The Relationship Between Fatigue and Headaches

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Fatigue is a common symptom in many diseases such as fibromyalgia, chronic fatigue syndrome, lupus, multiple sclerosis, HIV, depression, thyroid disease, and sleep apnea.

It's also common for people who get frequent headaches. As researchers have looked into the connection between fatigue and headaches, they've uncovered a definite relationship.

Man sleeping on the keyboard of his laptop
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One study found fatigue in 70% of people with headaches, and another study found fatigue in 84% of those with chronic migraine.

People with chronic fatigue syndrome, a medical condition characterized by fatigue lasting at least six months plus flu-like symptoms and cognitive dysfunction, also have a higher prevalence of migraine, with and without aura.

What Is Fatigue?

Fatigue is difficult to define, even within the medical profession.

  • Fatigue can be physical, meaning you have difficulty starting or maintaining activity.
  • Fatigue can be mental, meaning you have trouble with concentration, memory, and/or emotional stability.

Many people use terms to describe fatigue interchangeably, including sleepiness, muscle weakness, loss of strength, lack of energy, and loss of interest.

Complicating the problem, even medical researchers don't really know what actually causes fatigue, and that makes it challenging to treat.

When Fatigue is Chronic

Fatigue is considered chronic when it lasts for more than six months. (That's chronic fatigue as a symptom, not the disease called chronic fatigue syndrome.)

Who Gets Fatigue?

Fatigue is one of the most common complaints doctors hear. Everyone is likely to experience some level of fatigue at some point in their lives.

About two-thirds of people who complain of chronic fatigue have an underlying medical condition (like headaches and migraines) or psychiatric condition that's causing it. (Less than 10% of those people have chronic fatigue syndrome.)

The other one-third of people may have lifestyle causes of fatigue, which can include too little sleep, too much stress, nutritional deficiencies, or low activity levels.

How Fatigue Is Evaluated

If you experience a lot of fatigue, it's important to see your doctor so they can determine the source of it. For instance, is your fatigue related to your headache disorder? Another medical or psychiatric condition? Or "idiopathic," meaning no known cause?

Your doctor will ask you questions to better understand what "fatigue" means to you, including:

  • How would you describe your fatigue?
  • When did your fatigue start?
  • With the treatment of your headaches, is your fatigue improving?
  • How long does your fatigue last? Does it occur daily?
  • What makes your fatigue better or worse?
  • How does your fatigue affect your job or your interpersonal relationships?

Your doctor will also inquire about sleep hygiene and any medications or supplements you are taking, as they could be causing or exacerbating your fatigue.

To rule out an underlying medical cause for your fatigue, like cancer or an autoimmune disease, your doctor will perform a thorough physical examination and order laboratory studies.

Finally, to examine the potential role of psychiatric illness in your fatigue, your doctor will screen you for disorders like depression, anxiety, and substance abuse.

Treatment

If fatigue is secondary to a psychiatric or medical condition such as a headache, your doctor will focus on treating that underlying illness. Even with treatment, though, fatigue can still persist. Some therapies may help you minimize it, including:

  • Cognitive-behavioral therapy (CBT): CBT involves multiple sessions designed to reorient your beliefs surrounding you fatigue, alter behaviors that'll help you gain control over your fatigue, and help you achieve various physical and personal health goals.
  • Graded exercise therapy (GET): GET involves engaging in physical activity slowly and increasing the level of activity gradually over time. Avoiding extremes and stopping before fatigue sets in is critical.

Other treatment options include:

  • Antidepressants
  • Referral to support groups
  • Counseling on sleep hygiene (e.g., avoiding over-sleeping)

A Word From Verywell

Fatigue can be a debilitating symptom, either on its own or as a result of another underlying disease process, including headaches and migraines.

Try not to be discouraged by it. Speak with your doctor, seek out resources, and stay proactive in your health care.

You may not be able to completely eliminate fatigue from your life, but you can strive to minimize it and gain control.

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Article Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Diagnosis of ME/CFS. Centers for Disease Control and Prevention. July 2018.

  2. Larun L, Brurberg KG, Odgaard-jensen J, Price JR. Exercise therapy for chronic fatigue syndrome. Cochrane Database Syst Rev. 2019;10:CD003200.  doi:10.1002/14651858.CD003200.pub8

  3. Find a Support Group. American Myalgic Encephalomyelitis and Chronic Fatigue Syndrome Society.

Additional Reading
  • Fosnocht KM & Ende J. Approach to the adult patient with fatigue.I n: UpToDate, Basow DS (Ed), UpToDate, Waltham, MA, 2014.
  • Peres MF, Zukerman E, Young WB, Silberstein SD. Fatigue in chronic migraine patients. Cephalalgia. 2002 Nov;22(9):720-4.
  • Ravindran MK, Zheng Y, Timbol C, Merck SJ, Baraniuk JN.Migraine headaches in chronic fatigue syndrome (CFS): comparison of two prospective cross-sectional studies.BMC Neurol. 2011 Mar 5;11:30.
  • Solomon S, Lipton RB, Newman LC. Clinical features of chronic daily headache. Headache 1992; 32:325–9.
  • Spierings EL, van Hoof MJ. Fatigue and sleep in chronic headache sufferers: an age- and sex- controlled questionnaire study. Headache. 1997; 37:549–52.