33 Possible Reasons Why You Feel Tired All the Time

If the question that comes up most often when talking to yourself (it’s totally fine!) is “Why am I always tired?” you’re not alone. An estimated 70% of Americans report they don’t get enough sleep—at least one day a month—according to the National Safety Council.¹ The thing is, when you have a packed schedule (hello, five-day-work-week, 24/7 parenting, or constant exams), finding a few minutes to sneak in a nap or even just sleep through the night is as elusive as the energy of your favorite indoor cycling instructor (seriously, where do they get it?).

We all get a bit tired, but normal fatigue gets better with proper rest. It’s not normal to feel persistent fatigue for more than a few weeks, miss work or social events because you’re tired, or to need excessive caffeine to get you through the day, Jenepher Piper, M.S.N., a certified registered nurse practitioner of family medicine at Hunt Valley Family Health, an affiliate of Mercy Personal Physicians in Baltimore, tells SELF. If you’re experiencing those symptoms, you need to flag your fatigue to your doctor.

There’s also a difference between being sleepy and excessively fatigued. “Sleepiness is simply the drive to sleep. Falling asleep during concerts, sales meetings, or intercourse are sure signs of excessive sleepiness,” board-certified sleep medicine doctor and neurologist W. Christopher Winter, M.D., of Charlottesville Neurology and Sleep Medicine and author of The Sleep Solution: Why Your Sleep Is Broken and How to Fix It, tells SELF. And, of course, there’s also fatigue that falls somewhere in between, like feeling totally wiped even though you know you got enough sleep.

The reasons why you’re always tired can come down to lifestyle factors, certain health issues (sleep apnea is a big one), or a combination of both. It’s possible that some of the reasons you feel constant fatigue and exhaustion are factors beyond your control, but others (thankfully) you can control.

Lifestyle causes | Health causes | When to see a doctor | Tips to stop feeling tired

Do certain lifestyle factors cause fatigue?

So, what are some of the reasons you could be feeling extremely exhausted on the daily? We’ve got a few common behaviors you might want to examine in your own life.

Okay, so it makes sense that exercising too much might lead to exhaustion, especially if you don’t give yourself a rest day or two. But not exercising enough can also make you feel tired, because regular workouts help boost your energy levels, according to the National Institute on Aging. Breaking a sweat can also help reduce your stress and anxiety levels, both of which are known sleep-stealing bandits. So, getting in a quick 20 minutes of moderate exercise at least five days a week may help you get the rest you need.

The timing of your heart-pounding HIIT workouts could also be causing you to sleep poorly, leading to feelings of fatigue. Some people may not have a problem with exercising before bed (and may even benefit from it) whereas others are more sensitive. That’s because exercise raises your core body temperature and causes hormonal changes that can impact sleep, Rachel Salas, M.D., an associate professor of neurology at Johns Hopkins Medicine who specializes in sleep medicine, tells SELF.

Stick to something low-key, like gentle stretching or yoga, if you want to move late at night. Otherwise, it’s best to work out in the morning or right after work. “You probably do not want to exercise within three to four hours or so of your planned bedtime,” Daniel Barone, M.D., sleep expert at Weill Cornell Medicine and New York-Presbyterian, tells SELF.

“If you’re getting a lot of bright light stimulation later in the day, it can impact your circadian rhythm and sleep quality” by impacting melatonin (sleep-inducing hormone) production, Dr. Salas says. She recommends dimming the lights when you get home after work, using lamps instead of harsh overhead lights, and lowering the brightness on your phone, tablets, computers, and TVs to signal to your body that it’s nighttime and sleep is near. “I always advise my patients to completely stop using electronics about 30 to 60 minutes before their planned bedtime,” Dr. Barone says.

“It’s amazing how many people still have their childhood pillow,” Dr. Salas says. That mound of fabric and feathers collects dust (which can contain things like dust mites and dead skin cells) over time. Especially if you’re allergic to dust, this can impact your health and keep you from sleeping well. You should replace your pillow every two years, Dr. Salas recommends. Your mattress also shouldn’t be vintage; if you never feel fully rested and you can’t remember when you bought it, it might be time to invest in a new one. (Your body will thank you later.)

