Olson, Karin, Zimka, Oksana, Stein, Eleanor · Qualitative health research · 2015 · DOI
This study asked 14 people with ME/CFS to describe their experience of fatigue in their own words. Participants identified three different types of tiredness: regular tiredness (before diagnosis), fatigue (during daily activities), and exhaustion (after overexertion). The most helpful strategies people used were pacing activities and taking extended rest periods to manage their symptoms and prevent crashes.
Understanding how ME/CFS patients experience and describe different types of fatigue can help healthcare providers recognize symptom escalation patterns and work with patients to prevent post-exertional malaise. This patient-centered approach validates the distinct experiences people with ME/CFS report and provides evidence that pacing and rest strategies are central to symptom management.
This study does not prove that pacing and rest are universally effective for all ME/CFS patients or quantify how much symptom improvement they produce. It does not establish the biological mechanisms underlying the three fatigue domains, nor does it demonstrate causation—only that patients associate certain strategies with better adaptation. The small sample size limits generalizability.
About the PEM badge: “PEM required” means post-exertional malaise was an explicit required diagnostic criterion for participant inclusion in this study — not that PEM was studied, observed, or discussed. Studies using criteria that do not require PEM (e.g. Fukuda, Oxford) are tagged “PEM not required”. How the atlas works →
The first block is for the primary paper and is the citation you should use in research work. The atlas-snapshot line only applies if you are specifically referring to this atlas’s reading of the paper on the date shown.
Primary citation
Olson, Karin, Zimka, Oksana, & Stein, Eleanor (2015). The Nature of Fatigue in Chronic Fatigue Syndrome.. Qualitative health research. https://doi.org/10.1177/1049732315573954
BibTeX
@article{mecfsatlas-olson-2015-nature-fatigue,
author = {Olson, Karin and Zimka, Oksana and Stein, Eleanor},
title = {The Nature of Fatigue in Chronic Fatigue Syndrome.},
journal = {Qualitative health research},
year = {2015},
doi = {10.1177/1049732315573954},
note = {PubMed: 25721719},
url = {https://www.mecfsatlas.com/evidence/olson-2015-nature-fatigue},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-30. https://www.mecfsatlas.com/evidence/olson-2015-nature-fatigue
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