| Why am I so tired? |
Check out these common causes of fatigue and the best counter-strategies
Phillip Holden
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Chances are you know the drill. The workday’s not over, but your energy is headed south, big time. It’s mid-afternoon and lethargy, fatigue and drowsiness are moving in fast. You should be blasting through that report for tomorrow’s big meeting, but instead of reading, you’re…fighting…to…keep…your…eyes...open...
Cameron Morch, 36, a Toronto television producer, was feeling completely exhausted. His high-demand work life — made up of equal parts heavy workload and less-than-smooth relationship with his boss — took a toll on his sleep. During the day, he felt nauseated and unable to eat. His commitment to exercise — once an important outlet for stress — was no longer possible, thanks to his “bust your chops” schedule. On weekends, instead of enjoying time with his young family, he found himself sitting on the couch and falling asleep. “For me, fatigue was the energy vampire,” says Cameron.
While Cameron’s situation may sound extreme, fatigue, in the form of daytime sleepiness and perhaps a leaden feeling where energy used to be, is an all-too-common complaint for many Canadians of all ages and walks of life. Everyone is being asked to do more with less and to work harder for longer periods. But a fast-forward lifestyle, whether you’re working in an office or at home, may not always be the culprit. Here are eight of the most common causes of fatigue and what you can do about them.
1. Not enough sleep
Most adults need at least seven or eight hours of sleep a night. Chronic sleep deprivation can have a negative impact on your health and, in the short term, can leave you feeling frazzled and unable to concentrate. To improve the odds of getting the right amount of sleep, turn your bedroom into a tranquil sleep sanctuary. This means no television, laptops, cellphones or other hand-held communications devices. Create a pre-bedtime relaxation routine (otherwise known as good sleep hygiene) with the following: a glass of warm milk (tryptophan, an amino acid found in milk is sleepinducing), meditation, soothing music or a warm, not hot, bath. And strict bedtimes are not just for kids; get to bed around the same time each night.
2. Poor-quality sleep
If you’re getting the right amount of sleep each night but still feel tired, you may not be getting a quality sleep. Sleep apnea, a common sleep disorder characterized by hundreds of breathing pauses, is the leading cause of excessive daytime sleepiness. Breathing pauses reduce the amount of oxygen the body receives during sleep and can occur from five to 30 times (or even more) an hour. A loud snort or choking sound usually heralds the return to normal breathing in sleep apnea, which often goes undiagnosed until a family member complains.
Sleep apnea must be diagnosed through a referral to a sleep centre, and it’s treated with continuous positive airway pressure, which delivers oxygen during breathing pauses. For those with severe sleep apnea,” says Dr. Lydia Hatcher, a family physician in Mount Pearl, N.L., treatment can turn your life around. “Patients can go from barely being able to function during the day to waking up feeling refreshed, getting back on track with diet and exercise, and doing all the other things they couldn’t before because they felt so tired,” she says.
3. Not enough fuel
The foods you eat and the times at which you eat them can have a huge impact on the ebb and flow of your energy throughout the day. Not fuelling your body properly, especially in the morning, can leave you feeling not only extremely fatigued but also irritable, unable to focus and emotionally down in the dumps. It can also interfere with digestion, making you feel gassy and bloated. Stress at work and long hours can also contribute to making poor food choices, including foods loaded with sugar, which may cause a spike in blood sugar followed by a precipitous drop. This process, known as reactive hypoglycemia, can lead to sleepiness.
One of the best ways to fuel your body for energy that lasts throughout the day is to eat a good breakfast, say nutrition experts. The meaning of the word, after all, is literally to break your fast, points out Martha McCarney, a Toronto-based registered dietitian with EatRight Ontario, a free governmentsponsored nutrition call centre. “How can you run your engine after going for six or eight hours with no fuel?” she asks.
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The best breakfast combines a complex carbohydrate (e.g., a high-fibre cereal or bread) with some protein (e.g., peanut butter, milk, yogourt or an egg). This combo provides a slow, steady source of energy throughout the morning. Aim for a breakfast cereal that contains no more than 15 grams of sugar per serving (check the nutrition label) and at least five grams of bran or oat fibre.
If you don’t have time for breakfast, grab a banana or a yogourt on your way out the door. When you get to work, take five minutes to eat something you brought for lunch. “Before you turn on your computer and get engrossed with the daily tasks at work, eat part of your lunch and get your metabolism started,” advises Samara Felesky-Hunt, a registered dietitian and nutritionist at The Downtown Sports Clinic in Calgary. “That’s a really good way to boost your energy right away and also prevent fatigue later,” she says.
Okay, about that lunch. Don’t skip this meal, either. But it means being prepared, particularly if you work in a superbusy office where lunch is sometimes difficult to take. Prevent the post-lunch energy letdown by bringing in non-perishables: canned salmon and tuna and high-fibre crackers. Stock the office fridge with milk, yogourt, fruit and vegetables. “You spend 60% of your waking time at work, so bring in 60% of the food you consume every day,” advises McCarney.
Half of your lunch should consist of an assortment of vegetables; the other half should consist of lean protein with some whole grains. Drink a glass of milk — low-fat dairy, soy, rice or almond — to boost lean protein. And keep lunch small so blood sugar levels and energy remain stable during the afternoon. A big carbohydrate-laden meal at noon will send blood to the stomach to help with digestion, leaving you feeling lethargic and fuzzy-headed. “I call it the ‘three o’clock slump’ or the ‘four o’clock drop,’” says Felesky-Hunt.
