Monday, July 25, 2016

Fatigue – what could rheumatology patients learn from pilots?

I’ve seen a study on pilots complaining about fatigue. Fatigue, however, is a daily problem in rheumatology. No matter if patients suffer from rheumatoid arthritis, psoriatic arthritis, ankylosing spondylitis, or fibromyalgia, fatigue is always a hot topic. Fatigue on its’ own may promote other health problems and effect work-life balance.

Pilots face irregular working schedules – patients face irregular disease activity.
Pilots may have long working hours and/or cross time zones – patients might suffer from longer hours of pain and missed sleep.
Pilots and patients may suffer from sleep disturbances and fatigue due to desynchronized biorhythm (daylight, when there should be darkness, high cortisol, when it should be low).

What can be extracted for patients’ benefits?

• expose yourself to daylight; avoid staying in the dark during daytime, when you feel depressed because of pain

• ask your rheumy to adjust your steroids (avoid second dosage or even evening dose of prednisone)

• work on sleep behaviour, develop a sleep ritual, and look for regularity (same time every evening) as well as timing of sleep (allow enough time)

• planned nutrition might help (no large meal before bedtime, a small amount of complex carbohydrates may help however)

• time your physical activity well before sleep time, but exercise regularly


Alwin van Drongelen and colleagues: “Development and evaluation of an intervention aiming to reduce fatigue in airline pilots: design of a randomised controlled trial”.
BMC Public Health
2013, 13:776 doi:10.1186/1471-2458-13-776

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