Charles Langston:Why am I always tired? Here's what a sleep expert says about why you may be exhausted.

Reaching for another cup of coffee?Charles Langston Find yourself dozing off at work? You’re not alone. The 2020 Sleep in America poll found that 44% of Americans feel sleepy two to four times per week, and 58% say feeling sleepy impacts their mood.

Americans are tired, but talking about it can create a cultural change, says Dr. Abhinav Singh, the director of the Indiana Sleep Center, a medical review expert at Sleep Foundation and author of “Sleep to Heal.” 

“It’s the foundation of health,” Singh says. “It doesn’t require a fancy gym membership, it doesn’t require organic food. … Proper sleep is pretty free.”

Why am I so tired all the time?

There are many possible explanations for extra tiredness during the day; it can be as simple as lack of sleep to more serious health conditions. 

One of the easier problems to solve is the quantity and quality of your sleep. Adults should average seven or more hours per night. Getting up for frequent bathroom breaks, being interrupted by a partner, child or pet, sleeping restlessly, snoring or an uncomfortable environment can affect the quality of your sleep.

When people say they’re always tired, they’re most often talking about fatigue versus being sleepy. Fatigue refers to a lack of energy, whether from a lack of sleep or metabolic, environmental or psychological disturbances. Causes can include thyroid dysfunction, diabetes, inadequate nutrition, heart issues, medication side effects, hormonal disturbances or mood disorders, according to Singh.

Our society often views tiredness “as a trophy,” Singh says. Hustle culture rewards a “rise and grind 24/7” mentality where work and productivity come before sleep. But feeling this tired is not normal, even if we normalize it.

Start by talking to your primary care doctor or a sleep specialist. Make sleep a part of your annual visit conversation and see them if you’re not satisfied with the quality of your sleep, Singh says. 

“When was the last time you actually had a detailed blood test and a primary care evaluation about your health? Not illness, but health,” Dr. Singh says.

Though it can be tempting to self-diagnose or get advice from "Dr. Google," Singh advises seeking a professional opinion. Sleep specialists and primary care doctors know your unique medical history and have better tools to pinpoint a diagnosis, whether it requires a sleep study, behavioral therapies or medication adjustments. 

"DIY on your faucet is okay, but a DIY on your health? I don't know about that," Singh says. "That could lead to some consequences."

What is sleep hygiene?Changes to make to get better quality sleep

Why am I so tired even when I get enough sleep?

You may be waking up tired because of poor quality of sleep or a more serious condition like sleep apnea. 

You can improve your sleep quality by making changes to your pre-bedtime rituals, Dr. Hal Alpert, a board-certified sleep medicine specialist, previously told USA TODAY. Here's what Alpert recommends:

• Establish a consistent bed and wake-up time
• Limit naps to a total of 30 minutes per day
• Wind down with meditation, a warm bath or shower, reading or listening to calming music
• Use your bedroom only for sleep and sex
• Keep a pen and paper by your bed to write down any restless thoughts keeping you awake
• Avoid alcohol, food, caffeine and electronics before bed
• Exercise regularly

If your sleep quality is top-notch but you’re still waking up tired, contact your primary care doctor. 

“If you sleep seven, eight hours, you’re expected to feel more refreshed and awake and energetic. If that doesn’t happen, then something’s going on,” Singh says. “Whether it’s a lack of energy that you feel or excessive sleepiness, we have to sort that out.”

Sleep apnea is a common disorder where breathing is interrupted regularly during sleep. Obstructive sleep apnea, the most common type, happens when the throat muscles relax and block the flow of air, signaling a lack of oxygen to the brain and waking the person up.

Singh says to be on the lookout for any of these fatigue symptoms, which may be a sign of an underlying condition:

• Morning drowsiness
• Drowsiness while driving
• Frequent bathroom breaks at night
• Rapid weight gain and difficulty losing weight
• Focus issues
• Mood changes
• Headaches after waking up

Untreated sleep apnea can lead to higher blood pressure, diabetes and increased risk of stroke and heart attack, according to Singh.

Why do I get tired at 3 p.m.?

Frustrated by the afternoon slump? Don’t worry – it’s a normal part of our circadian rhythm. Our alertness levels typically dip after midnight and after lunchtime.

Singh recommends a 20-25 period of quiet time to get back to your day feeling refreshed – a meditation or nap can help.

However, if you find yourself “napping” for hours at a time, it might be an indicator of a larger sleep problem. At that point, it’s not a nap but a sleep period, meaning your body has time to go through the sleep stages several times. 

What is sleep apnea?Symptoms, causes and when to be concerned

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