Lethargic, weary, debilitated, exhausted…sound familiar?
Written By Ruth Cruz
Lethargic, weakness, weary, debilitated, dull, exhausted, enervated, feeble, weighted, tiredness, listless, burnt out, foggy, overtired, fatigue. All of these are a basic description of how many of us are spending our days. Yet we bravely trek on through going to work, taking care of our families, and trying to stay on top of the basics that are important in our lives.
Yet why do so many of us experience these, which can be overwhelming feelings of exhaustion? Well there are many reasons for fatigue, yet there are also various levels of fatigue as well as various reasons.
Sleepiness – Let’s start by talking about your basic garden-variety sleepy feeling that many of us carry throughout the day. Maybe you’re thinking you just haven’t been able to get that good night sleep, or you may need a new mattress. Another cause might be that you’re jet lagged, or have just come back from vacation so it’s taking you a bit to get back into your your normal routine. Then there’s the possibility that your job may be leaving you sleep deprived or that you’re simply working too hard. Then there are those that try to skimp on sleep in order to keep up with a self-imposed schedule and a long to do list in a never-ending attempt to satisfy ourselves and go that little bit further. This usually get’s paired with the bunch that has become so dependent on stimulants like caffeinated beverages to help keep us going. So much so, that we really don’t know what to do with ourselves if we can’t find a filled coffee cup by 3 o’clock. Uhm…in full disclosure that would be me, but I must confess to this being a result of a family tradition to have coffee at 3pm so we’re talking about years of training that would have to be reprogrammed, yet-I diverge.
Although if sleepiness is the main concern, it should be addressed, as there could be other serious health concerns at bay such as sleep apnea or another sleep disorder. There are always those periodic occurrences accountable for losing sleep some nights. More common sleep interruptions might include noisy neighbors or that late night cup of coffee after an evening out that point to a transitory impediment. However not getting the required amount of quality sleep on a regular basis can lead to health issues, not to mention just make you plain ol’ crabby. Regardless of the components to our individual sleep crises, it seems to be a growing problem across the board.
The National Sleep Foundation (NSF) estimates that 20% of people feel excessively sleepy to the point that it interrupts their daily lives. The numbers on the sleepy assembly show that 35% of adults nod off, 23% have difficulty concentrating and 18% report having difficulty concentrating as a result of being sleep deprived. Research confirms that those who were not able to get the recommended 7-9 hours of sleep at night were more likely to have difficulty with basic daily tasks. This led the CDC[1] to declare that insufficient sleep has reached epidemic proportions[2].
Should we be MADD about Drowsy Driving? – Although M.A.D.D. stands on the issues of drunk driving, a movement is following to make people aware of the dangers of how Drowsy Driving can affect the quality of driving performance as much if not more than the affects of alcohol. The NSF estimates that at least 36 percent of Americans have dosed off at the wheel, while a study conducted by the American Automobile Association (AAA) estimates that one out of every six deadly traffic accidents, and one out of eight crashes requiring hospitalization of car drivers or passengers is due to drowsy driving.[3] The picture gets even grimmer when we look at the numbers involving young people who drive drowsy. A recent survey conducted by the AAA determined that one in seven licensed drivers ages 16-24 admitted to having nodded off while driving in the past year as compared to one in ten of all licensed drivers who confessed to falling asleep[4].
Beyond the Sleepy Somber – The next phase of tiredness leans into what is considered fatigue. With fatigue there is a residual lingering tiredness that is constant and limiting beyond sleepiness. With fatigue you have unexplained, persistent and relapsing exhaustion, which might be compared to how you feel when experiencing the flu. Yet without the flu bug as the offender, chronic fatigue can leave you too exhausted to function without explanation and has become the norm for the masses. Many of us might occasionally feel tired, but when fatigue reaches a higher level it is neither normal nor typical. This may be a symptom of a more serious health problem.
Veni, Vidi, Dormivi (I came, I saw, I slept)…if only…
Insomnia, which is Latin for “no sleep,” is the inability to fall asleep or remain asleep. Insomnia is also used to describe the condition of waking up not feeling restored or refreshed. Contrary to popular belief, insomnia is a symptom not a disease. Although for the insomniac it can feel like it has intensified to the level of disease, as it’s chronic nature seems to elude itself of any direct solution. Self-reported problems sleeping, dissatisfaction with sleep quality and daytime tiredness are the only defining characteristics of insomnia, and is subjective as it is defined by an individual’s perception of sleep.
Transient or short-term insomnia is typically caused by such things as stressful life events, jet lag, changes in sleeping environments, some acute medical illnesses and stimulant medications. Normal sleeping habits return once the acute event is over. If a person has experienced sleeping difficulties for a month or more, this is called persistent or chronic insomnia. Long-term insomnia may require professional help from a sleep disorder clinic as the cause(s) should be identified and corrected. Insomnia that has persisted for years may require some time before being able to re-establish normal sleeping patterns.