An intense workout isn’t the only reason your body might be tired. A lack of vitamin D and vitamin B12 in your diet can leave your muscles feeling fatigued. When you have a vitamin D deficiency, you can experience both muscle weakness and muscle loss. In severe instances, vitamin B12 deficiency can cause tingling or numbness in your hands and feet. Vitamin B12 is present in eggs, tuna, dairy products, and fortified foods, like cereal. Vitamin D-containing foods can be a little harder to incorporate in sufficient amounts, but egg yolks, fish, and fortified foods can help. Finding foods that contain these vitamins can be especially difficult for plant-based eaters, so supplements might be necessary.

If your doctor determines that a nutrient deficiency isn’t your issue, eating a diet that’s high in sugar could be. Research in teens shows things like sweetened drinks and fast foods are associated with poorer sleep quality.²

A nightcap might sound like a good way to doze off—and it will technically make you sleepy at first—but it doesn’t actually set you up for a good night of sleep, according to the Cleveland Clinic. That’s because alcohol disrupts those deep, restorative stages of sleep, and you end up in lighter stages of sleep all night. Too much booze also sets the stage for breathing issues, nightmares, and parasomnias, like walking or talking in your sleep—not exactly a restful way to spend the night.

This might seem like a no-brainer, but eating a pizza (burger, fries, you get the picture) before bed is probably not a good idea. A full stomach can affect your sleep quality. “If you have a heavy meal right before bedtime, you’re more likely to experience GERD or heartburn,” Dr. Salas notes, and waking up to that burning sensation in your chest is highly unpleasant, leaving you fatigued in the morning.

On the other hand, going to bed hungry can feed that always-tired feeling because it can be just as disruptive. “It can cause you to have arousal, where you’re not fully awake but your brain is being stimulated,” Dr. Salas explains. If your growling stomach often wakes you up in the middle of the night, try having a light bedtime snack, like a bowl of yogurt or some fruit, she suggests.

Dehydration can cause symptoms that include fatigue, lowered alertness, and problems concentrating.³ Making efforts to stay hydrated throughout your day could even have a beneficial effect on your mood. When that 3 p.m. slump comes around, don’t only reach for an invigorating snack filled with nutrients like complex carbs and protein, but also try drinking more water. Your energy levels—and coworkers—will thank you.

A little caffeine during the day is fine, but you may want to pump the brakes on the double-espresso after dinner. Having caffeinated beverages, like coffee, tea, and soda too late in the day can make it harder for you to fall asleep, according to the National Institute on Aging. That’s because it takes four to six hours for your body to metabolize half of the caffeine you consumed, according to the U.S. Food and Drug Administration, so you’ll want your coffee cutoff to be at least four to six hours before bedtime.

If you’re powering the workforce in the evening hours, you’re significantly more likely to get less sleep than those who work during the daytime, according to the National Safety Council.¹ Working night shifts can lead to a condition called night work sleep disorder. This basically takes place because your body’s sleep-wake cycle can’t find a sense of balance. As a result, you experience symptoms like problems sleeping and affected performance when you work at night.

It also seems that night work sleep disorder is usually worse when you work rotating shifts or you’ve been doing overnight shifts for a long time. If possible, try to schedule yourself with some break times in between shifts to catch up on sleep.

Generally, staying up too late can make you feel tired all the time. For parents, a common struggle is feeling exhausted but wanting to stay up later than your kids because it’s the only way to get a little time to yourself. Chronic late night workers might stay up even later to reclaim that “me time.” It’s called revenge bedtime procrastination (yes, it’s a thing) and it’s not really good for your sleep. But really trying to stick to a routine sleep schedule—yes, even on weekends—can actually help you sleep better, per the National Institute on Aging.

“Social jet lag” is also a thing: It involves going to bed later on weekends, and then trying to go to bed at your normal time on Sunday nights only to find yourself tossing and turning.