If you’re hungry mid-afternoon, have a highfibre snack: a handful of almonds or walnuts with a glass of milk; a piece of cheese with a whole-grain cracker; or fruit, veggies and hummus dip. “Eating small amounts five or six times a day helps to stabilize blood sugar and energy levels,” says McCarney. Avoid sugary snacks such as candies, cookies and doughnuts.
4. Excess caffeine
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Too much of this pick-me-up can also let you down. Health Canada now recommends a daily caffeine intake of no more than 400 milligrams (300 mg for women of childbearing age). This translates into three eight-ounce coffees or one Starbucks Grande. Since caffeine stays in your system for up to eight hours, in the interest of that good night’s sleep, a mid-afternoon coffee is not recommended, says McCarney. Instead, have a decaf latte, which is three-quarters milk and one-quarter decaf coffee. Even better, have a herbal tea, hot apple cider or hot chocolate made from real milk. According to research at Yale University, caffeine can drive low blood sugar levels even lower, says Felesky-Hunt. “When it comes to caffeine, sometimes going downstairs, going out for a walk, just getting out of the office is all you need — instead of, ‘I need a break. I’m going for a coffee,’”she says. “It’s just about changing your environment. Recognizing this helps.” Moving to two or three cups of decaf green or white tea every day steers you clear of energy-sucking caffeine and provides you with health- promoting antioxidants.
5. Dehydration
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Not being properly hydrated can cause sluggishness and fatigue during the day. “To have good energy, every cell in the body needs to be well hydrated,” says Felesky-Hunt. Health Canada recommends 2.7 litres of water daily for women and 3.7 litres for men. Some of this can come from other sources such as milk and diluted juice. Eating more fruits and vegetables will also help you to meet daily fluid requirements. (Coffee and tea are almost 100% water but are not recommended as healthful ways to meet daily fluid intake needs, says McCarney.) If you get distracted at work, set the alarm on your cellphone or your computer to remind yourself to get up and have a drink four to six times a day. “Walking to the cooler or wherever you get your water also gives you a little break, and that helps combat fatigue,” notes McCarney. Fill up a big jug with water and float orange slices, cucumbers, lemon or lime in the water — whatever’s in season to make it more interesting.
Plan to get 80% of your daily fluid by 2 p.m. or 3 p.m., advises Felesky-Hunt, noting that fluid intake after 4 p.m. will rehydrate your body for tomorrow.
6. Anemia
Women with heavy menstrual periods are particularly at risk of iron-deficiency anemia. This energy sapper is caused by insufficient iron in the diet that robs the body of oxygen-carrying hemoglobin found in red blood cells. Women with iron-deficiency anemia may not even be aware of their condition, notes Hatcher. But the condition can weaken the immune system, resulting in increased susceptibility to viral infections, including coughs and colds. (Ironically, those with anemia usually get lots of sleep because they feel so tired.)
Anemia can be diagnosed with a simple blood test and treated with more iron-rich foods added to the diet. In addition to red meat, good sources of iron include green leafy vegetables, molasses and dark legumes such as kidney beans. “I always tell patients that if they don’t eat red meat or are vegetarian, they should take a vitamin with iron,” says Hatcher. “Even cooking in a cast-iron pan can add iron to your diet,” she adds. Anemia can also be caused by vitamin B12 deficiency, which can be treated with oral supplements.
7. Undiagnosed diabetes
You’re eating well and getting lots of sleep but still have chronic unexplained fatigue. What’s the problem? See your physician about being tested for diabetes, a disease that can have a profound effect on energy levels because it changes how the body metabolizes blood glucose. If you have diabetes or an early form of the disease — known as insulin resistance — your doctor may recommend lifestyle modifications, including diet changes and exercise, as well as medication.
8. Workplace-related stress and depression
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You may recognize that your workplace is stressful but not be aware of the impact it’s having on your health. You may not be sleeping well or find that you’re having difficulty concentrating. “If you’re going to bed tired and waking up tired, you have to look at both your work and home environments. “It’s a chicken and egg thing,” notes Hatcher. “Workplace stress can sometimes be caused by issues going on at home, either personal or physical.” She suggests that you evaluate what you can control and what you can’t. “You may not be able to control a boss who is not a very nice boss,” she points out. Similarly, if restructuring and downsizing are going on and you’re worried your job may be affected, talking to someone can make a big difference. Most larger employers offer an employee assistance program, a free and confidential resource that can help you get help.
Take good care of yourself: get a good night’s rest, exercise, relax, have some downtime and get involved in other activities, such as getting together with friends or volunteering somewhere.
Ongoing stress can lead to clinical depression, and, unlike stress, which can be self-managed, depression requires a physician’s attention. “With stress, people need to be able to change things for themselves,” notes Hatcher, “whereas with depression, they have reached the point where they literally cannot help themselves.” In addition to counselling, you may need medication and ongoing psychotherapy.
An underlying medical condition such as thyroid disease can also induce fatigue, but the above are the common culprits.
As for Cameron, the stressed-out television producer, he took a leave from work to try to sort things out. He says he took every opportunity to de-stress his body. “I went for walks. I walked my dog. I went to the cottage and read the paper every day, front to back, sitting in the sun.”
He also sought professional help and went on antidepressants, which helped him get to a place where he could get more actively involved in making lifestyle changes to alleviate stress. Once Cameron started to sleep better, the nausea went away, and he was able to eat better. As for his workplace, that’s another matter that may well take longer to resolve.
