28 Apr Why Do I Feel Tired All the Time?
“I’m tired all the time.”
“I have no energy.”
“I’m too tired to go to the gym.”
“I need a nap.”
Walking around in a fog seems like standard operating procedure nowadays. No matter how common it is, though, feeling exhausted, low energy, or sleepy all the time is not normal. It’s always a sign that something else is going on.
Tiredness, Sleepiness, Fatigue: What’s the Difference?
What does it mean when someone says, “I’m tired all the time?” Are they falling asleep at their desk? Do they need to take an afternoon nap in order to function in the evening? Perhaps they feel too wiped out to exercise or even get off the couch?
Colloquially, we use the word “tired” to describe the subjective experiences of both sleepiness and fatigue. “Sleepiness” is the familiar experience of needing sleep due to sleep debt. We all know what this feels like.
“Fatigue” can mean a few things. There is the tiredness you experience after overwork or exertion, which is usually temporary. Then there are the chronic feeling of exhaustion, low motivation, physical weakness, or inability to function.
From a medical perspective, sleepiness and fatigue are different. The boundaries are fuzzy, though, and there is a lack of agreement about the best ways to assess and differentiate the two.https://www.sleepfoundation.org/sleep-disorders/excessive-sleepiness‘>2
Obviously, the first question you should ask yourself is, “Am I getting at least seven hours of sleep per night?” Really, I’d say at least eight for most people. That doesn’t mean seven hours in bed. It takes a while to fall asleep, and most people wake up at least a couple times per night. An analysis of over 10 million users’ Fitbit data revealed that the average person is awake or restless for 25.5 minutes per night.https://pubmed.ncbi.nlm.nih.gov/8843535/‘>4 If you are maintaining one sleep schedule during the week and a completely different one on the weekends, stop. Make a concerted effort to maintain the same sleep and wake times for a few weeks and see if that helps.
Sleepiness is also a sign of circadian rhythm misalignment.https://pubmed.ncbi.nlm.nih.gov/25367475/‘>6
Consider keeping a sleep-wake diary or using a sleep tracker such as an Oura Ring or Fitbit. This can provide some initial insight into what’s going on.
Can Your Diet Cause You to Feel Tired All the Time?
Possibly. There are certainly links between certain vitamin and mineral deficiencies and fatigue. Low iron (even without anemia),https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5207540/‘>8 B vitamins (especially B12https://pubmed.ncbi.nlm.nih.gov/10767667/‘>10 Vitamin D in particular seems to be associated with sleep disorders.https://pubmed.ncbi.nlm.nih.gov/12741468/‘>12 and non-celiac gluten sensitivityhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC3280075/‘>14,https://pubmed.ncbi.nlm.nih.gov/16549311/‘>16 Of course, it’s entirely possible that sleepiness leads people to consume more caffeine, not the other way around. Experimental tests on the effects of caffeine consumption are mixed, suggesting individual differences in the degree to which caffeine affects sleep.https://www.sciencedirect.com/science/article/abs/pii/S1087079201901625‘>18 It’s counter-intuitive, because a lot of people like to have a glass of wine or other beverage to help them sleep. While it may help you fall asleep, alcohol has a tendency to disrupt sleep phases in a way that renders your sleep incomplete.
On the other hand, maybe it’s what you’re not drinking—enough water. Dehydration, perhaps even mild dehydration, can cause fatigue.https://pubmed.ncbi.nlm.nih.gov/26290294/‘>20 You don’t have to force yourself to drink a certain amount each day, but consider adding a glass of water or two, perhaps with a pinch of sea salt, if you’re feeling somewhat fatigued.
Lifestyle Factors That Affect Tiredness
Leading a sedentary, indoor lifestyle
Being sedentary is associated with experiencing greater fatigue.https://pubmed.ncbi.nlm.nih.gov/18277063/‘>22,https://pubmed.ncbi.nlm.nih.gov/27995604/‘>24 Exercise can also improve sleep.https://bjsm.bmj.com/content/32/2/107‘>26 I don’t think I need to tell you how I feel about chronic cardio, do I?
Taken as a whole, the evidence suggests that low-level aerobic activity is particularly effective for helping to relieve tiredness. If you’re feeling tired all the time, try going for a daily walk. Walking is by far my favorite low-intensity activity. Plus, you get the added bonus of sun exposure, weather permitting. Get that vitamin D boost! One study found that three-quarters of patients who complained of fatigue were deficient in vitamin Dhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC5207540/‘>28
Stress
Experiencing extreme and/or chronic stress can also lead to fatigue and sleep problems. Mindfulness Based Stress Reduction interventions have been shown in many studies to reduce symptoms of fatigue in individuals with a wide range of chronic health problems.https://pubmed.ncbi.nlm.nih.gov/26519614/‘>30,https://www.sciencedirect.com/science/article/abs/pii/S0093775401902076‘>32
These are just some of the many issues that are associated with otherwise unexplained sleepiness or fatigue. There are others, namely chronic fatigue syndrome and fibromyalgia, for which fatigue is a defining characteristic, not just a symptom.
When you talk to your doctor, try to be as specific as possible about what you are experiencing. Is it fatigue that manifests as physical exhaustion, weakness, or lack of desire or ability to do daily activities? Persistent sleepiness despite apparently good sleep habits? Make a note of frequency and patterns, such as if you experience fatigue more at certain times of day, after meals, or, if applicable, at specific times of your menstrual cycle. Track your sleep for a few nights at least. Your doctor will ask.
Tell your doctor about any other symptoms you are also experiencing, even if they seem unrelated. Your doctor might spot a pattern that leads to a diagnosis. Finally, make sure you tell your doctor about any medications you are taking, as fatigue might be a side effect.
Getting to the Root of Your Issues
As you see, there are lots of possible causes for tiredness. If your sleepiness or fatigue is significantly affecting your quality of life—you have trouble completing your daily tasks, your memory is impaired, your mood is affected or you feel depressed—a doctor’s visit is absolutely in order.
If you want to try to self-experiment at home first, start with the obvious and easy steps:
- Optimizing sleep hygiene
- Staying in bed for eight to nine hours every night at the same time
- Eliminating gluten if you haven’t already
- Removing caffeine in the afternoon
- Making sure you’re hydrated
- Avoiding long periods of being sedentary
- Getting outside and getting plenty of sunlight
- Taking steps to alleviate stress
You can also try tracking your food for a week using Cronometer to see if you are consistently low on any vitamins or minerals. Up your intake of foods rich in the vitamins or minerals you need. If you’re not already eating a serving of liver each week (for iron and other nutrients) and small, oily fish (for essential fatty acids) on the regular, do that. If you think you’re clinically deficient in one or more areas, get tested before supplementing willy nilly.
Is Inflammation the Key?
What do poor sleep, chronic illness, sedentary lifestyles, poor gut health, chronic stress, and nutrient-poor diets all have in common? Inflammation.
It’s perhaps no surprise, then, that some scientists believe that inflammation is a key feature in fatigue of various etiologies.