Do you crave sleep? Do you drag yourself from your bed in the morning already looking towards the moment you can climb back under the duvet? Or does it sometimes feel as though you’re stuck in first gear and just can’t find the energy to shift up? If so, you’re not alone.
Unexplained tiredness is one of the most common reasons for people to see their GP [1]. At any given time, one in five people feel unusually tired, and one in ten have prolonged fatigue [2], but it’s not always easy to understand why we feel this way and what, if anything, we can do about it; many of us simply accept tiredness as an unavoidable consequence of our busy lives and carry on regardless. But feeling tired all the time can have an enormous impact on our quality of life – and could be an indication that there’s something medically wrong – so it’s something you shouldn’t ignore.
Fatigue can be caused by many factors and these often work in combination with each other. Jermaine Izukanne , physiologist at AXA PPP healthcare looks at the symptoms and causes of fatigue and offers up some top tips to get you firing on all cylinders this festive season.
What is Fatigue?
Fatigue is a feeling of extreme tiredness. While there is a difference between physical and mental fatigue, they often occur together. Fatigue is most prevalent in individuals who are defined as middle aged (45 to 65 years); research also suggests that this demographic sleep the least [3], which doesn’t help matters!
Symptoms of Fatigue
Feeling tired is a general – and obvious – symptom of fatigue, but there are others, including:
- headache
- dizziness
- slowed response and reflexes
- lack of concentration and poor decision-making ability
- lack of motivation
- aching and weak muscles
- feeling moody and irritable
These symptoms can be a result of various causes, as listed below and some of these causes can work together in combination.
Causes of Fatigue
Medical causes – fatigue is a symptom commonly seen in a variety of illnesses, including sleep apnoea, diabetes and heart disease. It can be a sign of kidney disease, hypothyroidism and anaemia; and is also an early indicator of pregnancy! So, if you are experiencing frequent or prolonged periods of tiredness or any of the symptoms described above it would be advisable to see your GP to rule out a medical cause.
Workplace and screen-related causes – work-related stress and prolonged or excessive screen time during the working day have been shown to cause feelings of fatigue [4], as well as headaches, sore eyes and other unpleasant symptoms that exacerbate that feeling of tiredness. They can also make it harder for us to sleep.
Even if your brain doesn’t go into overdrive with work worries the moment they get a shoe-in, there’s the physiological effect of looking at a screen for a large part of the day. Numerous studies have concluded that the blue light from screens can affect the amount and quality of sleep we get, because it disrupts the body’s production of melatonin. This is the hormone that regulates our circadian rhythms and which would, in our natural state, be triggered by nightfall, helping us to feel tired and fall asleep at the end of the day.
Clocking up even more screen time, watching TV or catching up on social media when we get home ramps up the effect of a day spent working at a computer, exacerbating the problem. By way of example, in one small study, participants who spent 4 hours reading e-books before bed for 5 nights produced 55% less melatonin than participants who read print books; they also reported being more alert before bed, taking longer to fall asleep and being more tired in the morning.[5]
Lifestyle choices – excessive consumption of caffeine, alcohol and/or drugs, lack of exercise and poor dietary choices are common causes of fatigue that can quickly lead to unhelpful cycles that amplify the effects. For example, how often do we turn to coffee to kick start our day or a glass of something in the evening to perk ourselves up, when actually both are sleep disruptors that may be contributing to our fatigue in the first place?
Similarly, heavy food and a lack of fitness aren’t the greatest foundations for getting active, and if you’re not exercising your fitness is going to decrease and you may find yourself with more sedentary time when you’re inclined to snack.
We’re not saying you should stop doing the things you enjoy, or be out training every day, just that if you’ve ruled other causes out and you’re still feeling sluggish there may be elements of your lifestyle you can tweak to help tackle your tiredness.
Stress and mental fatigue – depression and grief can place a mental strain on the mind, which can affect motivation and lead to irritability [6]. This makes perfect sense, but what may be less obvious, and is important to bear in mind, is that it’s not just the bad stuff that takes its toll. Positive events, such as getting married, moving house – even going on holiday – can be similarly stressful and draining, but it can be harder to accept that we may be struggling when we’re ‘supposed’ to be happy. The solution? Try to accept it, get a little perspective, delegate if you can, and focus on the destination, not the getting there.
What Else Can I Do To Prevent & Overcome Fatigue?
The good news is that for most of us fatigue doesn’t have to be a fact of life and there are plenty of simple everyday things you can do help boost your energy and banish long-term tiredness for good.
Nutrition
Adequate nutrition is essential for a healthy lifestyle and balanced diet, and can help boost your energy. Be sure to always eat breakfast: a healthy breakfast such as rolled oats topped with banana and blueberries provides you with vitamins and minerals that stimulate the process of energy production.
Some examples of energy boosting foods include:
- Rolled oats
- Fruit and vegetables
- Hummus
- Edamame
- Chickpeas
- Brown rice
- Nuts and seeds (flax, chia and pumpkin seeds)
Feeling fatigued could also be the result of having an iron deficiency [7]. Consider eating adequate amounts of iron rich foods, such as:
- Chicken
- Turkey
- Beans
- Lentils
- Iron fortified cereals
- Whole grains like quinoa and amaranth
- Leafy greens
- Baked potatoes
Ensure that you’re also drinking plenty of water to prevent dehydration, as this is known to decrease energy.
