I don't sleep but feel run down. Maybe from lack of that but I always had a sleep problem. I think being in pain can cause fatigue. Everything takes that extra push. You have to work much harder to do little things. I also think it is a vicious cycle cause if I allow myself to rest too much it is hard for me to get going again. Before this issue I never noticed how far things are sometimes like for ex a bathroom in a store its in the way back. I also think some of the fatigue is mental for me maybe not for you. I hate using that word mental cause I do know for a fact that the pain is real not mental but also having to face this every day takes its toll and is draining.