One of the biggest things people should know before becoming parents is that it isn’t just tiring when you have a newborn. What’s more, a 2016 study published in the journal American Sociological Review found that of more than 12,000 people, moms report greater fatigue and more stress levels in spending time with their children than fathers. The study found that mothers typically have less quality downtime to “recover” from parenting, which can lead to fatigue.⁴

If you’re a parent (or caretaker, for that matter), it’s important to know that taking time for yourself isn’t selfish—it’s restorative.

The right partner can be a buffer to stress. But the wrong partner? They can worsen it. And the more stress you have, the more fatigue you’re likely to experience and vice versa. Partners who have shared experience, such as similar sleeping patterns and eating patterns, are more likely to have positive interactions that reduce fatigue levels.⁵

If you and your partner or even a friend or friend group just haven’t been on the same level recently, chances are you’re more tired than usual too. Ideally, you and your partner can reconnect to enhance your relationship. But if you aren’t sure they’re right for you, your stress and fatigue levels may be telling you something.

There are so many effects of the pandemic that we are still experiencing. One is pandemic fatigue, which is also called burnout or COVID-19 fatigue, according to the American Medical Association. This occurs due to the buildup of COVID-19 effects, such as isolation, wearing masks, social distancing, and yes, even Zoom fatigue.⁶

Pandemic fatigue is an understandable reaction to the stress and tragedy the pandemic has brought. To get through this challenging time, it’s important to focus on what you can and can’t control—for instance, you can wear a mask in public, get vaccinated, and wash your hands appropriately to reduce your risk. It’s also important to maintain relationships and interactions with loved ones as much as possible. Feeling connected plays a big role in staying strong and resilient during these isolating times.

If you’ve recently retired, or you’re one of the millions of people who are now working from home, suddenly losing the vibrant life you had outside those four walls you call home can be, well, boring. That feeling can translate to a sense of tiredness, especially if you envision your day as a long stretch of time staring into the ether (or the blank wall in front of you). Making a plan for your day and scheduling activities, such as getting outside for exercise, volunteering, or visiting with a friend can all help you find a new purpose, which can feel energizing, according to the National Institute on Aging.

Sometimes, no matter what you do, you still just feel so damn tired. A lot of medical conditions result in fatigue, even when you get what appears to be a reasonable amount of sleep—usually about seven to nine hours. If you’re making a concerted effort to get enough sleep every night (and we’re talking good-quality sleep here), yet you’re still tired, it may be time to explore a larger health issue or a potential underlying medical condition. Here are a few to keep on your radar:

If you wake up after a full eight hours of sleep feeling less than refreshed, you’ll want to read this. One of the biggest reasons for always feeling tired despite getting enough sleep is obstructive sleep apnea (OSA). This occurs when your breathing stops and starts unexpectedly during the night. Snoring is a hallmark sign of the condition, but that’s not a surefire way to diagnose it. At least 47% of people assigned male at birth and 23% of people assigned female at birth have sleep apnea, but up to 85% of cases go undiagnosed.¹ In other words, it’s a super common problem that’s super underdiagnosed.

So, if you get sufficient sleep (at seven to nine hours), but you wake up still feeling exhausted, it’s a good idea to check in with your doctor. “Sleep apnea upsets the restorative nature of sleep, so fatigue is often seen with poor quality sleep,” Dr. Wider explains.

Sleep apnea can cause you to stop breathing numerous times a night, which puts a strain on your heart. Seeing a doctor if you have these symptoms is important not only to help you feel less tired, but to also improve your overall health.

What if all your fatigue symptoms were a diagnosable medical condition that affected your ability to fall asleep or fall back to sleep? This is the definition of insomnia, a condition that affects about 12% of women.¹ This condition causes pronounced daytime sleepiness and problems concentrating. Plus, it increases your risk for depression and affects your quality of life.

Anxiety (more on that below) can also trick you into thinking you didn't sleep even if you did. It’s called paradoxical insomnia, and in this case, the anxiety is actually making you feel tired rather than insomnia.

If you have chronic problems sleeping, it’s worth talking to your doctor about—you may have insomnia or another sleep disorder like narcolepsy, which are both treatable conditions.

