What to Do If You Feel Tired All the Time

So you’re tired. A lot. Most of the time, in fact. And it’s more than just being tired of the pandemic (aren’t we all?).  

If you have attempted to Google reasons for your predicament, you’ve probably come across everything from cancer to depression to insomnia. An information overload that’s not very helpful and pretty alarming. 

It’s true that tiredness can be a symptom of a lot of medical conditions, some mild and some serious. But there are lots of ways to clue yourself in to what is causing it for you.

Here’s what you need to know about tiredness and what you can do to start feeling more awake. 

Tiredness versus fatigue versus sleepiness

Tiredness, fatigue, sleepiness: to you, these words may mean the same thing. To doctors, however, they don’t. 

Fatigue

To a doctor, saying you’re fatigued means you don’t have energy to do or sustain your normal activities, says Dr. Nathaniel Watson, a neurologist and sleep medicine specialist who is also co-director of the Sleep Medicine Center at Harborview Medical Center.

Fatigue could also refer to muscular or aerobic fatigue or feeling like your mind is slow or your thinking unclear.

Sleepiness

Feeling sleepy means you feel like you could fall asleep at any time, according to Watson. It’s less severe than fatigue because, while you feel like snoozing, you can still get daily tasks done. 

Tiredness

This term is more vague. It doesn’t have a strict medical definition like fatigue or sleepiness, and often people may use it to explain what is actually fatigue or sleepiness, Watson says. 

Additionally, saying you feel tired means something different to everyone. One person may mean they have a little less energy than usual; another may mean they’re so tired they can barely stay awake during the day. 

What causes tiredness?

In case you haven’t scoured the internet for different causes of tiredness, we’ll list a few for you: lack of sleep or poor sleep habits, anxiety, depression, anemia, lack of physical activity, medications, excess alcohol use, a thyroid disorder, chronic fatigue syndrome plus serious conditions such as cancer, heart failure, liver disease, and, of course, COVID-19. The list goes on and on.

Another potential cause is an actual sleep disorder. But first doctors will want to determine if there’s an underlying medical issue unrelated to sleep. 

If you’re feeling extra tired, fatigued or sleepy, the first step is to examine your sleep routine (or lack thereof). 

“The most common cause of sleepiness in our society is sleep deprivation,” says Watson. “About one-third of individuals don’t get the seven-plus hours of sleep necessary to support optimal functioning.” 

While there are easy ways to improve your sleep habits (more on that shortly), if you’re sleeping well or are noticing significant tiredness — more than you’d get from, say, doomscrolling before bed the past few sleepless nights — then it’s probably time to make an appointment with your doctor. 

Your doctor will likely do an exam and possibly a blood test. The idea is to get a comprehensive medical history to find out what’s causing your tiredness, be it work, mental health issues, medications or something else. 

They should also ask about sleep: whether you’re getting enough and if it’s restful. 

When you visit your doctor, it’s important to describe your symptoms — what tiredness feels like for you, specifically — in as much detail as possible, and to accurately answer all of your doctor’s questions. 

If no cause can be determined after the appointment, or if your doctor suspects a sleep disorder, the next step is being referred to a sleep medicine specialist. 

How to get better sleep and have more energy

If you know your tiredness is due to stress or unhelpful sleep habits, there are ways to practice better sleep hygiene — which is particularly important nowadays during the pandemic. 

Here are a few ways to get better-quality sleep so you have more energy during the day.

Keep it consistent

As much as you can, try to go to bed and wake up at consistent times each day — yes, including on weekends. 

Additionally, having a bedtime routine is a great way to signal to your body that sleep is approaching. Your routine could be as streamlined as brushing your teeth, washing your face and getting your pajamas on, or it could be more significant and include things like reading or writing in a gratitude journal.     

Keep it cool

Since your body naturally cools down as you start to fall asleep, it can be a good idea to help it out by keeping your sleeping environment cool. Watson recommends setting your thermostat to 67 or 68 degrees or, if you don’t have air conditioning, opening a window. 

Watch what you drink

Seattle may be the coffee capital of the country, but that doesn’t mean you should indulge in caffeine at all hours of the day, particularly if you want to sleep well at night. Try to avoid drinking coffee after 2 p.m. — this goes for alcohol, too. 

Make sleep a priority

We all have different things that get in the way of sleeping: work, stress or anxiety, a snoring bed partner. But at the end of the day, any way you can commit to getting quality sleep is only going to help your overall health.

It might not be possible for everyone to get perfect sleep 24/7. But there are small things you can do that will help you sleep better overall, such as putting your phone down instead of doomscrolling before bed, or not watching scary shows late at night.

“Prioritizing sleep is a decision everyone makes whether they know it or not, so make a choice to value your sleep and protect your sleep,” Watson says.

What to know about common sleep disorders

At an appointment with a specialist, they will probably ask you a lot of questions about your sleep habits, like if you’re so busy you don’t have enough time to sleep or, if time isn’t an issue, you just can’t fall or stay asleep once you try.

Additionally, taking a full sleep history is important, Watson says.

“A sleep history helps us learn more about their sleep schedule (going to bed and wake up times on weekends and weekdays), how long it takes to fall asleep, how disturbed their sleep is, whether or not they nap, if they snore,” he explains.

From there, it’s a process of elimination. Doctors start by asking about symptoms of more common sleep disorders, such as insomnia and sleep apnea. 

Many people with these disorders are undiagnosed and untreated, Watson says. 

While insomnia is characterized by difficulty falling or staying asleep, sleep apnea involves brief moments where you stop breathing during sleep, which can manifest as waking up gasping. Sleep partners of people with sleep apnea are often the first to notice, Watson says; however, if you sleep alone, it may be harder to recognize what’s happening.  

Rarer sleep disorders

If insomnia and sleep apnea are ruled out, doctors will test for narcolepsy, a condition marked by excessive daytime sleepiness, regularly disrupted sleep and so-called sleep attacks where someone has the urge to nod off suddenly during inappropriate times.

Testing for narcolepsy often involves overnight observation while you snooze or a sleep test (termed a multiple sleep latency test by doctors).

There are even rarer sleep disorders than narcolepsy, such as idiopathic hypersomnia, where someone is regularly sleepy but doesn’t have the sudden sleep attacks or the cataplexy common with narcolepsy; and Kleine-Levin syndrome, where behavioral changes accompany excessive sleepiness, typically in teenagers. 

But the chances of one of these conditions being the culprit are slim.

“The vast majority of time, someone with tiredness has sleep deprivation or obstructive sleep apnea,” Watson says.

Serious signs to watch for

If you’re having other symptoms along with fatigue or sleepiness, that may be a sign that your issue isn’t just a sleep problem.

For example, if exercising makes you more fatigued than normal, that could point to a heart issue. If you’re an older adult, a doctor may want to examine your heart and lungs. And if you no longer feel motivated to do things you used to enjoy, that could point to a mood disorder like depression. 

Basically, if you have any symptoms other than tiredness that are causing problems, or if your sleepiness or fatigue is so severe that you’re having trouble functioning, it’s time to see a doctor.