Chronic Fatigue and Sleep Problems

Chronic fatigue and sleep problems are common after transplant and can interfere with daily activities.

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Chronic Fatigue

Chronic fatigue is common after transplant. It can interfere with mood, physical activity, job performance and sleep. It can linger for many years.

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

Is There a Medical Cause for Your Fatigue after Transplant?

Chronic fatigue is usually caused by a combination of factors.  The first step is to identify and treat any underlying medical causes. These may include: 

  • low blood counts
  • dehydration
  • thyroid hormone deficiency
  • side effects of medication
  • infection
  • insufficient nutrients
  • heart problems
  • lung problems
  • pain
  • stress
  • sleep disruption

It's important to let your doctor know if there are changes in your energy level. Many medical causes of fatigue can be treated with medication.

Energy Management Plan

You can create an energy budget and daily schedule to help reduce the effects of chronic fatigue on your daily life.

  • Decide which activities are most important to you.
  • Schedule priority activity for times of the day when you have the most energy.
  • Pace yourself. Break tasks into several, smaller steps.
  • Build short rest breaks into your day to restore your energy.

Exercise and Chronic Fatigue

Although it may be counter-intuitive, moderate physical activity is one of the best treatments for fatigue. Resting too much during the day can actually make fatigue worse.

A walking program can improve your tolerance for activity and improve your heart health. Walking is good exercise for almost everyone.

Use a smart watch or pedometer to measure your steps each day and gradually increase them over time.

If you want to begin a more rigorous exercise routine, talk with your doctor to confirm there are no medical issues that limit the type and amount of exercise you should do.


Difficulty Sleeping

Insomnia is the most common sleep problem after transplant.

Symptoms of insonia include:

  • difficulty falling asleep
  • problems staying asleep
  • waking up too early

Poor sleep can increase daytime fatigue affect mental health and contribute to cognitive problems such as attention, memory and learning.

Doctors can prescribe sleep medication for this problem.However, medication doesn't address the cause of the disease, only the symptoms.

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

The gold standard for treating insomnia is cognitive behavioral therapy for insomnia. CBT-I helps patients:

  • track and understand their 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

CBT-I is traditionally delivered by a licensed provider through one-on-one sessions. You can find a trained sleep therapist near your through the Society for Behavioral Sleep Medicine  If there is no CBT-I specialists in your area, you can 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™  free if you qualify for a research study
  • CBTi Coach
  • Insomnia Coach


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Updated June 2024