Narcolepsy is not the most likely cause of feeling tired—it only affects between .03 and .16% of people globally—but it is a possibility. A neurological condition that affects your sleep-wake control, one of the main symptoms of narcolepsy is excessive daytime sleepiness, according to the Cleveland Clinic. Sleepiness typically strikes when you are sitting still or in a boring, monotonous situation (hello, morning meeting), and comes on as an irrepressible urge to snooze.

Loss of muscle tone (known as cataplexy) may also be a symptom, which shows up as a weakness in certain areas of the body—like the face, neck, and knees—when you laugh or get excited.

It’s not fair to blame everything on your period. You probably already point fingers at premenstrual syndrome for crankiness, but fatigue really is a big player when it comes to symptoms. “Feeling tired, even to the point of fatigue, is a common symptom of PMS,” says women’s health expert and media personality Jennifer Wider, M.D. The fatigue part is caused by a few different factors that create the perfect storm of tiredness, she says, including hormonal fluctuations, bloating, and sleep disturbances. Talk with your gynecologist if you’re experiencing out-of-the-ordinary fatigue or other symptoms. 

When you have seasonal allergies, you’re constantly trying to keep wheezing, coughing, and a runny nose at bay—all of which suck your energy and the very will to be productive. That’s because it requires your immune system to be in high gear to fend off allergens, Piper explains, and can leave you feeling wiped out as a result. (Depending on when they strike, allergy symptoms can also make it harder to get good rest if they interrupt your sleep at night.)

When you start to feel better after contracting a virus, it makes sense that your energy levels should rebound at the same time too. But, unfortunately, it can take a little time. Your immune system works really hard to fend off an infection and that requires energy, Piper points out. As a result, you can still feel a little run down, even as the rest of you is feeling better post-sickness.

Fatigue is a symptom closely related to depression. In fact, if you have depression, you’re twice as likely to experience fatigue compared to someone who does not.⁷ Additional depression symptoms include persistent feelings of sadness or hopelessness, not enjoying things you once did, irritability, appetite changes, and trouble focusing, among others.

Depression is a serious medical condition, so it’s important to seek help. If you have thoughts of self-harm or feel like you’re in a crisis, seek emergency medical attention or call the National Suicide Prevention Lifeline at 800-273-8255.

Depression isn’t the only mental health issue that can lead to feeling tired all the time. Things like everyday stress and worry can also contribute, but clinical anxiety is persistent and can lead to more prolonged fatigue. According to the National Institute of Mental Health, it can leave you exhausted and plagued with sleep disturbances.

Think about it: All of your energy is being channeled into feeling on-edge, which can really take a toll on your overall well-being. “Anxiety in particular can be draining,” licensed clinical psychologist Alicia H. Clark, Psy. D., tells SELF. If you suspect that you’re suffering from anxiety, it’s a good idea to reach out to a mental health professional if you can, as they will help you develop coping methods that can help you feel better.

Sleep can also be an issue if you have an adjustment disorder, which basically means you feel 10 times the amount of stress as other people when experiencing difficult situations, like divorce, having a baby, or losing a job.

Autoimmune diseases, conditions in which your own immune system mistakenly attacks parts of your body, can create a whole host of wildly different symptoms. One of the common ones, though, is fatigue, according to a 2019 study published in Frontiers of Immunology.⁸ These conditions can include but are not limited to:

• Rheumatoid arthritis
• Lupus
• Type 1 diabetes
• Psoriasis
• Psoriatic arthritis
• Multiple sclerosis

So, technically these are also autoimmune diseases, but they specifically affect your digestive system and can also cause constant exhaustion. Celiac disease is one possibility, where the immune system attacks the small intestine when you eat gluten, a protein found in wheat, rye, and barley (basically all the bread).

Some studies suggest as many as 100% of all people with celiac disease name fatigue as one of their main symptoms.⁷ You probably already know that people with celiac disease can get diarrhea, gas, and vomiting if they ingest gluten, but it can also cause people to feel weak or fatigued even without gastrointestinal issues, according to the Mayo Clinic. If you notice you don’t feel great after having wheat, barley, or rye products, talk to your doctor about getting tested for celiac disease.

