Ten Reasons You Are Tired All The Time

If you frequently feel tired, you’re not alone. According to the National Sleep Foundation, about half of US adults report feeling sleepy during the day between three and seven times per week. The causes of persistent sleepiness, fatigue, or low energy during the day can vary widely. That said, learning about some common causes may help you decide how to move forward in addressing this issue in your life. 

Why sleep matters

Sleep is vital for maintaining overall health and preventing chronic conditions such as heart disease, type 2 diabetes, kidney disease, and more. Poor sleep can exacerbate chronic fatigue and contribute to serious health issues like heart failure and blood sugar imbalances. Adequate sleep is essential for managing symptoms and improving the quality of life for individuals with conditions such as rheumatoid arthritis and multiple sclerosis. 

Good sleep also plays a crucial role in mental health, helping to control emotions and reduce the risk of disorders such as depression and anxiety. If you're experiencing sleep problems, it's important to find a doctor who can provide appropriate guidance and treatment to help prevent these health complications.

How much sleep do you need?

If you notice that you’re not feeling rested after getting seven hours, you might try to get a bit more. If you’re still not feeling rested, it could be that your sleep quality is poor. Practicing good sleep hygiene is one way to address this, which we’ll cover below.

Top 10 common causes of feeling tired all the time

If you’ve been asking yourself, “Why am I sleepy all the time?”, one of the reasons below could be the cause. If your sleepiness is persistent, especially if you’ve tried various methods to address it, you may want to meet with a healthcare provider for evaluation. 

1. Simply not sleeping enough

The first potential cause of frequent daytime sleepiness—also referred to as hypersomnia—is the most obvious: You may simply not be getting enough sleep. Many people find themselves staying up too late and getting up too early to allow their body to get the rest it needs each night, often due to a busy schedule. However, it’s worth prioritizing your seven to nine hours of sleep every night if you can; research has linked an ongoing lack of sufficient sleep to increased risk of cardiovascular disease, obesity, stroke, diabetes, depression, and even a reduced lifespan.

2. Chronic/excessive stress

When the body experiences stress, a cascade of physiological responses is triggered in order to enable you to face the perceived threat. When you experience chronic stress—such as if you have a high-pressure job, an unstable living situation, or a volatile relationship with someone close to you—your body may engage in this response for longer than it’s meant to. This can lead to a variety of health problems over time, including trouble sleeping. After all, your body preparing itself to meet a direct threat usually includes an increased heart rate, increased levels of alertness, and muscle tension—all of which can make it difficult to rest properly. Finding healthy ways to manage stress levels may help.

3. Worry and/or anxiety

Getting into bed at night represents the first chance many people have in the course of a day to take a break from constant “doing” and be alone with their thoughts. That means it can end up as a time for processing the day’s events and planning for tomorrow rather than a time for calm rest. For those who have an anxiety disorder, such as generalized anxiety disorder (GAD), quieting the mind to get ready for sleep can be even more difficult. If you’re experiencing symptoms of a mental health condition like GAD, it’s usually recommended you consult with a mental healthcare professional for advice. You might also try strategies to calm your mind before bed, such as meditation or journaling.

4. Depression

People diagnosed with depression often have trouble sleeping, and many even develop insomnia.  A lack of sleep can cause or exacerbate depression in a vicious cycle. That’s why it’s usually worth consulting with a qualified healthcare provider if you're experiencing symptoms of depression—which can also include persistent sadness, a loss of interest in activities once enjoyed, difficulty concentrating, irritability, and changes in eating patterns and/or weight. Depression is considered to be a treatable illness, so seeking professional support for it could help you address your fatigue.

