Chronic Fatigue and Sleep Problems

Chronic fatigue and sleep problems are common after transplant. You may need to adjust your activities and lifestyle for awhile.

Printer-friendly version

When you return home, you will look forward to resuming your normal activities. However, chronic fatigue may make that difficult for a while.

Chronic fatigue after transplant is different than just feeling tired. You can't take care of it simply by taking a nap

There are things you can do, however, to minimize the impact of chronic fatigue on your daily activities.

Is There a Medical Cause for Your Fatigue after Transplant?

The first step is to identify and treat any underlying medical causes. These may include: 

  • anemia
  • dehydration
  • thyroid hormone deficiency
  • side effects of medication
  • infection
  • decreased physical activity
  • insufficient nutrients
  • heart problems
  • pain
  • stress
  • sleep disruption

If one of these issues is contributing to your fatigue, your doctor may be able to prescribe medication to resolve the problem.

Keep Active

Being inactive can lead to fatigue. Try to exercise daily, starting out slowly and increasing your activity a bit each day.

Walking is good exercise for almost everyone. If you want to begin a more rigorous exercise routine, talk with your doctor before you begin.

Plan Ahead

Plan your activities around the times in the day when you have the most energy.

Prioritize activities according to what is most important to you. You may not have the energy to do all the things you want to do during the day, so choose the one or two that are most important to you.

Watch a video demonstration of exercises that can help improve fatigue after transplant.

Getting Enough Sleep

Sleep problems are common among transplant survivors, as well as family caregivers, and can persist for years. Insufficient sleep over a long period of time can have serious health consequences including:

  • Heart disease
  • Diabetes
  • Obesity

Poor sleep can also contribute to:

  • Headaches
  • Daytime fatigue
  • Depression
  • Anxiety
  • Substance abuse
  • Attention, concentration and memory problems
  • Irritability

Doctors often prescribe sleep medication for this problem. However, you can also achieve a good night’s rest without medication using cognitive behavioral therapy designed specifically for insomnia (CBT-I). In fact, the American College of Physicians recommends that all adult patients receive cognitive-behavioral therapy for insomnia as the initial treatment, rather than medication.

What is Cognitive Behavioral Therapy for Insomnia (CBT-I)?

Cognitive behavioral therapy for insomnia is a form of treatment that helps patients understand their sleep and change the thoughts and behaviors that interfere with their poor sleep.

Over the course of about 6-8 sessions over a few months, a therapist who specializes in CBT-I helps you:

  • track and understand your current sleep behavior
  • identify behaviors that interfere with sleep
  • adopt habits that promote a good night’s rest
  • become aware of negative thoughts about sleep that worsen sleep problems

A sleep therapist can help you stop behaviors that interfere with sleep such as:

  • Inconsistent sleep/wake schedule
  • Using the bed for activities other than sleep
  • Taking extended naps during the day
  • Using electronic devices in the bedroom such as television, smart phones, and computers

Sleep-promoting habits that a therapist might help you develop include:

  • Establishing a regular sleep schedule. It’s especially important to wake up at the same time each day, including weekends.
  • Using your bed only for sleep and sex. This helps train your body to recognize your bed for these purposes only.
  • If you wake up during the night and can’t sleep, get out of bed rather than lay there trying hard to fall back asleep.
  • If worries about things you need to do the next day are keeping you awake, take 20 minutes prior to bedtime to list all the things you have to remember to do, and make a note when you will deal with these issues – tomorrow, next week or next month. If you wake up worrying about these things, remind yourself that you have a written plan.

You can find a trained sleep therapist near your through the Society for Behavioral Sleep Medicine at (click on provider search) or by phoning 859-312-8880. If none exists in your area, try these print and online resources:


  • Overcoming Insomnia, by Jack D. Edinger and Colleen E. Carney
  • The Insomnia Workbook, by Stephanie A. Silberman, PhD, DABSM
  • Say Good Night to Insomnia, by Gregg D. Jacobs, PhD


  • Sleepio™ at, free if you qualify for a research study

Watch a video about managing sleep problems after transplant.

(To view this page in Spanish click here)

Next Page: Sexual Health after Transplant

Updated August, 2023