Another possibility is inflammatory bowel disease (IBD), which includes ulcerative colitis and Crohn’s disease. These affect the G.I. tract, causing open sores. Fatigue is a very common symptom of both conditions, according to the National Crohn’s and Colitis Foundation, and could be due to a number of factors, including inflammation in the body.

Autoimmune diseases aren’t the only suspects when it comes to your health and feelings of exhaustion. Other types of chronic health conditions can also cause varying levels of fatigue. Things like fibromyalgia (a condition that causes muscle pain and tenderness), type 2 diabetes, chronic kidney disease, heart disease, and COPD can also be filed under energy-zapping conditions.

Chronic fatigue syndrome is a condition that affects up to an estimated 2.5 million Americans, according to the Centers for Disease Control and Prevention (CDC). Also known as myalgic encephalomyelitis, this condition causes severe instances of fatigue and exhaustion, especially after physical activity, that cannot otherwise be explained. Unfortunately, doctors don’t have a definitive test or treatments for chronic fatigue syndrome, meaning there’s still lots to be learned about diagnosing and treating this condition.

Your thyroid helps impact several important functions of your body, including how fast or slow your heart beats and how well your bodily movements flow, Piper says. Having an underactive thyroid, a condition known as hypothyroidism, can slow down your bodily functions and leave you feeling tired, she says. On the flip side, hyperthyroidism, which is when your thyroid is overactive, speeds everything up and can cause insomnia and an inner restlessness that makes it tough to relax—leaving you wiped out as a result.

Anemia happens when you don’t have enough healthy red blood cells to carry adequate oxygen to your body’s tissues. The result can be shortness of breath, dizziness, pale-appearing skin, problems tolerating exercise, and—you guessed it—fatigue. People with uteruses are especially vulnerable to anemia because of additional blood loss from their period.⁹

The most common cause of anemia is an iron deficiency, meaning you’re not getting enough in your diet or there are other things going on—like issues in the G.I. tract or even pregnancy. This type of anemia is treatable (usually via taking iron supplements), so don’t ignore this potential underlying symptom.

Leave it to 2021 to throw in a new reason why you may feel tired all the time: Post-COVID fatigue. Doctors are now identifying that more and more patients are experiencing what is known as post-COVID syndrome or “long COVID.” Those with long COVID have symptoms that include fatigue, “brain fog,” insomnia, and anxiety. The symptoms are very similar to those of chronic fatigue syndrome or myalgic encephalitis.¹⁰

The good news about this one is that post-COVID fatigue seems to be a pretty rare occurrence.

Medications and dietary supplements can contribute to fatigue. Examples include antihistamines, pain medications, some antidepressants, beta blockers, and anxiety-relieving medications.

Sometimes, it’s the combinations of medications and supplements that make you more tired than expected. That’s why it’s important you show your doctor a list of all the medications and over-the-counter supplements you take to review. Just note that you shouldn’t just stop taking your meds because you feel tired—always talk to your doctor first to make sure it’s the true cause and, if it is, if there are alternatives you can consider taking.

Postural orthostatic tachycardia syndrome (POTS) is a condition that affects mostly young women from their teenage years to their 40s. Those with POTS will typically have a significant heart rate increase when they go from sitting to standing that leads to really unpleasant symptoms like dizziness, chest pain, and a racing heart. The condition can also cause pronounced fatigue.

“Fatigue is for many patients their most disabling symptom,” Brent Goodman, M.D., a neurologist at the Mayo Clinic, tells SELF.

Up to 50% of people with POTS report having an infection that seems to come before their condition, he explains. “This is relevant to our current COVID pandemic in that some individuals with persistent symptoms following COVID infection have symptoms and testing that is typical of POTS,” Dr. Goodman says. With all the attention that COVID is receiving, he says the hope is that some of the research will be helpful in understanding the connection between COVID and POTS and how to treat it better.

In a word, yes. Feeling tired all the time has a number of effects on your body and mind. The National Safety Council estimates that costs related to sleep deficiency in the United States totaled more than $410 billion in 2015.¹ This includes factors like missed workdays, affected performance, and illness due to poor sleep.

