May 27, 2024

It’s normal to feel tired after a late night or early morning. However, if you feel tired all the time—even after getting enough sleep—there may be something else at play. Poor-quality sleep, stress, sleep disorders, and medications are just some of the factors that can cause you to feel so tired.

Experiencing fatigue or excessive sleepiness during the day can make working, thinking clearly, driving, and socializing difficult. Not addressing the underlying cause of your tiredness can make it difficult for your body to function optimally and increase your risk of injury and health issues. 

Figuring out what’s causing your tiredness can help you address the issue and feel more alert.

Even if you’re getting the recommended seven or more hours of sleep each night, you may still feel tired if you’re not getting quality sleep. Sleep quality is how well you sleep at night. Signs of poor sleep quality include having trouble falling asleep and waking up periodically throughout the night. Lifestyle factors like limited exercise, caffeine use, and poor sleep habits often cause a lack of high-quality sleep.  

When sleep is delayed or disrupted, your sleep patterns can get out of whack, which causes your brain to not fully rest and your body to not fully repair. As a result, you may have slept, but you feel exhausted.

Sleep disorders are health conditions that directly affect your sleep quality and duration. In addition to constantly feeling tired, signs of a sleep disorder include trouble sleeping or trouble staying awake during the day. Sleep disorders can also cause unusual and sleep-disrupting behaviors like talking or walking around while you sleep.

Common sleep disorders that can make you feel tired include:

  • Insomnia: This condition makes it difficult or impossible to fall and stay asleep, leading to excessive sleepiness during the day. 
  • Parasomnia: This disorder is marked by unusual nighttime activities that disrupt sleep or begin when you start to fall asleep. These activities include sleep talking, sleepwalking, and sleep-related eating.
  • Sleep apnea: This condition causes you to temporarily stop breathing while you sleep, causing snoring, gasping, and poor sleep quality.
  • Circadian rhythm disorders: Issues with your body’s internal sleep-wake cycle (circadian rhythm) can make it hard to sleep at night and stay awake during the day.
  • Narcolepsy: Excessive daytime sleepiness can make people fall asleep during the day.
  • Restless legs syndrome (RLS): Legs that feel tingly or prickly at night can make sleeping challenging. RLS can also make you feel like you need to move your legs. 

Feeling stressed about work, school, or life can make falling or staying asleep difficult. Stress increases the hormone cortisol, which makes you feel hyperaware and awake to aid your fight-or-flight response. As a result, stress is often the cause of insomnia. 

Mental health conditions like anxiety and depression can also make it difficult to get proper sleep quality. Research has found that trouble falling and staying asleep are often related to depression and anxiety. People with anxiety disorders like generalized anxiety disorder and post-traumatic stress disorder (PTSD) are especially prone to fearing sleep and feeling anxious about sleeping.

In addition to sleep issues and fatigue, anxiety symptoms can include:

  • Intense feelings of worry 
  • Anxious thoughts  
  • Rapid heart rate
  • Unexplained aches and pains
  • Shortness of breath
  • Avoidance of activities you once enjoyed

Other than sleep issues and tiredness, depression can cause symptoms like:

  • Excessive sleeping
  • Changes in appetite
  • A stop in participation of social events and activities
  • Feelings of agitation, restlessness, or irritation
  • Feelings of hopelessness or guilt
  • Trouble concentrating
  • Thoughts of self-harm

Not getting enough essential nutrients from your diet can make you tired. You need vitamins and minerals to help your cells function optimally. Your cells are crucial for creating energy from food (metabolism) and fueling your brain and muscles. If you lack vital nutrients to help the cells function, you can have low energy and experience mental and physical fatigue.

Fatigue can be linked to deficiencies of the following vitamins and minerals: 

In addition to feeling tired, nutrient deficiencies can cause symptoms like muscle weakness or pain, irritability, loss of appetite, and memory loss.

If you have your period, you may also feel tired because the blood loss can lead to iron deficiency anemia. This is when your body doesn’t have enough red blood cells because you don’t have enough iron in the body. However, decreasing estrogen hormone levels during menstruation can also make you feel exhausted.

Feeling tired all the time can indicate high or low thyroid hormone levels caused by a thyroid disease. Your thyroid gland is located near the front of the neck and produces hormones needed to regulate your metabolism. 

