Fatigue and Sickle Cell Disease

Reviewed by: HU Medical Review Board | Last reviewed: January 2021

Fatigue is a common symptom experienced by children and adults with sickle cell disease (SCD). It is defined as a feeling of exhaustion and lack of energy. Fatigue has a negative impact on quality of life for many people with SCD.

Fatigue occurs because of anemia, or a low number of healthy red blood cells. But other factors, such as pain, stress, and depression, may also contribute to fatigue. Not much research has been done on treatments for fatigue in people with SCD. However, there are techniques to reduce the impact of anemia on your energy level.

What is fatigue?

Fatigue is a major symptom of many chronic illnesses. It is a condition of extreme tiredness and an inability to function due to a lack of energy. The exhaustion can be physical and mental, and can be acute or chronic.1,2

Fatigue is important to treat because it affects quality of life. It can lead to:1,3

  • Lower cognitive function
  • Social withdrawal
  • Modified daily activities
  • Lower psychological well-being
  • Increased healthcare use
  • Reduced work productivity
  • Loss of work and school days
  • A reliance on caregivers

Why does sickle cell disease cause fatigue?

Fatigue is an important symptom of SCD. Young people with SCD report being tired, having low energy, wanting to sleep, and being unable to perform many daily activities. They express fatigue-related concerns more often than pain-related concerns. But much less research is done on fatigue than on pain in SCD.1,4

People with SCD experience fatigue because of anemia. This happens when sickle cells die early and there are not enough healthy red blood cells to carry oxygen throughout the body.5

SCD also causes acute and chronic pain because of blocked blood flow. Adults with SCD who experience worse pain have lower energy levels. This is because pain crises can lead to poor sleep quality. People with SCD commonly experience stress, depression, and anxiety. These may also contribute to fatigue.1,6,7

We need more research to understand how anemia, pain, and depression are connected to fatigue in SCD. We also do not know how other personal factors like age, sex, socioeconomic status, treatments, and disease severity contribute to fatigue.1

How is fatigue treated?

Fatigue is hard to treat because many factors can contribute to feelings of exhaustion. Also, very little research has been done on treatments that reduce fatigue in people with SCD.3

Fatigue is usually treated by reducing the impact of anemia. These steps may include:8

  • Eating a balanced diet
  • Developing a healthy sleep routine
  • Planning your day to include rest periods
  • Drinking plenty of water.
  • Trying to do light exercise every day
  • Asking for help when you need it with childcare, shopping, chores, or driving
  • Avoiding injuries that might cause bleeding or bruising.
  • Making time for distracting or relaxing activities, such as meditation, yoga, and reading.

Treatments that reduce the frequency of pain crises, such as hydroxyurea, may be helpful if pain is disrupting your sleep. Severe anemia caused by an infection or enlarged spleen may be treated with blood transfusions.5

Addressing stress, depression, and anxiety may also help. Counseling, support groups, and stress management techniques may improve your mood and energy levels. Sometimes, medications for depression or anxiety may also help combat fatigue.

Talk to your doctor about the best way to treat fatigue for you. They may refer you to physical therapists, nutrition counselors, or other specialists. They can also discuss how certain medications may help or hurt your energy level.

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