you may enjoy a brisk walk that gets your heart rate up.
Some people find that having an exercise partner can help them feel motivated to exercise. This may be especially helpful if you have feelings of apathy.
Watch the exercise videos on Parkinson’s UK’s YouTube channel. You can show these to your physiotherapist and discuss what might help.
Your GP, local council or sports centre may offer exercise referral schemes. Exercise referral schemes are short physical activity courses lasting 12 to 16 weeks. If they are available in your area, usually your GP can refer you, but some allow you to refer yourself. They are designed and supervised by health or trained exercise professionals to help people feel more confident about getting active. Speak to your doctor or Parkinson's nurse to see what might be available near you.
Some gyms offer free or reduced membership to people with Parkinson’s and sometimes a friend. Ask your Parkinson’s nurse if there are any options near you.
We’ve partnered with Everyone Active, who run gyms and leisure centres across England, to offer free membership to people with Parkinson’s and their carers. Find out how to get free Everyone Active gym membership here.
PureGym also offers a year’s free membership to people with Parkinson and a carer.
A physiotherapist can recommend exercises that are right for you.
Your GP, specialist or Parkinson’s nurse can make a referral for you to see a physiotherapist.
You can also pay for physiotherapy privately. Search for a private physiotherapist near you on The Chartered Society of Physiotherapy website.
Read more about physiotherapy and Parkinson’s and physical activity and exercise.
An occupational therapist (OT) can suggest ways to manage fatigue at work and at home. They can advise on adaptations and equipment that can help too.
As fatigue can affect your mind too, keeping your brain active is important.
Staying involved with your hobbies and interests could help. You could try taking up something new or learning a skill. Find local or online activities for people with Parkinson’s.
It’s also important to keep up your social connections. Seeing family and friends may help you to reduce stress and feel more able to manage your fatigue.
Eating a healthy, balanced diet can help you maintain your energy levels. Getting enough water is important too.
You could try:
- eating a small, healthy snack every 3 to 4 hours. Many people find that regular, healthy snacks help boost their energy. However, this will not work well for everyone, especially if you have diabetes
- having a lighter lunch. Avoiding large meals might help you feel less fatigued after lunch
- cutting back on alcohol and caffeine. These can make it harder to sleep well and may make you more tired the next day.
Make sure to discuss any significant changes in your diet with your GP, Parkinson’s nurse or a dietitian.
Vitamins
Not getting enough of certain vitamins, including vitamin D and B12, can lead to fatigue and other symptoms.
If you eat dairy, fish or meat, your diet should give the vitamin B12 that you need.
If you follow a vegan diet, you may not get enough vitamin B12 through your food alone.
Read what the NHS says about vitamin B12 here. You can also speak to your GP.
If you’re interested in taking vitamin D or vitamin B12 supplements, it’s a good idea to speak to your GP first. They may arrange a blood test to find out the levels of each vitamin in your body before you start taking supplements.
Vitamin D supplements
Clinical guidelines recommend that everyone with Parkinson’s takes a vitamin D supplement. A 10 microgram supplement daily is usually enough. This is because vitamin D is important for healthy bones and people with Parkinson’s are at a higher risk of bone problems. Read the NHS advice on vitamin D here. You can also speak to your GP.
Read more about diet and Parkinson’s and bone health and Parkinson’s.
Constipation can be caused by not getting enough fluids, fibre or enough variety in your diet. It can also be a symptom of Parkinson’s. It can make you feel like you have less energy, which can make fatigue worse.
Constipation can also affect how well your Parkinson’s medications work, which might worsen fatigue.
Speak to your GP or Parkinson’s nurse if you have constipation, as they can help you manage it.
Read more about looking after your bladder and bowels when you have Parkinson’s.
The Parkinson’s UK Tech Guide is a reliable source of information about products for people with Parkinson’s, including some which may help with fatigue.
Products in the guide are reviewed by people with Parkinson’s. These reviews should help you decide whether a product could improve your quality of life, before you buy it.
Finding out what helps your fatigue can be helpful.
