A lack of energy is one of the most challenging things to work up.  Getting objective data on sleep quality using sleep testing equipment can help discover things that a person may not be aware of.  A common scenario is a patient who has been trying hard with a new gym membership and is struggling to build stamina and push past the fatigue. A close analysis of that person’s sleep is warranted given how common sleep problems are as we have a complete lack of perception of issues at night.  Sometimes the bed partner is the first to recognize the issue. 

In addition to deconditioning from poor exercise and a compromised ability to get deep sleep, there are many physical disorders that contribute to fatigue, including neurologic disorders such as narcolepsy, respiratory disorders that cause elevated blood CO2 levels or low oxygen, cardiac conditions like congestive heart failure and valve dysfunction, endocrine disorders like low thyroid hormone, adrenal insufficiency or low testosterone, gastrointestinal pathologies like malabsorption, IBS and gluten insensitivity, infection disorders such as an occult smoldering viral or fungal infection and hematologic and oncological issues such as profound anemia or cancer that has yet to be detected. 

 

Making the diagnosis is a slow and systematic process that requires great care not to miss any essential tests or physical findings.  At Sleep Doc LA, we believe that physicians are necessary to help navigate the challenge of chronic fatigue given the complexities involved.  However, we ensure that we are looking for contributing mental health challenges, like depression, that may require simultaneous treatment.  Many patients are in a chronic state of despair with regards to true life difficulties resulting in low activity levels, poor diet and other unhealthy lifestyle choices.  “Anhedonia” or the chronic state of life without joy can lead to a downward spiral of mental and physical health that even the sufferer may not be fully aware is happening.  We understand that we are in a position to help breathe new energy into a patient's life and to encourage healthy behaviors.  It is an important role for us that we do not take lightly.