Basic recommendations for insomnia include reducing anxiety and sticking to a day–night routine that can improve sleep quality. Suggestions include avoiding napping during the day, cutting down on smoking and drinking as both these can lead to disrupted sleep, avoiding tea, coffee or other caffeinated drinks in the evening, avoid exercising three hours before bedtime, and engaging in something relaxing such as meditation or a warm bath as you bring your day to a close. In addition it’s recommended to not go to bed unless you feel sleepy and if necessary delay your bedtime. You may even want to go to another room and do something else until you actually feel sleepy. Lastly, it’s suggested to get up at the same time every morning regardless of how much sleep you’ve had.
Just the facts ma’am –
The basic causes of sleepiness and fatigue can be boiled down to one of three things, lifestyle factors, psychological conditions or medical conditions[5]. By making an honest assessment of your lifestyle and choices you may be able to troubleshoot what is at the cause of your sleep dilemma or fatigue. This becomes especially important to determine whether or not your fatigue is indeed an indication of a more serious health matter.
Lifestyle factors – Feelings of sleeplessness often have an obvious cause, such as alcohol use or abuse, caffeine use, extensive physical activity or inactivity, choosing to not schedule sufficient time for sleep, unhealthy eating habits, and medications which may have adverse affects such as antihistamines, cough medicines or cold remedies.
Psychological conditions that can cause fatigue can be indicative of mental health problems, such as anxiety, depression, grief or stress.
Medical conditions – Unrelenting exhaustion may be a sign of a medical condition or underlying illness. Although the list that follows seems a bit extensive and alarmist, the documentation I reviewed for this article indicated the importance of these as medical considerations. They include acute liver failure, anemia, cancer, Chronic Fatigue Syndrome, Chronic kidney disease, Chronic Obstructive Pulmonary Disease (COPD), emphysema, heart disease, hyperthyroidism/hypothyroidism, Multiple Sclerosis, obesity, Restless Legs Syndrome, sleep apnea, diabetes or if you’re on certain medications.
Yum, Yum, Yum…gloom…
Although most of us reach for caffeine or a sugar boost when tired, this plan can backfire. Along with those temporary fixes are a subset of foods that are associated with insomnia. They include bacon, cheese, sugary and sweet foods, ham, tomatoes, caffeinated drinks, greasy foods and spicy foods. It should be noted that what and how much you eat are almost as important as when you eat. Researchers at the Mayo clinic have concluded that there is a link between insomnia and gastrointestinal disorders that include indigestion, heartburn and irritable bowel syndrome. While this sounds gloomy, these are simply lifestyle choices that can easily be adapted to help you get one step closer to claim that bounty of beauty sleep.
With so many people managing longer day schedules eating late isn’t so unconventional. It may be that you’re eating too late before bedtime and the choice of what you’re eating is adding to your inability to get good sleep. So if you’re making that fried egg, ham and cheese with a slice of tomato for a bedtime snack, this may be the cause of your insomnia[6].
Zzzzzzzzz…1, 2, 3 little sheep…
So why doesn’t counting sheep seem to work anymore? For some it’s as simple as not being able to turn off the day. For others carrying the latest technology into our sleep chamber might be the worst thing for us. Too many of us bring our cell phones in to not miss that last text, but replying keeps us engaged and active rather than allowing us to wind down. Many of us are choosing e-readers on iPads, tablets and phones versus the old soothing paper page that doesn’t house a luminous backlit display. While convenient, this light exposure may suppress our body’s ability to produce melatonin and disrupt the body’s natural circadian rhythm with as little as a two-hour exposure of the light before bedtime.[7] One final suggestion is to try to keep the bedroom as a sanctuary. Allow it to be a quiet and restful place rather than a last stop for tying up work at the end of the day.
Exercise breeds energy… You might think that you feel too tired to exercise, but regular exercise will make you feel less tired in the long run and you’ll have more energy. During exercise the contracting muscles generate force or power and heat. So physical exercise is in fact a form of mechanical energy.[8] Even a single 15-minute walk can give you an energy boost, and the benefits increase with more frequent physical activity.
The old adage slow and steady wins the race comes to mind here, as the goal is to come up with a workout program that you enjoy and that makes you feel better. Starting with low-intensity exercise can help build your stamina gradually. Low-impact exercises like yoga, tai chi and pilates are good choices for a person with chronic fatigue, as are walking or even biking. Yoga and tai chi can also serve as good stretching and strengthening exercises, which are an essential part of any exercise program. Higher-level aerobic activities are most effective at increasing oxygen in the blood and boosting energy levels and are key to build oxygen levels in the blood. A commitment to this can amass various health benefits and provide the means for a solution to your fatigue.
You may have heard that it’s important to remember to finish exercising three hours prior to bedtime to enable your body and mind to wind down. Here’s why…exercising raises your core body temperature, increases your heart rate and prompts your system to release stimulating epinephrine (adrenaline). If adrenaline is high, the brain is active, and it’s difficult to wind down. By ending your exercise routine with enough of a margin before slumber time, it will allow your body temperature to return to normal, your heartbeat to return to its resting rate and your adrenaline levels to stabilize so you can get your Z’s. Although there is a set of individuals who find that exercising before bedtime actually helps their sleep cycle.
