Still feel sleepy after 8 hours sleep

In the course of a typical day, several patients will report a concern about a lack of energy and feeling fatigued. Commonly the patient will tell me that they sleep 8-9 hours a night without waking but have to drink several cups of coffee in the morning before they feel “awake”. Throughout the day they have trouble concentrating on their work and after lunch have an overwhelming urge to take a nap, which leads them to search out more caffeine or a snack to boost their energy levels. When they return home, they will oftentimes fall asleep on the couch while watching television after supper. Despite getting more than 8 hours of sleep a night, however, they wake up the following morning still feeling fatigued.

Feeling fatigued and with little energy during the day, particularly after midday meals, is, unfortunately, a common complaint with many causes. I often see patients that have been to several physicians, had multiple studies performed to evaluate their thyroid, adrenal or cardiac function, been prescribed sleeping medications and / or stimulants to combat their symptoms and continue to complain of the same symptoms.

The missing piece is frequently a sleep study to review the quality of a patient’s sleep pattern and detect any physiologic abnormality that would cause poor sleep. There is a direct relationship between poor sleep due to apnea, low oxygen levels at night, or periodic limb movement disorder (better known as restless leg syndrome) and daytime fatigue. 

More than one patient has given me a frowned or puzzled look when I ask them to undergo a sleep study in order to further evaluate their symptoms of fatigue. I have patients tell me that they “don’t snore”, they “sleep straight through the night”, or they “don’t want to use a CPAP machine”. My response is that we are looking for the cause of their symptoms and not discussing treatment. If Americans are statistically more likely to have sleep apnea than thyroid dysfunction, you should undergo a sleep study in addition to checking your thyroid function when investigating the reason for feeling fatigued (Hiestand 780-786).

A bad night's sleep can leave you feeling pretty tired the next day. Put a string of those together and nagging fatigue starts to set in.

Getting good sleep, in the right amount, can make a big difference in how you feel. Too little or too much sleep can increase your perception of fatigue. And even if you get enough hours of sleep, you might find yourself dragging the next day if that sleep was interrupted by frequent awakenings or was of poor quality.

Although most of us need about eight hours a night to feel refreshed during the day, what counts as sufficient sleep is highly individual. It makes sense that getting less sleep than you need might leave you feeling tired, but you may be surprised to learn that getting more sleep than you need may not leave you refreshed and energized. In fact, many people find that on days when they hit the snooze button more times than usual, they feel more lethargic and unmotivated.

Research bears out the connection between too much sleep and too little energy. It appears that any significant deviation from normal sleep patterns can upset the body's rhythms and increase daytime fatigue. The best solution is to figure out how many hours of sleep are right for you and then stick with it — even on weekends, vacations, and holidays.

For more information on the role of sleep in feeling energized, read Boosting Your Energy, a Special Health Report from Harvard Medical School.

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Feel like you're constantly tired? Whether you're brain is constantly buzzing with work – perhaps exacerbated by a home-working set up that means zero delineation between graft and play – you're simply strung out from a year living in a dystopian thriller, or you have no time to yourself between your myriad responsibilities, it's not a fun place to be.

Why am I tired all the time?

Aside from the exceptionally weird circumstances that could have kept you awake over the past year or so, there are a few things that can be blamed.

Often, when we feel particularly tired, we can pinpoint a physical, psychological or lifestyle cause. But sometimes the reason could be a bit harder to identify, so we've asked the experts for the other most common causes.

1. You could be dehydrated

Without adequate fluid intake, blood pressure drops, slowing the delivery of oxygen to the brain, which can leave you feeling flat out.

How do you know if you're getting enough?

• If you're still tired after sleeping 8 hours, you may need to up your H2O.
• The amount of fluid needed depends on the individual, but you should aim to go to the toilet at least three times a day.
• Between six and eight glasses of water-based drinks – including tea and coffee – a day are recommended.

2. It could be your thyroid

Hypothyroidism is when your thyroid, a gland that produces hormones to control sleepiness and hunger, is underactive.

It’s a common cause of over-sleeping, but hard to pinpoint without a doctor. If you’re feeling sluggish but getting plenty of sleep, book an appointment with your GP to arrange the simple blood test.

3. You need to cut back on booze

More than half of us reach for a glass of vino between three to four times a week to relax after a hectic day. But, while alcohol relaxes you initially, it can compromise your sleep quality as the chemicals disrupt your sleep cycle, preventing you from entering deep sleep — even if you're getting the recommended 7-8 hours.

