Fatigue is an unwelcome side effect of migraine that affects many sufferers. In fact, studies reveal that up to 84% of people with migraine are also battling this issue. In some people fatigue can actually trigger migraines, or it may be a warning of an imminent attack. The fatigue might not appear until after the pain goes away, or it could be present throughout the episode.

It’s also been found that fatigue can make some migraine symptoms worse, such as heightening the effects of vertigo. Experiencing vertigo during a migraine can also trigger feelings of fatigue. Separating the conditions is not easy because they are interlinked for many migraineurs. Fatigue can also cause depression, which is deeply linked to migraine.

What is Chronic Fatigue?

Patients suffering from fatigue typically experience a general sluggishness, a feeling of extreme weakness or tiredness. Both physical and mental activity can cause long periods of exhaustion. You might constantly want to sleep, or may have trouble coping with ordinary, daily tasks.

Chronic fatigue is categorized by intense feelings of tiredness, which have no apparent cause and aren't relieved by periods of rest.

Diagnosis of chronic fatigue also depends on criteria set by the Center for Disease Control and Prevention existing for at least six months before diagnosis, including:

• Inability to concentrate or difficulty remembering.
• Either physical or mental activity causes feelings of exhaustion.
• Muscle or joint pains without swelling or other visible indications.
• Headaches that are more severe, plus tenderness in the neck or axillary lymph nodes (located in the armpits).

Chronic fatigue can be disabling, severely limiting your ability to go about normal, daily life. If you find tiredness plays a part in your migraine pattern, make sure you record the levels in your migraine diary, including which activities produced exhausted feelings and whether rest or sleep reduced it. Your doctor will want to review these findings to determine your levels of fatigue and how best they can help.

In the meantime, here are strategies you can take to help yourself:

Coping Strategies to Ward off Migraine Fatigue

• Perform a self-assessment on how you feel before you get out of bed in the morning. Did you sleep well? Do you feel refreshed? Are you tired before your feet even hit the floor? Determine your energy levels and plan your day accordingly.
• Delegate tasks to family and learn to say ‘no’ to friends. Some tasks only you can do, but many can be taken over by family members. If you’re tired, avoid social gatherings and household chores. There will be other events, and the chores will still be there when you feel better.
• Keep lists of priorities. Lists jog your memory so you don’t forget important errands, and they are positive affirmations when you check items off and see evidence of progress. You can write things down on a note pad, or use reminders and calendar apps on your phone.
• Take regular breaks. When you’re busy this is difficult, but taking a few minutes to relax, breathe, do a short meditation or just close your eyes enables you to recharge a little. You'll tackle the next item on your list with a bit more energy.
• Eat the right foods. It’s important you don’t skimp on healthy meals, but hard to do when you’re too tired to cook. On days when you have more energy, try preparing a little extra and freezing portions for days when you’re tired. Teach older children how to cook for themselves so they can fend for themselves when you need to rest. Make sure you’re getting the right balance of proteins, vegetables and carbohydrates.
• Improve your sleep hygiene. Having a bedtime routine may help. Always go to bed and rise at the same times each day, even if you need to nap in the afternoon. Avoid caffeine drinks before bed, and indulge in restful activities instead of watching action movies on TV. Looking at device screens before trying to sleep is not recommended because the blue light they emit prevents the body producing the melatonin vital for sleep.
• Drink plenty of fluids. Waiting until you’re thirsty means you’ve gone too long between drinks and your body is dehydrated. Drink water often during the day to keep your body topped up with the liquid it needs for optimum health.

Researchers believe the fatigue that often accompanies migraine is not because of the toll pain takes on us. Rather, the evidence points to fatigue being part of migraine pathophysiology, which is defined as the functional bodily changes produced by the disease. Include fatigue symptoms in your migraine diary, and mention them to your health care providers. There may be help available that you’re not aware of.