What’s Behind Fatigue in EDS & HSD: More Than Just Feeling Tired
If you live with Ehlers-Danlos syndrome (EDS) or hypermobility spectrum disorder (HSD), you may know that fatigue isn’t just “being tired.”
It’s something deeper.
It’s exhaustion that wraps around your entire body like a dense fog. It can hit when you wake up, linger even when you’re doing nothing, and weigh down everything you try to do—whether it’s getting through your workday or simply making it out of bed.
Fatigue in EDS and HSD is real, and it’s multifactorial. Let’s talk about what may be contributing to it.
Cognitive Load: Living in Constant Vigilance
People with hypermobility often describe the experience of needing to consciously monitor every movement—walking, sitting, bending, turning, even sleeping. Why? Because one wrong move can mean pain, subluxation, or a new injury.
That constant mental effort takes a toll.
Monitoring posture
Avoiding painful movements
Navigating symptoms others can’t see
Planning life around flares or energy crashes
It’s like running background software 24/7, and eventually, your mental battery runs low.
Muscle Overcompensation
In EDS and HSD, connective tissue is too lax to provide proper structural support. As a result, your muscles may be forced to work overtime just to keep your body stable.
Even basic activities like standing, walking, or sitting upright can require much more energy than they do for someone without joint instability.
This muscle overuse can cause:
Fatigue after minimal exertion
Muscle cramping or spasms
Pain that increases with effort
Weakness that fluctuates throughout the day
Over time, this cycle can lead to physical burnout.
Chronic Pain
Living in pain is exhausting—period.
Even when you’re not actively focused on it, your nervous system is still processing and responding to pain signals. That persistent demand drains your body’s energy reserves and can also:
Disrupt your sleep
Increase muscle tension
Heighten stress and anxiety
Trigger mast cell activity or dysautonomia
Fatigue and pain feed into each other, creating a vicious loop that’s hard to break without targeted interventions.
Autonomic Dysfunction (Like POTS)
Many people with hEDS or HSD also live with dysautonomia—most commonly postural orthostatic tachycardia syndrome (POTS).
When the autonomic nervous system isn’t working properly:
Blood pools in the lower body when standing
The heart races to compensate
Oxygen delivery to the brain and muscles drops
Fatigue, dizziness, brain fog, and weakness may set in quickly
This is why people with dysautonomia often feel crushed by fatigue after standing, walking, or even showering.
Poor Sleep Quality
Even if you get 8+ hours of sleep, that doesn’t mean it’s restorative.
Common EDS- and HSD-related sleep disruptors include:
Pain and discomfort
Obstructive sleep apnea (OSA)
Mast cell activation syndrome (MCAS) flares at night
Autonomic arousals or temperature dysregulation
Restless legs syndrome or nighttime spasms
Rest is not always restful, especially when your body is constantly fighting for balance behind the scenes.
Emotional Burden & Social Misunderstanding
One of the most painful parts of chronic fatigue is how invisible it can be. Friends, coworkers, or even doctors may assume you’re lazy, unmotivated, uninterested, depressed, or “just tired”.
But this isn’t regular tired. It’s a deep, systemic, full-body exhaustion caused by a body that’s working harder than most people realize—every single day.
That misunderstanding and invalidation add to the emotional weight you carry, which can deepen both mental and physical fatigue.
Fatigue in connective tissue disorders is complex and very real. It’s often the backdrop to everything else you’re managing—and while it may not always be obvious to others, it affects your entire life. You deserve access to support that honors the full picture of your experience.
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Disclaimer: This blog post is for informational purposes only and shall not be construed as behavioral health or medical advice. It is not intended or implied to supplement or replace treatment, advice, and/or diagnosis from your own qualified healthcare provider.