Types of fatigue in sarcoidosis patients.

OBJECTIVE Fatigue is frequently reported in sarcoidosis and appears to differ between patients. Three types of fatigue (Early Morning Fatigue, Intermittent Fatigue, and Afternoon Fatigue) are described in the literature for sarcoidosis, but have not been validated. Therefore, the aim of this study was to examine whether these types of fatigue can be identified in sarcoidosis. METHODS Outpatients (n=434) from Maastricht University Medical Centre participated in this study. Data were obtained from medical records. Patients also completed questionnaires regarding depressive symptoms, fatigue, quality of life, restless legs, dyspnea, depressive symptoms, anxiety, sleeping problems, symptoms indicative for small fiber neuropathy, and employment. RESULTS Latent Cluster Analysis revealed three clusters: 1) Mild Fatigue: patients with mild or no complaints of fatigue, 2) Intermittent Fatigue: patients with complaints of fatigue that varied during the day, and 3) All Day Fatigue: patients who felt tired the whole day. The three patient clusters differed regarding clinical, psychological, and demographical characteristics, with All Day Fatigue patients reporting the most complaints. CONCLUSION Intermittent fatigue was validated and two other types were found. Careful consideration to categorize patients with sarcoidosis in the three types of fatigue will help healthcare providers to understand the challenges these patients encounter. The usefulness of psychological counseling should be evaluated in future research in order to improve the wellbeing of the patients, especially for those with All Day Fatigue.