IF you thought of yourself—struggling to start your inner engine in the morning, desperate to keep it humming after lunch in the afternoon, and only too willing to let it sputter to a stop in the evening—you are not alone.
Everyone, at one time or another, feels fatigued. The usual Rx is some R and R. But if you’re all caught up on your rest and relaxation, and you still feel pooped, it’s time to wonder why.
Here are some reasons for being dog-tired:
Insomnia
Insomnia ranks right behind the common cold, stomach disorders and headaches as a reason people seek a doctor’s help. In a Gallup poll of more than 1,000 adults, one-third of them complained that they woke up in the middle of the night and couldn’t get back to sleep.
“Insomnia is not a disease,” explains The Merck Manual of Medical Information. “It is a symptom that can have many causes, including an irregular sleep-wake schedule, physical disorders, drug use or withdrawal, drinking large amount of alcohol in the evening, emotional problems and stress.”
Symptoms of insomnia include irritability, fatigue during the day and problems concentrating or performing under stress.
“The treatment of insomnia depends on its cause and severity,” the Merck manual notes. “If insomnia results from another disorder, treatment of that disorder may improve sleep. For most people who have insomnia, some simple changes in lifestyle, such as following a regular sleep schedule, can improve sleep.”
Sleep apnea
When it comes to comedy, snoring has always given us a good laugh. Unknowingly, snoring could be a sign of a potentially life-threatening condition called sleep apnea, in which the throat relaxes and closes during sleep.
“The difference between regular snoring and sleep apnea is that with sleep apnea, you actually stop breathing, anywhere from 10 seconds up to three minutes,” says Dr. Peter Hauri, codirector of the Mayo Clinic Sleep Disorders Center in Rochester, Minnesota. “And these stoppages are frequent—a minimum of at least 15 per hour.”
Actually, there are three types: obstructive sleep apnea, central sleep apnea and mixed sleep apnea. The first one commonly occurs in obese people, who tend to sleep on their back. Smoking and excessive use of alcohol worsen this condition.
Central sleep apnea, a rare type, is caused by dysfunction in the part of the brain that controls breathing (brain stem). The third one is a combination of the two types and this is very rare.
As the person keeps gasping for air, he won’t have a good sleep and feel very tired the following day. Since obstructive sleep apnea is the most common form, the Merck manual gives these suggestions: “Losing weight, quitting smoking and not using alcohol excessively can help. Heavy snorers and people who often choke in their sleep should not consume alcohol or take sleep aids, antihistamines, or other drugs that cause drowsiness.”
Iron-deficiency anemia
Some people—mostly women, infants and children—are rundown because of iron-deficiency anemia. This is the most common form of anemia and it occurs when the body does not store enough iron, the primary raw material of hemoglobin (the molecule that carries oxygen to cells).
“Iron deficiency is usually a dietary problem, but in many cases, other conditions complicate the picture,” informs The Medical Advisor: The Complete Guide to Alternative and Conventional Treatments.
For example, women who lose excessive amounts of blood through heavy menstrual flows may have a lower-than-average iron level. Women who are pregnant or nursing may also have low iron levels because of loss to the developing fetus or because of milk production. Iron deficiency anemia also afflicts patients who have had surgery to remove part of the stomach, thereby impairing the ability to absorb iron.
If you suspect you are anemic, blood tests can measure your hemoglobin and the number of red blood cells. Then get a doctor’s advice. Generally, anemia can be corrected by taking iron pills just to be safe. Actually, that’s not safe for everyone. Anemia can be a sign of serious illness, such as kidney failure or colon cancer, and pills won’t solve the problem.
Hypothyroidism
The Merck manual defines hypothyroidism as “underactivity of the thyroid gland that leads to inadequate production of thyroid hormone and a slowing of vital body functions.”
A chronic lack of iodine in the diet is the most common cause of hypothyroidism in many developing countries, including the Philippines.
Insufficient thyroid hormone causes body functions to slow. Symptoms are subtle and develop gradually. They may be mistaken for depression, especially among older people. Facial expressions become dull, the voice is hoarse and speech is low, eyelids droop, and the eyes and face become puffy.
“Treatment begins with small doses of thyroid hormone, because too large a dose can cause serious side effects, although large doses may be necessary,” the Merck manual says. “The starting dose and the rate of increase are especially small in older people, who are often most at risk of side effects. The dose is gradually increased until the levels of thyroid-stimulating hormone in the person’s blood return to normal.”
Chronic fatigue syndrome
It’s just like flu, but unlike flu, it just won’t go away—not in days, weeks or even months. It’s so bad that many people can’t get out of bed, let alone hold jobs.
The Merck manual places chronic fatigue syndrome (CFS) under “diseases of unknown cause.” The second series of The Doctors Book of Home Remedies offers this explanation: “Doctors aren’t sure what causes CFS, nor do they agree on how best to treat it. Some consider CFS a sleep disorder, since its victims often sleep twice as long as other people yet still feel severely fatigued. Others think it results from stress, since CFS often strikes young high achievers who lead stressful lives but, otherwise, are in good health.”
According to the Merck manual, regular aerobic exercise, such as walking, swimming, cycling, or jogging under close medical supervision may reduce fatigue and improve physical function. Psychotherapy, including individual and group behavioral therapy, may be helpful, as well.
In most cases, symptoms of CFS lessen over time. But here’s a warning for those who want to take longer rest when CFS attacks: “Excessive periods of prolonged rest may worsen symptoms of CFS.”