“Why am I always tired?” is one of the most frequently asked questions on the internet. There are several potential causes for ‘being tired’. Here, we will discuss the causes of being tired. First, it is important to determine what is meant by ‘being tired’.

Let’s first discuss the word ‘Tired’.

The word “tired” can mean different things to different people. Clinicians usually try to differentiate if the person has fatigue or excessive daytime sleepiness.

Fatigue generally refers to the sensation of not having enough energy to complete certain tasks. The differential diagnosis (potential causes) of fatigue is very long. The list includes medications, anemia, depression, medical disorders, and many other causes.

Excessive Daytime Sleepiness, or EDS, has a much shorter list. However, the list is still long. Generally, the list includes causes that interfere with quality or quantity of sleep.

Causes of Excessive Daytime Sleepiness 

Many of the causes of Excessive Daytime Sleepiness include sleep disorders, such as sleep apnea, insomnia, circadian rhythm disorders, narcolepsy, and other sleep disorders.

Let’s return to determining the difference between fatigue and sleepiness. With fatigue, a person will usually complain that he or she does not have enough energy to get going, or to do certain things. But, when they close their eyes sitting or laying down, they do not fall asleep. This is an important point in differentiating the two symptoms.

With EDS, obviously when the person does sit or lay down for a rest opportunity, the person does fall asleep.

What can I do to be more alert and less sleepy?

There are many things that you can do to be less sleepy. Once you know what the cause is, then you know where one of the fixes might be. A good start with improving daytime alertness is following good sleep hygiene. This includes getting adequate total sleep time. It also includes avoiding alcohol and caffeine before bedtime, not watching TV or reading in bed, and have a comfortable, quite, and dark bedroom.

Yes, people can have, and often do have, both complaints. It is also common for someone to have more than one problem. To start, it helps to know the difference between Excessive Daytime Sleepiness and fatigue. Instead of asking, “Why am I always tired?”, the question should be “Why I am always so sleepy?” or “Why I am I always so fatigued?”.  Once this has been determined, the next step is to figure out why.

In the following pages, we will explore some of the many sleep disorders that contribute to being sleepy. Part 2 – Sleep Disorders