You’ll have to decide which category you fall into to make your workout most effective. You may you choose to exercise with the early morning risers sprinting through the streets as you listen to the birds twittering, or you may be a late night launcher getting in a workout before the day ends. So let go of the misconception that if you don’t workout early it’s not worth the while, it certainly is at any time of the day or night.
The 21st Century Syndrome – Another cause for excessive fatigue is adrenal exhaustion. Although fatigue may be a symptom of many different health problems as we’ve noted earlier, fatigue coupled with other symptoms can point toward adrenal exhaustion, including dizziness when standing up, frequent bouts of low blood sugar, mood and memory problems, aches and pains in the muscles of the upper back, arms, and legs, salt and sugar cravings, feeling cold, pollen allergies, food and chemical sensitivities, and morning tiredness.
While making lifestyle changes can certainly help, here are a few basic supplements that can help address your overall feelings of fatigue and sleeplessness:
Magnesium – there is an ongoing debate whether or not having a magnesium deficiency causes fatigue. In my opinion, I agree it does. Although it’s important to note that if you choose to take a magnesium supplement, it should be taken at night, as ironically it may cause drowsiness. Magnesium itself helps promote restful sleep and may serve to be a part of your new regiment in search of your optimal slumber event. This is a good supplement for those who have difficulty staying asleep through out the night. Taking a magnesium supplement can also ease muscle cramps and spasms that many of us begin to experience as we get older, as this often is another cause of sleep interruption.
Acetyl L-Carnintine[9] – L-carnitine is involved in cellular metabolism and can help increase energy production in the mitochondria, the “power plants” of all cells, and thereby may generally boost physical and mental energy. It should be noted that you should consult your doctor before taking this if you have hypothyroidism, as there are conflicting reports indicating it may impair thyroid function in some.
Alpha-lipoic Acid – This antioxidant is vital to cellular energy production, as it is helps convert glucose to energy, while it also helps to neutralize the damage caused by free radicals. The anti-oxidant effects of alpha-lipoic acid might provide protection in a number of conditions as it can help maintain the health of mitochondria.
B-complex -The B-complex vitamins are anti-stress nutrients. Take a high-potency supplement that contains at least 50 mg of vitamins B1, B2, and B3. The dosages of other vitamins in a B-complex supplement will fall into place, though there will be differences between brands. For some they may not see any difference in how B vitamins affect their fatigue unless taking a 100 mg compilation. It may be a good idea to start with a 50 mg complex and double the dosage if you see no positive effects after 2 weeks.
Pantothenic Acid – The body needs this B vitamin to make adrenal hormones, and people with adrenal exhaustion usually need more than the amount found in high-potency B-complex supplements. Try 500 mg extra of pantothenic acid twice daily.
Vitamin C – Vitamin C helps make adrenal hormones. Take at least 1,000 mg three times daily. This may be a key supplement for those with adrenal dysfunction.
Melatonin – Finally to help you fall asleep there’s melatonin. Melatonin regulates the body’s circadian rhythms, the daily rhythms such as your sleep-wake cycle. Scientific findings show that melatonin decreases the time it takes to fall asleep, increases feelings of sleepiness, and may increase the duration of sleep. Melatonin has been used successfully for sleep enhancement in healthy individuals, as well as to reduce feelings of jet lag during global travels.
So whether you’re tired or a just a little sleepy, you’re not alone. Hopefully you have a clearer understanding that medically speaking fatigue is not the same thing as tiredness or sleepiness. And for those insomniacs out there, I’m sure you see many of your friends up at night posting on Twitter and Facebook, clearly indoctrinating you to an exclusive club of night dwellers. Whatever your personal experience may be, it certainly is worth looking into the causes so you can remedy the symptoms and regain getting the sleep you deserve.
[1] Center for Disease Control, http://www.cdc.gov/violenceprevention/pub/coping_with_stress_tips.html, June 2014
[2] National Sleep Foundation poll conducted in 2009
[3] http://drowsydriving.org/2012/11/national-sleep-foundation-white-paper-on-drowsy-driving/ – AAA, 2010
[4] http://drowsydriving.org/2012/11/young-people-more-likely-to-drive-drowsy/, June 2014
[5] http://www.mayoclinic.org/symptoms/fatigue/basics/causes/sym-20050894, June 2014
[6] These contain an amino acid called tyramine. This releases a substance that stimulates the brain and keeps you awake.
[7] http://www.ncbi.nlm.nih.gov/pubmed/22850476, June 2014
[8] http://www.ncbi.nlm.nih.gov/pubmed/19402743
[9] Acetyl-L-carnitine, also known as ALCAR, is a well-researched nutritional supplement. It is synthesized to provide a more bioavailable form of L-carnitine.