4. You could have Sleep Apnea

Sleep apnea causes people to wake up as they stop breathing anywhere from five times to hundreds of times an hour, meaning they sleep for longer because sleep quality is compromised. The disorder only affects 3-7% of the population, but often sufferers are undiagnosed.

The catch: you don’t remember waking up, so it’s hard to tell if you’re suffering. Sleep tracking apps which record noteworthy events in the night, like Pillow, can alert you to any irregularities in your breathing.

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Snoring, being overweight and waking up with a headache – caused by a nocturnal lack of oxygen - are all symptoms of sleep apnea. Speak to your doctor if they sound familiar.

5. You're taking too many naps

One for those who've spent the past six months working from home. A siesta can take the edge off an afternoon slump, but the duration of your downtime is crucial.

It has been clinically proven that taking a nap for up to 30 minutes is revitalising, but any longer than that and you’ll end up in a REM cycle for an hour.

Waking mid-cycle can leave you feeling groggy so, if you want to nap for longer, have one lasting 90 minutes and be disciplined about not snoozing.

6. Your mental health could need some work

Feeling depressed doesn’t necessarily make you sleep more, it just makes getting out of bed in the a.m. tougher, which could lead to excess sleep.

If you’re finding yourself lacking the energy to face the hours ahead of you or dreading the day, don't be afraid to speak to your GP.

7. You could have a mineral or vitamin deficiency

A lot of work goes into maintaining blood glucose levels, muscle health and concentration, so a lack of any one thing — iron, vitamin B12 (especially if you are vegetarian or vegan), vitamin D (make sure you supplement 10 micrograms a day in the colder months) or magnesium, for example — can leave you feeling lethargic.

Always make sure you're getting a balanced diet, especially if you cut out any big food groups, and book a blood test at your doctor if it continues to be a bother.

8. Your fat intake could be too high

According to a study, which didn't differentiate between good and bad fats, people who consume a high fat diet are more likely to feel sleepy during the day and report sleep problems at night.

Researchers from the University of Adelaide studied the dietary habits of over 1,800 Australian men between the ages of 35 and 80 and found a quarter of those who consumed the highest fat intake were 78% more likely to suffer from tiredness compared to those who ate the fewest fatty foods.

As we know all fats are not created equal and there has been plenty of research praising the benefits of 'good fat' so, rather than cutting avocado from your diet (the horror), be sure you're not going overboard.

9. You're eating a lot of sugar

There is some evidence to suggest that eating more sugar-y foods (think cookies and cakes) is linked with a lighter, more easily disrupted, sleep. Chocolate, especially, also contains caffeine–so snacking on a bar of Green and Black's before bed gives you a double whammy of possible slumber disruption. Try nixing the treats for a couple of days–perhaps replacing them with an oatcake and almond butter–and see how you feel.

Why am I so tired on Mondays?

If you begin every fresh week wondering why you're so particularly zonked, then it may be worth looking into what exactly is going on.

Here are five reasons why getting up after the weekend typically sucks (and the five best ways to combat them.)

1. Your sleep pattern is out of whack

Monday mornings may be a particular struggle because your circadian rhythm is confused. Sleeping in and staying up late at the weekend creates a mini jet lag that's akin to flying from London to New York on Friday and back again on Sunday.

Try:

Keep your sleeping and waking times over the weekend within an hour of your weekday ones. If you veer off schedule, open the blinds as soon as you wake up as daylight inhibits the sleep hormone melatonin and sends a 'rise and shine' cue to your brain for a less rude awakening.

2. Your mindset is all wrong

If you think Monday's going to blow, then it most likely will. Perception is a powerful thing. If you start the week a la Bob Geldof singing I Don't Like Mondays, having a non-crappy day will be a challenge. Not only will you won't be able to stop questioning why you feel so gawdamn tired, but those levels of meh will drag through until at least Tuesday.

Try:

Come up with a fun tradition to kick off each week, like grabbing a flat white with a pal. Even a short stretch with a cup of hot lemon can get you feeling in control of your week, rather than floundering under the covers until the last possible minute. With something to look forward to, you can gradually rewrite your Monday mental script.

3. You're juggling two extremes

Your Monday fuelled-dread could be because shifting from an R&R-filled Sunday to a busy work week is stressful for your mind and your body – causing your blood pressure to surge.

A survey of the WH office agreed that going from a Netflix sofa marathon to a day at a standing desk, in less than 12 hours, is one reason why they feel so tired on a Monday.

Try:

Try inhaling and exhaling deeply for 30 seconds upon waking to keep your blood pressure in check. Then add some cooked spinach to your lunch as it’s high in heart-healthy nutrients, like magnesium.