Try keeping a fatigue diary. This can help you spot patterns and plan your day for when you have more energy.
Treatments for fatigue
Your health professional may recommend psychological therapies or medication to help you manage fatigue.
Psychological therapies
Psychological therapies, including Cognitive Behavioural Therapy (CBT) and Acceptance and Commitment Therapy (ACT), may help with depression, anxiety and sleep problems.
Getting psychological support for these Parkinson’s symptoms may help you manage your fatigue too.
Mental health professionals, like a psychologist or a counsellor, can work with you using these types of therapies.
Speak to your GP or Parkinson’s nurse about a referral.
Unfortunately, there can be long waiting lists to access NHS talking therapies. Your GP or Parkinson’s nurse will be able to explain what is available near you.
Parkinson’s medication
At the moment, there is no strong evidence to support using Parkinson’s medication to treat fatigue directly.
If your fatigue is related to your other Parkinson's symptoms, such as tremor, stiffness or involuntary movements, Parkinson’s medication might help by helping you to manage your motor symptoms.
The timing of your Parkinson’s medication can affect how much energy you have. This can mean that you feel energetic and capable of doing everyday jobs at certain times of the day, but not at other times.
Fatigue management programmes
Depending on where you live, your local healthcare services may offer you a short fatigue management course.
This could be online or in person. Ask your doctor or Parkinson’s nurse if there is a fatigue management programme in your area. Sometimes, instead of a course, individual sessions with a health professional may be available.
Courses or individual sessions may cover:
- what fatigue is
- skills to help you manage your fatigue
- tips to improve your sleep
- physical activity and healthy eating
- ways to help you manage your mental wellbeing and emotions.
Your rights if you have fatigue
Your rights at work: reasonable adjustments
Reasonable adjustments are changes to working arrangements made by employers to help an employee with a disability or health condition.
Employers are required by the Equality Act 2010 (England, Scotland and Wales) to make reasonable adjustments.
There is similar legislation in Northern Ireland. Visit the NI Direct website for more information.
Reasonable adjustments to help you manage fatigue could include:
- changing the hours you work to times where you tend to feel less fatigued
- making time for a short extra rest, either at a fixed time or when you feel you need it.
As Parkinson's symptoms can cause fatigue, it may help to look at changes that make managing your Parkinson's easier overall.
This could include your employer:
- offering training or making changes to your role. Such as where or when you work or some of your responsibilities
- providing or changing your equipment. Such as computer adaptations, large button telephones or adjustable chairs
- flexibility in how you communicate. If tremor or muscle cramps make typing difficult, you could ask to use voice-to-text software instead of writing emails. If you have trouble speaking loudly, or have memory problems, you could ask to present your work in writing, instead of giving presentations.
If you're a trade union member, your trade union representative can support you to request reasonable adjustments at work.
Acas, an independent public body, provides information on reasonable adjustments, including how to request them and how to prepare for a discussion with your employer. Visit the Acas website for more information.
Your right to benefits
If fatigue or other Parkinson’s symptoms impact your daily life, you may be entitled to some benefits.
Our helpline and other useful contacts
Call our helpline free on 0808 800 0303 for advice on fatigue or any aspect of living with Parkinson's.
- Acas (the Advisory, Conciliation and Arbitration Service) can advise employees about their rights at work and help employees and employers resolve work disputes.
- The Equality Advisory Support Service (EASS) can advise and assist people on discrimination issues under the Equality Act and advise on reasonable adjustments.
- Visit the NHS website for information, self-help tips and videos on tiredness and fatigue.
- The British Association for Counselling and Psychotherapy can help you find contact details for local counsellors and psychotherapists.
- The British Psychological Society can help you find a clinical, health or counselling psychologist in your area.
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The Chartered Society of Physiotherapy can help you find a private physiotherapist near you.
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The Royal College of Occupational Therapists has details of qualified occupational therapists in your area.
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Next update due 2029
If you'd like to find out more about how we put our information together, including references and the sources of evidence we use, please contact us at [email protected]
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