It’s perfectly normal to feel groggy upon waking. It’s simply a phenomenon known as sleep inertia that requires you some time for your energy to kick in and our body and brain to feel awake. 'Hardly anyone feels fantastic when they first wake up,' says Scott Kutscher, M.D., board-certified neurologist and associate professor of sleep medicine at Stanford University. However, people typically perk up over the next 30 to 60 minutes, he says.
So, if you’re constantly tired several hours after leaving your bed, you might have a problem.
How to know if feeling tired all the time is a problem
We all have days – or even weeks – where we can’t seem to perk up. Blame it on an unusually heavy workload, a jump in running mileage, travel, or any number of other factors that can make the day drag.
Unfortunately, figuring out when tiredness is a problem can be tricky. 'Tiredness is a subjective experience, so it’s up to each person to feel for themselves when tiredness is interfering with their life,' Kutscher says.
If you notice that you’re more tired than normal, look at your diet and lifestyle habits. 'Diet is very important, and sometimes forgotten as the reason why people may feel tired all the time,' says Eric Ascher, D.O., a family medicine physician at Lenox Hill Hospital in New York City. 'Sometimes, adjusting the diet to focus less on sugar and processed foods will improve fatigue.'
Staying well-hydrated throughout the day and prioritising good sleep hygiene may help, too.
If you don’t feel perkier after two weeks of making lifestyle changes, Ascher suggests making an appointment to see your GP. He or she will likely run blood tests to check for nutrient and hormone deficiencies, and screen for health conditions that cause fatigue, Ascher says. If it turns out that you do have a health issue, your doctor will be able to refer you to a specialist for treatment.
6 reasons you might be tired all the time
While it is normal to feel tired, sometimes it can be something more serious. In fact, fatigue is a key symptom of the following health conditions.
1. Sleep Apnea
Sleep apnea is a potentially serious sleep disorder in which your breathing repeatedly starts and stops while you sleep. It’s also incredibly common, Kutscher says. In fact, an estimated 26% of adults between the ages of 30 and 70 have sleep apnea, per the American Academy of Sleep Medicine.
Sleep apnea can happen if the throat muscles relax (known as obstructive sleep apnea), if the brain doesn’t send proper signals to the muscles that control breathing (central sleep apnea), or a combination of the two (complex sleep apnea syndrome), per the Mayo Clinic. In any case, the result is broken sleep.
'Our bodies don’t like interrupted sleep, so someone whose sleep is very interrupted is going to go through their day feeling as though they had poor sleep the night before,' Ascher says.
2. Autoimmune Disease
Autoimmune diseases like lupus, rheumatoid arthritis, and type 1 diabetes occur when your immune system mistakenly attacks the healthy cells of your organs and tissues. While symptoms vary depending on the disease, fatigue appears in all of them. In fact, fatigue is often the most debilitating symptom for people with autoimmune disease, notes Harvard Health.
'When someone has an autoimmune disease, their body is in an inflammatory state, and that puts a lot of stress on the body,' Ascher explains. That’s why you might feel tired all the time.
3. Iron-Deficiency Anemia
According to the National Heart, Lung, and Blood Institute (NHLBI), iron-deficiency anemia is a condition that develops if you don’t have enough of the mineral iron in your body. Iron is part of red blood cells, a protein that carries oxygen throughout your body and helps your muscles store and use oxygen. Without enough iron, your blood can’t deliver enough oxygen to power your body, leading to tiredness and fatigue, the NHLBI explains.
Certain conditions can make it hard for your body to absorb iron, including celiac disease, ulcerative colitis, Crohn’s disease, and kidney disease. If you have one of these conditions, you may develop iron-deficiency anemia. However, iron-deficiency anemia can also occur if you lose blood. People with bleeding in the gastrointestinal or urinary tract, traumatic injuries, or heavy menstrual periods have a higher risk of iron-deficiency anemia, per the NHLBI.
Depression is a common mood disorder that affects your feelings, thoughts, and actions. You may feel persistently sad and hopeless, lose interest in normal activities, and/or feel anxious, notes the Mayo Clinic. At the end of the day, depression will cause you to feel fatigued more often than not, Ascher says.
It doesn’t help that people with depression have a higher risk of sleep problems – 75% have trouble falling asleep or staying asleep, per Johns Hopkins Medicine.
5. Type 2 Diabetes
Type 2 diabetes is a chronic condition that happens when your body doesn’t respond to insulin, a hormone that lets blood sugar into your body’s cells to use as energy, per the CDC. When your cells don’t respond to insulin (called insulin resistance), sugar builds up in your bloodstream, eventually leading to type 2 diabetes.
Fatigue is one common symptom of type 2 diabetes, and may even stick around after you’ve gotten your blood sugar under control, per an August 2018 editorial in Diabetes Therapy. There may be several reasons for this, from lifestyle and nutrition choices to the mental energy needed to manage diabetes on a daily basis to the hormonal changes that come with type 2 diabetes, researchers say.
6. Hypothyroidism (Underactive Thyroid)
Your thyroid is a small, butterfly-shaped gland in the front of your neck that makes thyroid hormones. 'These hormones regulate many different things, from metabolism to temperature,' Ascher says.
For some people, the thyroid gland doesn’t make enough thyroid hormones – a condition known as hypothyroidism (underactive thyroid). 'If your thyroid is underactive, you may feel sluggish and tired, because your thyroid isn’t producing enough hormones to keep up with your body’s needs,' Ascher explains.
You face a higher risk of hypothyroidism if you’re female, older than 60, have had thyroid surgery or treatments, recently gave birth, or have an autoimmune disease, notes MedlinePlus.
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