What Is APS-Associated Fatigue and What Can I Do to Improve It?

Improving APS-Associated Fatigue

APS Program Community Q&A Series

Yu (Ray) Zuo, MD, MSCS
Yu (Ray) Zuo, MD, MSCS

People with antiphospholipid syndrome often experience fatigue, which depending on the severity, can have a noticeable impact on their mental and physical well-being. In this edition of the APS Program Community Q&A Series, Dr. Yu (Ray) Zuo discusses fatigue associated with APS and steps you can take to help control it.

Persistent fatigue is a common and frustrating symptom experienced by many patients living with autoimmune diseases including APS. It is different than normal feelings of tiredness. Patients often describe it as an overwhelming, unpleasant, excessive whole-body tiredness, disproportionate or unrelated to physical activity [1]. This sustained feeling of exhaustion can often result in decreased mental and physical capacity.

People who have APS have an increased chance of having persistent fatigue. One recent study of 103 APS patients from the United Kingdom reported that persistent fatigue occurred in up to 62% of patients with APS [2]. Experiencing severe fatigue was also associated with lower mood, physical inactivity, poor sleep quality, and lower perceived social support among these surveyed APS patients.

Many factors can contribute to persistent fatigue. Heightened disease activity and uncontrolled inflammation from APS can cause fatigue. However, fatigue is not always related to APS, and it is important to think about all the possible causes. For example, non-APS medical conditions such as abnormal thyroid function, low blood cell counts, infection, sleep apnea, and depression, as well as certain medications such as muscle relaxants and pain medications can also cause abnormal persistent exhaustion. Thus, it is important to discuss other potential causes with your doctor and address them appropriately.

In addition to working with your doctor, here are some relatively simple strategies that may help you cope with your fatigue:

  • Make sleep your priority: If you aren't getting a good night's sleep, you will experience fatigue.
  • Be kind to yourself: Do not feel guilty about cutting down your to-do list. Take frequent breaks at work if needed. Experiencing fatigue does not mean you are lazy.
  • Adapt a healthy diet: What you eat can impact your body function, and the right diet can help with your fatigue. For example, a high protein and low-fat diet provides long-acting energy to your body.
  • Stay active: Exercise regularly even though you might not feel like it. Even low-intensity exercise can help strengthen your body and produce more energy.
  • Consider cognitive behavioral therapy: Chronic conditions are exhausting and can take a toll on your emotional health. Cognitive behavioral therapy has been shown to be effective at managing fatigue. 

In summary, persistent fatigue is not uncommon among APS patients, and it can take a toll on your physical and mental well-being. Recognize it early and talk to your doctor about how it affects your daily life. Work with your medical team to control APS-related inflammation and to make sure your fatigue isn’t caused by other conditions. Taking on a positive attitude, achieving a healthy lifestyle, listening to your body, and allowing yourself to have different expectations are all important parts of effectively managing APS-associated fatigue.


  1. Ahn GE, Ramsey-Goldman R. Fatigue in systemic lupus erythematosus. Int J Clin Rheumtol. 2012;7(2):217-27.
  2. Bearne LM, Bieles J, Georgopoulou S, Andrews J, Tully A, Stolarchuk-Prowting K, et al. Fatigue in adults with primary antiphospholipid syndrome: findings from a mixed-methods study. Lupus. 2020;29(8):924-33.

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