TIREDNESS

Tiredness is also known as fatigue. It affects most people at some point in their lives. Tiredness usually goes after some relaxation and a good night's sleep. You then feel refreshed and ready to face your usual activities.

A few people have a long-term disabling tiredness known as myalgic encephalomyelitis (ME) or chronic fatigue syndrome (CFS). For information, see Related topics.

Causes

Often tiredness is due to a combination of causes. Nine in 100 people with tiredness will have a physical disease. Around 75 in 100 people will have an emotional cause.

Physical causes

Being tired may mean you avoid physical activity. However, as you become more unfit you will be even more tired when you try to do something. When you are chronically tired this can become a vicious cycle.

Being overweight or underweight can cause tiredness. If you are overweight your body has to work harder than normal to do everyday activities. If you are underweight you have less muscle strength, and you may feel tired more quickly.

Conditions such as anaemia, an underactive or overactive thyroid and asthma can leave you feeling tired. For information, see Related topics.

Sleep problems, such as insomnia and sleep apnoea (abnormal breathing while asleep), can also stop you getting a good night's sleep. This is particularly problematic in those who are overweight. Pregnancy is another common reason for severe tiredness.

Emotional causes

Stress and worry are tiring emotions. Facing a stressful situation can be draining, especially when you can't see a solution to your problems. Feeling that you have no control over a situation may make you frustrated, irritable and tired.

Tiredness can also be triggered by stressful situations. This may include a recent bereavement, financial circumstances, moving house, family issues or work problems.

Mental health problems such as depression or anxiety can make you feel more tired. They can also prevent you from sleeping properly.

Lifestyle

If you have an unusual or disturbed sleep pattern, for example if you are a shift worker, nurse, doctor or nursing mother, you may find it difficult to get refreshing sleep. Try not to focus or worry about your disturbed sleep routine as this may further disrupt your sleep.

Looking after small children can be particularly exhausting, especially if children don't sleep through the night.

Sleeping in the day can prevent you from sleeping at night. Drinking too many caffeinated or alcoholic drinks can also make it difficult to get refreshing sleep, especially if you drink them just before you go to bed.

Treatment

You can often begin to overcome your tiredness with some simple measures.

Sleep routine

Try to improve your sleep routine using the sleep hygiene measures listed here. It helps to:

• go to bed and get up at the same time every day
• not take naps during the day
• develop pre-sleep rituals which will act as a cue to your body that it's time to sleep - such as having a warm bath or reading for a few minutes
• ensure that your bedroom is quiet, dark and comfortable, and that it's neither too hot nor too cold
• not have caffeinated drinks or smoke before bed
• eat heavy meals earlier in the evening - if you are hungry have a light snack before bed, such as milk, which may help you sleep
• find time to relax before bed - relaxing music or a warm bath can help
try to get problems and worries out of your head, perhaps by writing your thoughts down in a diary before you go to bed
• only use the bed for sleep and sex and not for work or watching TV - associate the bed with sleeping

Food and drink

What you eat and drink can have a big impact on how you feel. It can help to:

• ensure that you eat a balanced diet and have regular meals - even if you don't feel like cooking, for information see Related topics
• cut down gradually on caffeine and alcohol - especially in the evenings
• gradually increase your portion sizes and your overall calorie intake if you are underweight
• control your weight by increasing the amount of exercise you do and eating less if you are overweight

Physical activity

Being unfit makes you susceptible to tiredness. And being tired often means you don't exercise enough. Try to break out of this cycle.

• Introduce physical activity into your routine, gradually increasing the duration and intensity. Aim to do 30 minutes of moderate-intensity physical activity on at least five days a week.
• If you exhaust yourself for some reason, don't give up. Do a small amount of exercise again the next day and gradually increase the amount.
• Exercise at least three hours before bed, as exercise can invigorate you.

For information, see Related topics.

A balanced lifestyle

Think about what you could change to achieve a more balanced, stress-free lifestyle.

• Have realistic expectations about what you can achieve and aim to gradually increase what you can manage over time.
• Learning to relax will help to improve sleep and to relieve stress-related symptoms such as frustration, irritability and tiredness. Your GP surgery or local library may have details of local adult education classes, books, CDs or website that can help.
• Write down a list of things that may make you feel tired, such as family or work pressures. Are there ways that you could avoid overburdening yourself in the future?