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Pulmonary hypertension (PH) is a disease in which the pulmonary arteries (blood vessels) between the heart and the lungs become blocked by blood clots, narrowed, or even destroyed. This leads to high blood pressure and, if untreated, heart failure. According to the Pulmonary Hypertension Association, fatigue is one of the most common symptoms of pulmonary hypertension — along with chest pain, heart palpitations, and shortness of breath.

Everyone feels exhausted from time to time. But as those with PH know, fatigue goes beyond everyday tiredness. Fatigue can have a significant impact on a person’s ability to perform daily activities as well as their overall quality of life. However, there are ways you and your health care provider can work together to manage the symptom. Here is what you need to know about fatigue in PH, including what causes it and how it can be managed.

Causes of Fatigue in Pulmonary Hypertension

There are several reasons pulmonary hypertension may cause fatigue.

1. Reduced Oxygen and Blood Flow

PH causes the pulmonary arteries running between the heart and lungs to narrow, impeding blood flow. More specifically, in pulmonary hypertension, the right side of the heart struggles to pump blood to the lungs. This is where the blood picks up oxygen and is pumped to the rest of the body.

When the body struggles to get enough blood to the lungs, the heart works harder than it usually does. Combine this with the fact that the body is likely not getting enough oxygen, and you can understand how someone with PH might feel fatigued.

If you’re living with PH, your body expends a lot of extra energy on tasks that are essential to life, which can leave less energy for doing other things. On top of that, body systems (like the muscles, ligaments, and bones) cannot work as well when they do not have enough oxygen. The end result is fatigue.

2. Lack of Exercise

PH can also make it difficult to move around and do normal things, let alone exercise. A lack of exercise can mean that you feel additional fatigue during physical activity because your body tires more easily.

3. Sleep Problems

PH is associated with sleeping problems like insomnia and obstructive sleep apnea — a sleep disorder in which the muscles in the back of the throat relax, partially or completely blocking the airways. This repeatedly occurs throughout the night, disrupting a person’s sleep. If you have sleeping problems, you may struggle to get good sleep or to feel rested in the morning. This will only add to your sense of fatigue.

4. Other Health Conditions

PH often occurs alongside other medical conditions such as:

• Chronic obstructive pulmonary disease (often referred to as COPD)
• Scleroderma (a connective tissue disease)
• Liver disease (especially cirrhosis)
• Pulmonary fibrosis
• Sarcoidosis
• Congenital heart disease
• Emphysema

These conditions may contribute to or cause fatigue themselves.

How To Treat and Manage Fatigue With Pulmonary Hypertension

There is no cure for PH. However, there are many ways to treat PH. Treating the condition should help alleviate symptoms of fatigue, too. Talk to your health care provider to learn more about what might work for you.

1. Medications

Several medications can help with PH. These include:

• Blood vessel dilators (or vasodilators), like prostacyclin; treprostinil (sold as Orenitram, Remodulin, and Tyvaso); sildenafil; and tadalafil (Adcirca)
• Diuretics
• Endothelin receptor antagonists, like bosentan (Tracleer) and ambrisentan (Letairis)
• Blood thinners or anticoagulants

A pulmonary hypertension specialist will help you find the right combination of medications to manage your symptoms.

2. Oxygen Therapy

Many people diagnosed with PH find that using extra oxygen helps alleviate their fatigue. Some people use it all the time, and others use it only when they need it.

One member who uses oxygen said, “When I’m walking with oxygen … I stop and rest for a minute (to get my oxygen saturation rates up again), then I am good to go another 25 to 35 feet before I have to stop again.”

3. Pulmonary Rehabilitation

If you are eligible and your doctor thinks it would be helpful for you, pulmonary rehabilitation could give you the resources you need to manage your fatigue.

One member explained, “I joined a Healthy Living exercise program (similar to a pulmonary or cardiac rehab group). I go three times per week (1.5 hours) to exercise and work with several health care professionals. They are working with me to create a program tailored to help increase my exercise tolerance and decrease my fatigue.”

Although pulmonary rehabilitation will not make PH go away, it does help. One member put it this way: “Even a little bit makes a difference.”

4. Lifestyle Changes

Many doctors recommend lifestyle changes to help manage pulmonary hypertension. These include:

• Managing your diet and weight
• Quitting smoking
• Avoiding high altitudes (where oxygen levels are naturally lower)
• Getting enough sleep
• Keeping your activity levels as high as your body will allow
• Avoiding sitting in saunas, hot tubs, or even hot bathtubs or showers
• Seeing a doctor regularly
• Asking for help when you need it
• Getting all of the vaccines your health care provider recommends for you

These may seem simple, but they can help a lot.

As one member wrote, “Fatigue is dominant with this disease … Listen to your body and rest while fatigued. Little changes can add up to help you feel better."

You’re Not Alone Experiencing Fatigue With Pulmonary Hypertension

Many people diagnosed with PH experience fatigue. Some see it as a normal part of life, including one of our members who wrote, “I had an OK day today. Just fatigue and weakness.”

However, some people experience more extreme fatigue. One person explained, “I’ve had some OK days, but I got up this morning so tired and fatigued with even the slightest bit of exertion.”

Others find that the fatigue is pervasive and they struggle to find relief, like one member who shared, “I’m feeling tired and run-down. I take my meds and still experience little relief.”

Some find that fatigue is more challenging than their other symptoms: “I feel such fatigue when I try to walk. The fatigue is much more debilitating than the breathlessness.”

It’s easy for people to feel frustrated and down because their fatigue keeps them from doing things that they love. “It is so disheartening to become so fatigued after less than an hour of activity,” wrote one member. “I know — it’s the reality of my life now.”

Find Your Pulmonary Hypertension Team

By joining myPHteam, the social network for people with pulmonary hypertension, you can ask questions and share advice with more than 47,000 members who understand life with PH.

Join today to ask any of your pressing questions about the condition, share your story, or participate in ongoing conversations. Meet people from around the world who deal with pulmonary hypertension and build the support network you’ve been looking for.

Have you experienced fatigue with pulmonary hypertension? How have you managed it? Share your experience and tips in the comments below or by posting on myPHteam.