Take a look at our article for more nutrition tips to help increase your energy levels from AXA PPP healthcare registered nutritionist, Georgina Camfield.
Sleep
Sleep is arguably the most important contributing factor affecting our energy levels, but something that’s frequently sacrificed thanks to a busy lifestyle. The Sleep Council’s latest survey found that almost three quarters (74%) of people in the UK sleep for less than 7 hours a night [8].
Much of how you feel when you are awake is impacted by the quality of your sleep, so getting long-lasting, good quality sleep is essential for our body to rejuvenate, build muscle and grow, as well as to resynthesize hormones and maintain energy levels.
When it comes to how much sleep we need, that’s very much down to the individual, but experts typically recommend aiming for around 7-9 hours a night.
Some tips for improving sleep:
- Avoid bright lights, especially those coming from TV’s, laptops and e-readers; as we’ve seen this restricts the release of the chemical melatonin, which helps us fell sleepy and ready for bed [9].
- Set a regular time for going to sleep and waking up to help your body get into a routine.
- Refrain from doing work tasks late at night, as they can be stressful and keep you up awake.
- Try taking time before bed to do something you find relaxing to clear your mind, reduce stress and prepare the body for sleep.
- Refrain from eating heavy meals late at night and foods such as chocolate, fatty or spicy foods, caffeine and alcohol, all of which can disrupt sleep.
- Try keeping track of sleep duration and quality using a Fitbit, or sleep trackers such as Sleep Cycle, Sleep Better or Calm. These can give you a better idea of your sleep patterns and help monitor whether any changes you make to your lifestyle or your routine have the desired effect.[10]
You can find more tips and information from our clinical experts on our sleep hub. Or take a look at this recent article, where guest author and fitness expert Shona Vertue shares her tips for a better night’s sleep.
Exercise
While it might seem ironic that, when feeling exhausted, one way to tackle this is to do more physical activity, the relationship between exercise and an increase in energy levels is a well-established one. Regularly getting active has been found to decrease fatigue, increase physical health and good strength [11]; it can also build up your resilience to stress [12].
Furthermore, physical activity can help to reduce fatigue by improving your quality of sleep. The better the quality of sleep you have, the easier it is for your body to regulate the necessary processes needed for day-to-day life.
By contrast, a lack of activity can lead to weight gain and deconditioning, making it more difficult to carry out tasks that require physicality, such walking up the stairs. If this is something you struggle with, it’s really worth trying to increase your activity levels. It may feel difficult at first, but it’s one of the most effective ways of boosting your overall health and wellbeing and the more exercise you do, the more energised you’ll feel. This is because your body will start to create more mitochondria, which are the ‘powerhouses’ of your cells; with increased mitochondria, your body can produce energy more efficiently.
Regarding mental fatigue and stress, exercise promotes the release of ‘feel good’ hormones called endorphins. This can help to create a ‘buzz’ within the body that makes you feel better about yourself, and motivated to exercise more regularly.
Some top tips for increasing your activity levels include:
- Aim to do regular moderate intensity exercise for a minimum of 30 mins a day, five days a week
- If time to exercise is minimal, try to fit something into your day at work e.g. a 15-minute jog/brisk walk during your lunch break
- Set goals for yourself so that you have something to work towards and increase motivation
- Pay attention to how your body and mind react to exercise: did you sleep better? Did you feel better the next day?
For more tips, information and inspiration to get you moving more and keep you motivated, from our team of physiologists, personal trainers and wellbeing programme managers, visit our fitness and exercise hub.
References
1. Sleep and tiredness – NHS Live Well.
2. Tiredness – Royal College of Psychiatrists.
3. Sleep Aids UK Report 2017 – Mintel.
4. Sharpe M, Wilks D. Fatigue. BMJ. 2002;325(480–483).
5. What staring at a screen all day does to your brain and body, David Anderson and Rebecca Wilkin, 8 Feb 2019 – Business Insider.
6. G.E. Hardy, D.A. Shapiro, C.S. Borrill Fatigue in the workforce of national health service trusts: Levels of symptomatology and links with minor psychiatric disorder, demographic, occupational and work role factors. Journal of Psychosomatic Research. Volume 43, Issue 1, July 1997, pages 83-92.
7. Anaemia – NHS factsheet.
8. The Great British Bedtime Report 2017 – The Sleep Council.
9. How to get to sleep – NHS factsheet.
10. How do sleep trackers work – No Sleepless Nights.
11. Wenzel JA, Griffith KA, Shang J, et al. Impact of a home-based walking intervention on outcomes of sleep quality, emotional distress, and fatigue in patients undergoing treatment for solid tumors. Oncologist. 2013;18(4):476–484. doi:10.1634/theoncologist.2012-0278.
12. Childs E, de Wit H. Regular exercise is associated with emotional resilience to acute stress in healthy adults. Front Physiol. 2014;5:161. Published 2014 May 1. doi:10.3389/fphys.2014.00161.
13. Witlox L, Hiensch AE, Velthuis MJ, Steins Bisschop CN, Los M, Erdkamp FLG, Bloemendal HJ, Verhaar M, Ten Bokkel Huinink D, van der Wall E, Peeters PHM, May AM. Four-year effects of exercise on fatigue and physical activity in patients with cancer. BMC Med. 2018 Jun 8;16(1):86. doi: 10.1186/s12916-018-1075-x.