5. Certain medications

There are a variety of medications that may cause daytime drowsiness in some people. If you suspect a medication you’ve been taking is making you feel tired, it’s recommended that you consult with your doctor. Remember to seek their advice before starting, stopping, or changing your dose of any medication. Some that may cause drowsiness include but are not limited to:

• Anti-seizure medications

• Antidepressants

• Muscle relaxants

• Some cold medicines

• Some allergy medicines

• Opioid pain relievers

• Products containing CBD

6. Chronic pain

It’s not uncommon for people who live with chronic pain of some kind to experience frequent fatigue during the day. For one, the pain may make it difficult to sleep at night. However, researchers continue to look into other reasons chronic pain may cause fatigue as well. One theory is that inflammation associated with long-term, pain-related conditions could play a role in making a person feel tired or low-energy during the day.

7. Sleep disorders

Of course, insomnia can lead to a person frequently feeling tired throughout the day, since it’s characterized by an inability to get enough high-quality sleep at night. That said, other sleep disorders could also produce the same effect. Sleep apnea, for instance, can cause a person to wake up briefly but frequently during the night, resulting in tiredness the next day. Restless leg syndrome and narcolepsy are some of the other possibilities. 

8. Shift work

Those who work the night shift—especially if the hours are irregular or the shifts are very long—may experience sleepiness while they’re awake. This type of work can disrupt a person’s circadian rhythm, which is a set of natural processes that enable the body to sleep and wake at usual times in a 24-hour schedule. Tips like creating a conducive environment when you do sleep and trying different sleep schedules—such as staying up for a few hours when you get home or engaging in a nap routine—could be helpful for shift workers who frequently feel tired when awake.

9. Hormonal changes

Some individuals may experience sleepiness during certain periods of time or phases of life that are characterized by hormonal changes, which may resolve themselves once the phase has passed. For example, those who menstruate may face insomnia as a part of premenstrual syndrome (PMS). Sleep disturbances can also be associated with the hormonal changes of menopause.

10. Chronic fatigue syndrome

Finally, myalgic encephalomyelitis or chronic fatigue syndrome (ME/CFS) can cause frequent sleepiness during the day. It can be so severe that individuals experiencing ME/CFS may be unable to engage in the activities required for daily functioning as a result of their tiredness. They may also experience trouble thinking clearly or concentrating, and pain and dizziness could occur as well. There’s currently no treatment for this condition, but the Centers for Disease Control and Prevention (CDC) offers a variety of strategies that may help individuals manage their symptoms. 

What to do if you feel tired all the time

The recommended course of action for those who experience hypersomnia is typically to speak with their doctor. A qualified healthcare provider can perform an evaluation to determine whether a health condition may be at play, or if a prescribed medication is causing the issue. Otherwise, practicing good sleep hygiene is usually the suggested next step. This can include:

• Sleeping in a cool, dark, quiet room

• Going to sleep and waking at roughly the same time every day

• Avoiding caffeine and alcohol several hours before sleep

• Avoiding screens (phones, TV) before sleep

• Eating a balanced diet of nutritious foods

• Getting aerobic exercise 

• Trying meditation and/or stretching before bed

Addressing sleepiness in therapy

As mentioned, there are many different potential causes of daytime sleepiness—and some of them are related to mental health. Conditions like depression, anxiety, bipolar disorder, and post-traumatic stress disorder (PTSD), for instance, can all cause sleep problems that can result in daytime fatigue—as can stress or other mental health-related challenges. Speaking with a therapist is one way to address such challenges since therapy is the first-line treatment for many mental illnesses and concerns. 

If you are experiencing trauma, support is available. Please see our Get Help Now page for more resources.

Always attending in-person therapy sessions is not possible for everyone. Some may not have the time or the transportation required to commute, while others may face financial barriers to care. In cases like these, online therapy can represent a viable alternative. With a platform like BetterHelp, you can get matched with a licensed therapist who you can speak with via phone, video call, and/or in-app messaging from the comfort of home—and all for a cost that’s lower than the average in-person session. Research suggests that online therapy can offer similar benefits to face-to-face therapy, so you can generally feel confident in choosing whichever format is most effective and comfortable for you.