Here’s another surprising fact: Sleep deprivation can impair you so significantly, it’s like you’ve been drinking. According to the CDC, being awake for 17 hours (or more) can have the same impairment effects as having a blood alcohol content of 0.05%. So, being tired isn’t just a nuisance, it can actually be downright dangerous.

Fatigue can be a vicious cycle. You’re tired, but you still have commitments at home. So you work more and don’t rest when you should. This makes you more tired at your job, and you feel mentally and physically drained.

You can’t keep doing the same thing and expect a different result. Here are some key ways to improve your sleep hygiene, according to a 2020 study published in the journal Sleep Health.¹¹

• Eat breakfast. Those who skip it are more likely to have sleep problems. Try to keep your morning meal balanced, too. A nice mix of protein, carbs, and fat can help you avoid an energy crash later on.
• Limit your daily caffeine intake. Caffeine is associated with getting less sleep, taking longer to get to sleep, and frequent wake-ups (from your bladder, most likely) at night.
• Maintain regular mealtimes. Eating regular meals improves your circadian rhythms—the internal system that lets your body know when it’s time to be awake and asleep. When your dinner is at least one to two hours before bed, you’re more likely to sleep better.
• Sneak in some movement. Aim to get 150 minutes of exercise a week, and try to reduce how much time you spend sitting. Remember, doing vigorous activities right before bed could mess with your sleep, so schedule your run at least a few hours before bedtime.
• Reconsider your evening drink. Drinking alcohol reduces deep sleep and overall sleep time. If you do enjoy an adult beverage, make it more like happy hour than a nightcap.
• Use light and dark to your advantage. Your body is heavily cued by light (to be awake) and dark (to be asleep). Make sure your bedroom is dark and avoid exposure to a lot of lights—like those of a cell phone or television—in your bedroom before you go to bed.
• Address ways you can reduce your job stress. Job stress is closely tied with fatigue and poor sleep. From finding ways to delegate work to making efforts to truly leave your work at the workplace, finding ways to de-stress is important to your fatigue levels, according to the Mayo Clinic.
• Set boundaries. This could be for social media, your family, or any other influence that can keep you up at night. Limit how much you consume—whether that’s putting your phone in a different room before bed or turning off the TV an hour before sleepy time— and learn to identify when an interaction isn’t benefiting you.

Of course, there are times when you’ve simply got to call your doctor to see if there is an underlying medical condition that’s causing your fatigue. They may suggest you get a sleep study to see what’s really going on during your nighttime zzz’s. Life’s too short to feel tired all the time, and there are so many treatment options that could help you live a less-fatigued life.

Additional reporting by Korin Miller.

Sources:

1. National Safety Council, Calculating the Cost of Poor Sleep
2. British Medical Journal, The Association Between Sleep Duration, Sleep Quality, and Food Consumption In Adolescents
3. British Journal of Nutrition, Influence of Progressive Fluid Restriction on Mood and Physiological Markers of Dehydration in Women
4. American Sociological Review, How Parents Fare: Mothers’ and Fathers’ Subjective Well-Being in Time With Children
5. Psychoneuroendocrinology, Co-variation of Fatigue and Psychobiological Stress in Couples’ Everyday Life
6. Technology, Mind, and Behavior, Nonverbal Overload: A Theoretical Argument for the Causes of ZOOM Fatigue
7. Thomas Jefferson University, Fatigue in Primary Care: Doctor, Why Am I So Tired?
8. Frontiers of Immunology, Fatigue, Sleep, and Autoimmune and Related Disorders
9. Archives of Clinical Infectious Diseases, Post COVID Syndrome
10. adolescents: A Cross-sectional Study Using the Korea Youth Risk Behavior Web-based Survey
11. Sleep Health, Which Sleep Hygiene Factors Are Important? Comprehensive Assessment of Lifestyle Habits and Job Environment on Sleep Among Office Workers

Related:

• 15 Sleep Apps for the Permanently Exhausted
• Is Sleep Apnea Genetic?
• 8 Reasons Your Eyes Look Tired That Have Nothing to Do With Sleep