4. You've gone hard on the exercise

Perhaps Monday is awful because you overdid it during your boot camp classes? Intense bouts of exercise can cause inflammation that has your muscles screaming for mercy a couple of days later.

Try:

Go easy over the weekend, if this sounds familiar. If you go a bit hard, do a short yoga sesh or take a brisk walk to drive blood flow to muscles and ease soreness first thing. Weekend sofa-loafers, same goes for you.

5. Try less excess

Ever thought Monday may be a dud because you partied too hard over the weekend? A single episode of binge-drinking (that's four of those Aperol Spritzes you enjoy so much) doesn't only leave you hanxious and potentially wasting a whole day feeling nauseous, but it blunts the ability of cells called macrophages to destroy viruses and bacteria for up to a day, leaving you more vulnerable to illness.

Try:

Basically, if you don't want to feel so tired on a Monday morning then you need to learn self-control. Try not to see the weekend as a potential for blow-out and limit yourself to just two or three drinks a night, ideally with a meal. (Don’t forget to chase each drink with a tall glass of H2O to literally water down the effects of booze and starve off the dehydration-related headache the day after.)

Want to feel less tired on a Monday morning? Think before you (have your fifth) drink and don't let sleep drop to the bottom of your priority list.

How Can I Stop Feeling Constantly Tired?

So, what can you do to counter these snooze-inducing facts of life? How might you start your days – and continue them – feeling a little perkier? Check out these science-backed tips to up your energy levels naturally.

1. Assess your posture

'Having poor posture can make people feel fatigued,' says LloydsPharmacy pharmacist, Kate Taylor.

'You expend more energy when you are sitting or standing with your spine out of alignment because your muscles have to work harder to compensate, therefore using more energy.'

Not just that but hunching over can also restrict your digestion and breathing, which is another energy drain.

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Whether via a posture wearable or just a moment of body awareness, notice if you're slumped now then take a moment to fix it; pull those shoulders back, expand your chest and draw your belly button to your spine.

2. Top up your Vitamin D

'Vitamin D deficiency is very common – especially in the winter months,' says Mr Narendra Pisal, consultant gynaecologist at London Gynaecology.

'In fact, 40-50% of women of reproductive age show symptoms of vitamin D deficiency, and these include muscle pain, poor sleep – and fatigue.

'It is difficult to correct through diet alone so I recommend taking a vitamin D supplement.'

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Research from University of Newcastle has shown vitamin D, even in supplements, successfully boosts energy levels.

3. Drink a herbal tea

Who needs coffee when a brew could come with so many more health benefits? Nutrition health coach and medicinal chef Dominica Roszko recommends:

• Fresh ginger tea (with a slice of orange or lemon)
It balances blood sugar levels to avoid the midday crash

• Liquorice tea
It helps the body deal with stress and avoid becoming burnt out by regulating hormones

• Gingko tea
It increases alertness (like coffee), but also calm (unlike coffee)

4. Try an alternative supplement

'I take ginseng, daily,' says Dr Preethi Daniel, clinical director at London Doctors Clinic. 'Panax Ginseng has been shown to boost your natural response to fatigue and stress – it certainly makes me feel good.'

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Ginseng contains polysaccharides and oligopeptides that have been linked to lower oxidative stress and higher energy production in cells, which can help fight feelings of fatigue.

5. Have a glass of water

According to Natural Hydration Council, one fifth of GP visits are to report feeling constantly tired – and 10% of the time, dehydration is the cause. You do the maths.

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Find water hard to stomach? Instead of reaching for a sweetened juice, make the switch to infused H2O. Or get yourself a SodaStream to pimp up your water without contributing to single-use plastic.

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6. Eat small – and often

That’s right. If you’ve been trying to quash your snacking habits but have been left feeling constantly tired, it could be you actually need to munch more.

'Regular meals support blood sugar,' says A.Vogel nutritionist Emma Ross.

'Instead of famine or feast, eat every two to three hours. Snacks such as dates, figs, apricots, walnuts, pecans and pumpkin seeds will ensure energy and maximum mineral intake.'

Need more snack ideas? Try these homemade protein bars.

7. Eat more plants

Plant-based eating has been linked to improved energy levels, in addition to many other health benefits. (Here's how to go meat-free with easy vegan swaps.)

'Watch out for the likes of macadamia milk, jackfruit ‘meat’ and cashew ice cream,' says personal trainer Zanna van Dijk.

• Scroll down for more tips on foods for tiredness.

8. Get moving

You know the score – exercise equals energy. But this time of year, it’s even more important to take your routine outside.

According to nutritional therapist Alison Cullen, ten minutes is enough. Why?

