Why Am I So Tired All the Time? We Asked a Doctor, So You Don't Have To

Dr. Seema Marwaha answers all your mildly embarrassing health questions in our new video series, Asking for a friend.

Do you ever find it hard to get out of bed in the morning? Hit a wall in the middle of the day? Fall asleep on the couch about six minutes after sitting down? Nearly everyone feels overtired or overworked from time to time — but is feeling wiped out all the time normal? Here, general internal medicine specialist Dr. Seema Marwaha answers some of the questions about fatigue you’re probably too tired to ask.

What’s behind that wall I tend to hit at 2:30?
If you’ve had caffeine in the morning, it will be wearing off around then. Digesting a large lunch also brings on the sandman. If you have a desk job, sitting all day puts your body in a big of an energy conservation mode. And our bodies also start to release small pulses of sleep hormones in the afternoon.

Are there medical causes of fatigue I should be worried about?
Yes – such as anemia, diabetes, thyroid problems, menopause or sleep apnea. Your doctor can help diagnose these, as well as identify signs of depression or anxiety. There’s more chance of a medical reason for tiredness if you have other symptoms in addition to being tired – like heavy periods, weight loss, hair loss, a change in bowel habits or thirst.

What about other causes related to lifestyle? I feel like I probably make some bad choices in that area.
The first question to ask yourself is: How do you treat your body? There are three core pillars of health – sleep, diet and exercise. And they are all related.

Adults need 7-9 hours of sleep a night. Eating a balanced diet of fruits, veggies and lean protein is the fuel your body needs to make it through the day. Exercising regularly can help your energy levels during the day, and also helps you burn energy, so you rest at night.

Of course, if you are not sleeping well, it makes it harder to eat right and more difficult to exercise. And the couple of drinks you have after dinner? They can also interfere with sleep.

Is it also related to stress?
For sure — fatigue can be linked to the build-up of lots of little stresses in life. Feeling stretched, overwhelmed, taking in bad news, suffering some kind of emotional shock – and even positive things like moving houses or getting married – they’re all giant stress balls that can wreak havoc on your sleep and drain your energy.

So what can I do to address that? I have no time for an hour long meditation class.
Setting aside 30 minutes of de-compression time during these stressful periods can go a long way. Turn off your screens and silence your phones. Some people listen to calming music, others do yoga, but it doesn’t matter what you do, as long as it’s truly a break.

Watch: 10 minute yoga to help you sleep

Originally published August 2017; Updated July 2018.