Living with Sjögren's can be challenging, especially when fatigue becomes a persistent part of your life. In this comprehensive guide, we'll explore seven strategies to help you combat fatigue and regain control over your life. From small lifestyle adjustments to those requiring a more comprehensive approach, these expert tips can provide much-needed relief.
First - How does the body heal from fatigue?
When it comes to addressing fatigue and tiredness in Sjögren's, most people think of quick fix solutions or remedies, such as getting more sleep or taking a medication. However, addressing fatigue requires looking at the whole body and addressing the root causes of these issues. Because in addition to the Sjögren's autoimmune processes causing fatigue, there are often other factors that can be contributing to it as well.
That's why, in order to address fatigue effectively, it is not enough to take one single action: Several actions need to be combined to improve whole body health, which will improve fatigue. Ideally, you should work with a professional who can help you discern what the root causes of your fatigue are, and provide you a personalised diet and lifestyle protocol to address these issues methodically (this is something that Beyond Sjögren's can help you with - see here for more info).
Nevertheless, there is much you can do on your own in the meantime to improve whole body health and improving your Sjogren's fatigue (and other symptoms too).
7 tips and strategies to help you improve fatigue with Sjögren's:
1. Try and get at least 8 hours of sleep every day.
Adequate rest and quality sleep are vital for managing fatigue and improving Sjögren’s symptoms. A 2016 study by Priori et al. found that poor sleep quality was associated with reduced quality of life for those with Sjögren's - so taking some time to figure out how to get a good 8 hours of good quality sleep per night is a worthwhile endeavour. If you have broken or poor quality sleep, then spending 10 or more hours resting a day might be crucial for you.
You can improve your sleep routine and quality by:
Going to bed at the same time each night
Dimming lights 1-2 hours before bed
Avoiding screens and bright light 1 hour before bed
Cooling down the bedroom temperature (e.g. by opening windows) before going to sleep
Sleeping in a pitch black room (even small amounts of light can disrupt sleep)
Avoiding stimulating activities before bed, such as watching a TV show or using social media (listen to an uplifting audiobook or podcast instead)
Practising deep breathing exercises and/or positive affirmations before falling asleep
2. Optimise your diet:
A well-balanced, anti-inflammatory diet is one of the first steps to improving Sjögren’s and related fatigue. Incorporating anti-inflammatory foods such as fresh or frozen fruits, vegetables, gluten-free whole grains, lean proteins and legumes, healthy fats and herbs and spices, while staying away from highly processed foods is a must.
However there are many nuances and caveats to this that can greatly differ from person to person, so if you have already tried to apply this without result, then working with a qualified nutrition professional, specialised in Sjögren's, is a must to figure out the best dietary strategy for your body.
3. Drink at least 2 litres of water a day
Dehydration can exacerbate Sjögren's symptoms, as well as contribute to fatigue, and some Sjogren's medications can cause dehydration as well. Drinking at least 2 litres of fluids a day in the form of filtered water or non-diuretic herbal teas can really help to avoid additional fatigue caused by dehydration.
Stay away from excess caffeine, as it can be dehydrating, can accelerate the loss of nutrients from the body, can stimulate the release of cortisol from the adrenal glands, and can ultimately worsen existing fatigue.
4. Manage Stress Levels:
The body uses up more nutrients, such as B vitamins and vitamin C for example, during times of stress. And these nutrients are essential for immunity, energy and nervous system function (among others).
Being in a chronic state of stress is like having the oven on at maximum power, burning through all your reserves in a short time. That’s why addressing stress should be a top priority when looking to reduce fatigue and improve your Sjögren’s symptoms.
Start by making a list of activities that help you truly relax and get your mind off of worries. If no such activities come to mind, this is a good time to explore what they could be. Knitting, painting, free-form journaling, yoga/stretching, pilates, meditation or spending time with someone who uplifts you are just some examples to get you started.
5. Learn to pace yourself:
Learning to pace yourself is crucial when dealing with fatigue and chronic illness. It means learning to listen to your body so you can know what your energy levels are and organising your tasks around these levels, setting appropriate limits, and not over-exerting yourself.
Some great tips here are to learn about the 'spoon theory' and to become aware of how much energy ('spoons') each task consumes for you, planning your day and prioritising your tasks around this. Another tip is to ask for accommodations regularly - such as asking for a chair at an event, or asking for regular breaks. Â Embrace the concept of 'slow and steady' (wins the race) and listen to your body's cues to avoid overexertion.
6. Practise gentle movement:
Regular gentle movement (such as walking) supports blood flow through the body and helps maintain muscle mass. A recent study (Miyamoto et al., 2019) found that gentle walking three times a week improved fatigue and quality of life in women suffering with Sjögren's. Therefore, we suggest engaging in some form of gentle movement daily, whether it is walking or gentle seated stretches, in order to reduce fatigue, depending on your ability.
We understand many people with Sjögren’s experience pain when exercising (or after exercising), and fatigue post-exercising. What’s important here is to find and incorporate a level and form of movement which doesn't cause these issues, yet can still have a positive impact.
7. Learn to set boundaries:
Protecting your limited energy is a must in order to make sure your energy levels don’t end up depleted. Learning what your needs and limits are is a first step. You then need to be able to communicate these needs when necessary.
Since Sjögren’s is an invisible illness most people will unfortunately not know or understand just how depleting it can be - and may unintentionally push you beyond your current limits. This makes it even more necessary to sensitively set boundaries, prioritise self-care and adequate rest.
Need additional help?
We hope you find these tips helpful, however the reality is that Sjögren’s isn’t a condition that is likely to improve significantly with self-treatment alone. It requires a targeted and comprehensive root-cause approach developed with experienced professionals who know what to look for, how to look for it, and how to best address the specific issues found.
Fatigue can significantly impact the quality of life for individuals with Sjögren's, but it doesn't have to define it. By implementing these evidence-based strategies—prioritising rest, optimising nutrition, managing stress, pacing yourself, setting boundaries, practising gentle movement and exploring treatment options — you can take meaningful steps towards combating fatigue and regaining control over your life.
And if you feel that you would benefit from personalised guidance to effectively identify and address your root causes, we encourage you to book a free consultation to discuss your situation and the best next steps you can take to start feeling better.
References:
Mæland, E., Miyamoto, S. T., Hammenfors, D., Valim, V., & Jonsson, M. V. (2021). Understanding Fatigue in Sjögren's Syndrome: Outcome Measures, Biomarkers and Possible Interventions. Frontiers in immunology, 12, 703079. https://doi.org/10.3389/fimmu.2021.703079
Miyamoto, S. T., Valim, V., Carletti, L., Ng, W. F., Perez, A. J., Lendrem, D. W., Trennel, M., Giovelli, R. A., Dias, L. H., Serrano, É. V., Subtil, A. M., Abreu, V. C., & Natour, J. (2019). Supervised walking improves cardiorespiratory fitness, exercise tolerance, and fatigue in women with primary Sjögren's syndrome: a randomized-controlled trial. Rheumatology international, 39(2), 227–238. https://doi.org/10.1007/s00296-018-4213-z
Priori, R., Minniti, A., Antonazzo, B., Fusconi, M., Valesini, G., & Curcio, G. (2016). Sleep quality in patients with primary Sjögren's syndrome. Clinical and experimental rheumatology, 34(3), 373–379.