'Daylight activates your endocrine system, which activates your metabolism and therefore your energy production. Your thyroid gland tunes up with more daylight access,' she says.

9. Up your iron

Women are more prone to iron deficiency than men, due to losing it during periods and needing more when breastfeeding and during pregnancy.

A shortage of iron means your red blood cells struggle to carry oxygen aka haemoglobin, which leaves you tired and breathless.

Load up on dark leafy greens, asparagus, greek beans and raspberries, all of which are rich in iron. Or start taking a supplement, like Floradix.

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10. Prioritise your sleep

Could it possibly be the reason you’re feeling constantly tired is you’re simply not getting enough sleep?

Perhaps you’ve been burning the candle at both ends or maybe you simply struggling to sleep full stop. (If it’s the latter, read our guide on How To Get To Sleep and try our recommended sleep apps.)

Foods for tiredness: What to eat to help you sleep

Looking for foods to help you sleep better? Try these soporific snacks...

1. Rice

In a Japanese study of nearly 2,000 people, by Kanazawa Medical University, the more rice volunteers ate, the better they rated the quality of their sleep.

High GI foods increase levels of a protein called tryptophan, which is used by the body to make the sleep-inducing chemical serotonin. Nutritionists say tryptophan works best when your stomach is empty, so load up your dinner plate with the white stuff after a long day at work.

2. Cherries

'Tart cherries considerably increase the levels of sleep-inducing melatonin in the body. Consider them a healthy alternative to sleep supplements,' says Lifesum nutritionist Frida Harju-Westman.

3. Almonds

'These are rich in magnesium and tryptophan, helping to promote muscle relaxation and sleep,' explains Harju-Westman. 'They also supply the body with protein, helping to stabilise blood sugar levels whilst sleeping, as well as throughout the day to avoid energy crashes.'

4. Warm milk

Not just for babies, 'dairy products are rich in tryptophan and produces sleep-inducing melatonin and serotonin, both of which help to relax the brain,' says Harju-Westman.

Foods for tiredness: What to eat for energy

Had a bad night? As well as being upping energy levels, these will stop you reaching for tempting sweet treats that will bring on a sugar crash.

1. Berries

'Consuming mixed berries, such as strawberries, raspberries, blueberries and blackberries, in the morning has been shown to sustain and improve cognitive function for up to six hours,' says Emma Derbyshire, nutritionist for British Summer Fruits.

Try this Berry Blast Smoothie Bowl to get your brain firing on all cylinders.

2. Eggs

'These are a complete protein, containing all of the amino acids that are required for a healthy diet,' explains Harju-Westman. 'As a result, they’ll fill you up and provide an energy boost for longer.'

3. Sweet potato

'These are rich in B vitamins and slow-releasing energy, meaning no mid-afternoon slump. They’re also easily digested, so there's less likelihood of bloating,' says Harju-Westman. If you're not a fan of them in a savoury dish, try making some sweet potato brownies or even sweet potato toast.

4. Spinach

'A lack of iron in the body can decrease the oxygen flow to the brain, leaving you feeling fatigued,' says Harju-Westman. 'Add a few leaves to your morning smoothie or your lunch to keep you going.'

What to eat when you're feeling tired: a comprehensive meal plan

Ensure energy levels won’t flag when you need them most – and fight off study-proven sleep-deprived weight gain – with this satisfying and refuelling meal plan…

Laura Elizabeth

Breakfast: Baked eggs en cocotte Florentine-style

The protein in the eggs will keep an insatiable hunger at bay and curb unhealthy snacking, say University of Missouri-Columbia scientists, while iron-rich spinach plays a key role in energy production.

Lunch: Miso salmon with cauliflower rice

Boost body and brain with this power-packed option. According to nutritionist Rhiannon Lambert, fish scores more highly than all other protein-rich foods on the satiety index, while its omega-3s will help cognitive function.

Natasha Corrett

Dinner: Asian noodle broth

Pack your bowl with coloured vegetables and a small portion of noodles, and you’ll be guaranteed the beauty sleep you’re in need of. Eating a carb-rich meal with a high GI before bed can help you fall asleep, says Lambert – but keep your noodle serving size to 60-70g raw weight to maximise the benefits.

Ella Woodward

Snacks: Nut hummus and sweet potato bread

Serve a doorstop of this paleo bread alongside a magnesium-rich nut hummus. The fibre of the bread will provide a slow-release energy pick-me-up, while magnesium from nuts such as almonds and cashews has been shown to assist energy metabolism.

If you've been feeling tired for more than four weeks and don't know why, it's a good idea to see your GP to rule out any medical conditions.

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