If you rely on caffeine to power through the day or need to fight the urge to nap by midday, you’re not alone, but it’s not something you should ignore.
Fatigue is a common condition, and its symptoms go beyond just feeling tired. It can affect your physical health, emotional well-being and quality of life.
What is fatigue?
Fatigue is a persistent feeling of exhaustion or lack of energy that doesn’t improve with rest and can interfere with your life.
It can cause physical symptoms, like weakness, headaches and heavy limbs. It also can cause emotional and mental symptoms, like reduced motivation, brain fog, difficulty concentrating and forgetfulness.
“Many of my patients rank emotional symptoms like brain fog, trouble focusing, depression and anxiety as the most concerning,” said Tracy Ross, family medicine nurse practitioner with Sanford Health. “That’s when people often seek help because it’s starting to affect their jobs or lives.”
When fatigue occurs at least 50% of the time over a six-month period, known as chronic fatigue, it can affect the immune system, increase inflammation and make it easier to get sick.
What causes fatigue?
Fatigue is more common than you might think. It is ranked in the top 10 reasons patients visit primary care.
“I see patients for fatigue often, and more commonly in women than men,” Ross said.
There are many possible causes, which is why providers encourage patients to look closely at their daily habits and health.
Tracy Ross, APRN, CNP
Possible causes of fatigue include:
Behavioral: Poor sleep habits, staying up too late
Diet: Not getting enough fruits or vegetables or lacking nutrients
Medication: Fatigue may be a side effect
Mental health: Anxiety and depression
Health concerns: Thyroid disease, diabetes, heart conditions, anemia or hormone imbalances
Fatigue can also be temporary due to an illness or a recent stressful event.
“This could indicate your fatigue is a short-term problem and your body just needs more rest to recover,” Ross said.
Fatigue vs. tiredness
Waking up tired doesn’t automatically mean you’re experiencing fatigue. The difference lies in whether rest helps.
“Tiredness will usually respond to rest. If your symptoms are getting better after you rest, it’s probably just physiologic fatigue or tiredness,” Ross said. “Pathological fatigue means that no matter how much sleep you get, you’re still going to feel tired.”
If you’ve adjusted your schedule to allow for more rest and aren’t noticing improvement, it may be time for a deeper evaluation.
When to seek help for fatigue
“There are a few red flags that mean it’s time to see your provider. If your mental health is affected or if you’re noticing physical concerns, like falling asleep in traffic or it’s affecting your job and livelihood, seek care,” Ross said.
If you’re unsure, start by honestly reviewing your sleep habits:
Are you getting enough sleep at night?
Do you rely on caffeine throughout the day?
Do you use nicotine or alcohol?
Do you fall asleep watching TV or while using your phone?
“If you’ve made positive adjustments and feel you are getting enough sleep, but you still have fatigue symptoms, talk to your provider,” Ross said.
Primary care is the first step toward treatment
Your provider likely will review your schedule and ask questions including:
How much sleep are you getting?
When did your symptoms start?
Have you had any recent life changes?
Has your schedule changed?
“After we review your habits, if there’s not obvious changes we can make, I’ll check basic labs, like thyroid, blood counts, electrolytes and kidneys,” Ross said. “I’ll also look at your medication listing to see if any new medications have a side effect of fatigue.”
Screening for sleep apnea, depression and anxiety may also be part of your appointment.
Treatment is available
Once potential causes are identified, your provider will work with you to address them.
“If we can’t identify a specific cause, I’ll recommend a strict sleep and sleep hygiene journal to document your habits for about a month to see if there is improvement,” Ross said. “You might not be getting as much sleep as you think.”
Medications may be used in some cases to help with sleep or daytime energy.
“We try to improve sleep naturally and avoid stimulants and sedatives, when possible,” Ross said. “But medications can be helpful while we continue to work on resolving the underlying issues.”
Lifestyle changes that may improve fatigue include:
Having a consistent sleep schedule
Getting enough sleep for your needs
Avoiding screens at bedtime
Limiting caffeine and nicotine use at night
Exercising during the day
Eating a balanced diet
It’s OK to take a break
Just like a car, our bodies need maintenance.
“We’re always trying to get more out of the day. People might work all day, get home, start cooking supper or exercise and then stay up late because that’s the only time we can watch our shows,” Ross said. “We’re burning the candle at both ends, but we’re forgetting to prioritize rest.”
This doesn’t mean just closing your eyes.
“It’s more than just sleeping,” Ross said. “It’s emotional and mental rest, too. Lying down doesn’t help if your mind doesn’t slow down.”
Most importantly, know that you don’t have to be tired.
“It isn’t normal, but we live in a society where everyone expects it to be,” Ross said. “If you’re tired, talk to your provider.”
If you’re concerned about fatigue, schedule an appointment with your primary care provider. To find a primary care provider near you, visit sanfordhealth.org.
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Family Medicine, Healthy Living, Internal Medicine, Jackson