Still Sleepy?

Still Sleepy.jpeg

A couple of weeks ago, I posted about the importance of sleep. It would have been better if I had written about the importance of lack of exhaustion. As I began to catch up on sleep, I still couldn’t shake the feeling of being tired all the time. It was better, but still present enough to be a stumbling block. So I began to consider other possible causes. Sometimes exhaustion has nothing to do with how much sleep you get. Chronic and autoimmune conditions that affect hormones or metabolism can be just as guilty. Turned out adjusting my blood pressure medication did wonders, so let’s start with that one:

Hypertension (high blood pressure): Tiredness is a common symptom of hypertension. It causes the constriction of tiny arteries called arterioles. Your heart has to work harder to pump blood throughout your body, which makes you tired and out of breath. Risk factors for high blood pressure include diabetes, being overweight, lack of exercise, race, gender, smoking, and drinking.

Anemia (iron deficiency): Your red blood cells come equipped with hemoglobin, an iron-rich protein that bonds to oxygen molecules and distributes the oxygen to the rest of your body. When there isn’t enough iron in your red blood cells, your tissues don’t get the oxygen they need (including your brain). Lack of oxygen makes you tired, too. Many things can cause anemia, even something as simple as an iron-deficient diet or a heavy period. Chronic conditions like cancer, HIV/AIDS, rheumatoid arthritis, kidney disease, Crohn's disease, and other chronic inflammatory diseases can also cause anemia. (Please note that there are multiple types of anemia, but here I am talking about simple iron deficiency.)

Hypothyroidism (Thyroid imbalance): Hypothyroidism is when your body doesn’t produce enough T3 and T4, the hormones that regulate your body’s internal temperature, metabolism, and heart rate. It is not uncommon for hypothyroidism to go undiagnosed. As with other types of hormone deficiency, your body has to work harder to function properly, which makes you tired. But with hypothyroidism, exhaustion can come from too many directions to list here. Read this for an explanation of most of them.

Sleep apnea: Sleep apnea is when you don’t breathe properly while you are asleep. Instead of breathing evenly, you briefly stop breathing and/or breathe shallowly. Disrupted sleep causes exhaustion during the day just like hypothyroidism. Symptoms like exhaustion and snoring are commonly accepted as “just life,” so sleep apnea can go undiagnosed for a long time.

Undiagnosed condition. There are a lot of conditions that cause exhaustion even when they are being treated properly. Before they are diagnosed, or if they are misdiagnosed, it can get extreme. For example, before I was diagnosed with diabetes, I was sleeping 14 hours a night and still falling asleep in second period. No one bothered to mention that to my mother, so I continued misdiagnosed for several months. In fact, it was when I told my mother that I was too tired to school, she had me tested. (After responding, “Not in my house, you’re not.”) And if your condition is one that can cause dramatic weight loss, that’s like a double whammy – all you systems slow down and you enter starvation conditions, even if you are eating normally.

Drug interactions: I bring this up because of a particular incident I had at work about 10 years ago. I was a newly diagnosed chronic kidney disease patient, and one of the most common treatments for CKD is a class of blood pressure medication called beta blockers. If you have ever had asthma, even if you have grown out of it, you are not supposed to take beta blockers. Well, I forgot to tell my doctor because I hadn’t had it for years. As we adjusted my meds up to properly treat the hypertension, I began to feel tired and breathless, especially when I walked up the stairs. Basically, the beta blocker was working on both my blood vessels (which it was supposed to do) and on respiratory passages (which it wasn’t supposed to do). After just a couple of months, I went to an ER because I wasn’t getting enough oxygen. We knew because my lips had turned blue.

Exhaustion is common. Maybe you can never get to bed on time, or maybe you have young kids who keep you up at night. Or maybe it’s a common problem with a not so common cause – an autoimmune condition. Take stock. If you suspect your tiredness is due to causes other than everyday circumstances, schedule an appointment with your primary care physician and discuss it with them. If there is something medically wrong, better to treat it earlier than later.

NOTE: This post addresses physical, not psychological causes of exhaustion.