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- natural cell products or proteins, such as the interferons and interleukins , that are normally released by white
- blood cells , lymphocytes and macrophages in response to infection. These cytokines carry messages that
- regulate other elements of the immune and neuroendocrine systems. In high amounts, these cytokines can be
- toxic and lead to persistent fatigue.
- • Changes in the patterns of activity and rest can play significant roles in the prevention, cause and relief of
- fatigue. Unnecessary inactivity, prolonged bedrest and immobility contribute to loss of muscle strength and
- endurance. Muscle that is not exercised loses its ability to use oxygen, so more effort and more oxygen are
- required for the same amount of work performed by conditioned muscle. This is one of the reasons why
- aerobic endurance exercise—such as walking three or four times a week for 20 to 30 minutes—is often
- prescribed for patients and family members.
- • Lack of restful or adequate sleep at night can lead to fatigue and increased sleepiness and napping during the
- day. Sleep disturbances such as insomnia, multiple awakenings and early waking are common symptoms of
- depression.
- • Anxiety also can contribute to sleeplessness, increased energy demands and fatigue.