Hyperthyroidism

Hyperthyroidism is an overactive thyroid that produces too much thyroid hormone. As a result, breathing, heart rate, and digestion can all speed up. This requires the body to use more energy, making people feel tired. Other hyperthyroidism symptoms can include:

  • Irritability
  • Trouble sleeping
  • Weight loss
  • Mood swings
  • Swollen neck from an enlarged thyroid (goiter)
  • Diarrhea
  • Hand tremors
  • Troubler tolerating heat
  • Rapid heartbeat

Hypothyroidism

Hypothyroidism, or underactive thyroid, causes the thyroid to not make enough thyroid hormone. Without enough thyroid hormone, your breathing, heart rate, and digestion will slow. This can make you feel sluggish and tired. Other symptoms of hypothyroidism can include:

  • Weight gain
  • Puffy face
  • Trouble tolerating cold
  • Thinning hair
  • Constipation
  • Muscle and joint pain
  • Slowed heart rate
  • Depression
  • Goiter
  • Less sweating
  • Dry skin
  • Irregular or heavy periods
  • Female fertility issues

If you get enough sleep but have felt tired constantly for at least six months, you could have chronic fatigue syndrome (CFS). People with CFS constantly feel tired but have no underlying health condition causing their fatigue. If you have CFS, you may also feel even more exhausted after periods of stress or physical activity.  

However, many health conditions can affect your energy levels and make you chronically tired, including: 

  • Heart disease: Heart conditions can limit oxygen-rich blood to your organs, making it difficult for your body to function. This can make you feel tired and sluggish. 
  • Kidney disease: A damaged kidney that can’t properly filter blood will build up waste in your body and make you feel tired as your kidneys struggle to function. 
  • Liver disease: A damaged liver from cirrhosis (scarred liver), hepatitis, or fatty liver disease affects how the body removes waste and stores energy, which can make you feel tired. 
  • Autoimmune diseases: Conditions like lupus, multiple sclerosis, type 1 diabetes, celiac disease, and rheumatoid arthritis cause the body to mistakenly attack itself and cause fatigue. 
  • Bacterial, viral, and parasite infections: Being sick can cause fatigue as your body fights illness and diseases. Infections like the flu, COVID-19, mononucleosis, and Giardia can all cause fatigue. 
  • Cancer: Cancer and cancer treatments—like chemotherapy and radiation—can make you feel tired as cells die and hormone levels increase inflammation. Fighting cancer also uses a lot of energy to repair damaged cells.  

Certain medications can make you feel drowsy or fatigued as a side effect. Sleeping pills that purposely make you feel drowsy can make you feel sleepy the next day. Other medications that can make you feel tired include:

  • Antihistamines: These allergy medications block histamine for allergy relief, but blocking this neurotransmitter also alters your energy and brain function.  
  • Antidepressants: Medications like selective serotonin reuptake inhibitors (SSRIs) are used to treat depression and affect serotonin levels, which can affect sleep.
  • Anti-anxiety medications: Benzodiazepines bind to brain receptors that release chemicals that signal the brain and body to relax, which can lead to drowsiness.
  • Blood pressure medications: Beta-blockers used to treat high blood pressure (hypertension) reduce adrenalin production to slow heart rate and lower blood pressure. This can affect fatigue. 

If you think your medication may be making you tired, especially if you get enough sleep, chat with your healthcare provider. They can often swap your medication. 

If you have a health condition causing your tiredness, managing the condition can help make you feel more alert. Changing your lifestyle habits may help you feel less tired, too. Some ways to help you get more consistent rest and boost your energy levels during the day include:  

  • Go to bed at the same time every night and wake up at the same time every morning
  • Sleep in a dark, cool, and quiet room
  • Avoid eating large meals before bed
  • Quit smoking
  • Limit alcohol before bed
  • Avoid drinking too much caffeine during the day, and don’t drink caffeine in the afternoon
  • Keep a consistent exercise routine
  • Avoid using electronic devices that produce brain-stimulating blue light, like computers and phones
  • Lower stress levels with relaxing activities like meditation, breathing exercises, or yoga

 See your healthcare provider if you’ve felt extremely tired for several weeks. In addition to fatigue, you should also see your provider if you experience:

  • Frequent headaches
  • Insomnia
  • Thoughts of self-harm
  • Blurred vision
  • Confusion
  • Dizziness
  • Infrequent or no urination
  • Swelling
  • Unexplained weight gain
  • Unexplained muscle weakness 

To determine the cause of your fatigue, your provider will complete a physical exam and ask about your diet, sleep habits, and daily activities. They may also order lab tests to check your thyroid hormone levels, kidney function, liver function, or nutrient levels. Blood tests can also help identify underlying infections, inflammatory diseases, and diabetes. 

If your provider suspects a sleep disorder, they may refer you to a sleep specialist who may perform additional tests or a sleep study. If stress or mental health is causing fatigue, you may be referred to a therapist or other mental health provider for therapy or medication. 

There are plenty of reasons why you may feel so tired. Not getting enough sleep or having poor-quality sleep are two common reasons for tiredness. If you feel tired more often than not, an underlying condition might be causing it. Stress, depression, sleep disorders, nutrient deficiencies, thyroid issues, and chronic health conditions can all make you tired. Medications can also have an impact on how tired you are.

If you can’t seem to get enough sleep or constantly feel tired, see your healthcare provider. They can help you figure out what’s making you tired and help you feel more alert.

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