Depression is a serious medical condition, so it’s important to seek help. If you have thoughts of self-harm or feel like you’re in a crisis, seek emergency medical attention or call the National Suicide Prevention Lifeline at 800-273-8255.Or you could be dealing with anxiety.Depression isn’t the only mental health issue that can lead to feeling tired all the time. Things like everyday stress and worry can also contribute, but clinical anxiety is persistent and can lead to more prolonged fatigue. According to the National Institute of Mental Health, it can leave you exhausted and plagued with sleep disturbances.Think about it: All of your energy is being channeled into feeling on-edge, which can really take a toll on your overall well-being. “Anxiety in particular can be draining,” licensed clinical psychologist Alicia H. Clark, Psy. D., tells SELF. If you suspect that you’re suffering from anxiety, it’s a good idea to reach out to a mental health professional if you can, as they will help you develop coping methods that can help you feel better.Sleep can also be an issue if you have an adjustment disorder, which basically means you feel 10 times the amount of stress as other people when experiencing difficult situations, like divorce, having a baby, or losing a job.You might have an autoimmune disease.Autoimmune diseases, conditions in which your own immune system mistakenly attacks parts of your body, can create a whole host of wildly different symptoms. One of the common ones, though, is fatigue, according to a 2019 study published in Frontiers of Immunology.8 These conditions can include but are not limited to:Rheumatoid arthritisLupusType 1 diabetesPsoriasisPsoriatic arthritisMultiple sclerosisIt could be a GI disorder.So, technically these are also autoimmune diseases, but they specifically affect your digestive system and can also cause constant exhaustion. Celiac disease is one possibility, where the immune system attacks the small intestine when you eat gluten, a protein found in wheat, rye, and barley (basically all the bread).Some studies suggest as many as 100% of all people with celiac disease name fatigue as one of their main symptoms.7 You probably already know that people with celiac disease can get diarrhea, gas, and vomiting if they ingest gluten, but it can also cause people to feel weak or fatigued even without gastrointestinal issues, according to the Mayo Clinic. If you notice you don’t feel great after having wheat, barley, or rye products, talk to your doctor about getting tested for celiac disease.Another possibility is inflammatory bowel disease (IBD), which includes ulcerative colitis and Crohn’s disease. These affect the GI tract, causing open sores. Fatigue is a very common symptom of both conditions, according to the National Crohn’s and Colitis Foundation, and could be due to a number of factors, including inflammation in the body.You could have another chronic condition.Autoimmune diseases aren’t the only suspects when it comes to your health and feelings of exhaustion. Other types of chronic health conditions can also cause varying levels of fatigue. Things like fibromyalgia (a condition that causes muscle pain and tenderness), type 2 diabetes, chronic kidney disease, heart disease, and COPD can also be filed under energy-zapping conditions.It could be chronic fatigue syndrome.Chronic fatigue syndrome is a condition that affects up to an estimated 2.5 million Americans, according to the Centers for Disease Control and Prevention (CDC). Also known as myalgic encephalomyelitis, this condition causes severe instances of fatigue and exhaustion, especially after physical activity, that cannot otherwise be explained. Unfortunately, doctors don’t have a definitive test or treatments for chronic fatigue syndrome, meaning there’s still lots to be learned about diagnosing and treating this condition.You could have a thyroid condition.Your thyroid helps impact several important functions of your body, including how fast or slow your heart beats and how well your bodily movements flow, Piper says. Having an underactive thyroid, a condition known as hypothyroidism, can slow down your bodily functions and leave you feeling tired, she says. On the flip side, hyperthyroidism, which is when your thyroid is overactive, speeds everything up and can cause insomnia and an inner restlessness that makes it tough to relax—leaving you wiped out as a result.It might be anemia.Anemia happens when you don’t have enough healthy red blood cells to carry adequate oxygen to your body’s tissues. The result can be shortness of breath, dizziness, pale-appearing skin, problems tolerating exercise, and—you guessed it—fatigue. People with uteruses are especially vulnerable to anemia because of additional blood loss from their period.9
Stress is another contributing factor, according to Dr. Dimitriu. This is most likely caused by disturbing the natural depth of your sleep. “Whenever something wakes you, even slightly, you are prone to do something strange—as you are half asleep—sleep talking is one of those things, and sleep walking is another,” he says. Certain medications (either sedating or stimulating), anxiety, or just being really tired can sometimes trigger an episode of sleep talking in some people but not in others, Dr. Dimitriu adds.According to the Cleveland Clinic, depression, daytime drowsiness, alcohol, and fever can cause sleep talking, too. Underlying medical conditions could also cause sleep deprivation, leading to sleep talking. This includes sleep apnea, a sleep disorder where breathing is repeatedly interrupted during sleep.The good news in all of this? “There is no danger to random isolated episodes of sleep talking,” Dr. Dimitriu says. However, if it begins to occur frequently, or there are other symptoms, such as insomnia, waking up several times per night, or being sleepy by day, he says it may be worth speaking with your doctor, and considering a sleep study. For most people, though, sleep talking is a short-lived phenomenon and no treatment is really necessary.So, do sleep talkers tell the truth?Maybe it’s because we’ve seen too many movies or want to coax secrets out of our loved ones, but many nighttime conversationalists have one burning question: “When you talk in your sleep, are you telling the truth?”While sleep talking parallels awake talking for semantics, syntax, and turn-taking in conversation, according to a 2017 study published in the journal Sleep,6 it’s not a reliable method of getting someone to spill their dirty secrets. Partly because you are in an unconscious state simply expressing words and noises. However, researchers from the study did discover a few interesting tidbits: The most frequent word spoken during sleep talking was “No,” and an interrogation-type tone was found in 26% of speech episodes.How to stop sleep talkingIf you’re unsure about why you’re talking in your sleep, it might be a bit challenging to figure out how to stop. While no official sleep talking treatment protocol exists, eliminating or reducing the conditions triggering it is a good place to start. And your first order of business if you want to curb your nightly chatter is to overhaul your sleep hygiene (a fancy word for your pre-sleep habits).“With my patients, I increase their overall sleep and decrease things that are disrupting their sleep—so decrease caffeine, decrease alcohol, decrease stress before bed,” Dr. Breus says. “Those types of things can then really help make the situation literally go away by itself.”“Regular bed and wake times cannot be underscored in their ability to improve and stabilize sleep,” Dr. Dimitriu says. Also, make sure the bed is comfortable and cool, and the sleeping area is dark. “If anything bothers you at night, it could wake you or cause something strange to occur when you are half awake,” he adds. Being really tired or sleep-deprived can also cause sleep talking to occur, so make sure you get enough sleep (ideally seven to nine hours) consistently.
For example, you can try progressive muscle relaxation (which you can even do in bed!). This simply involves tensing your muscles and relaxing them one body part at a time, SELF previously reported. First, try scrunching and tensing your toes tightly for about 5 to 10 seconds. Then, release them and feel the difference in the sensations. Slowly move up your body, muscle by muscle, to your calves, thighs, and so on. (Find a full list of grounding techniques for anxiety here).9. Do some gentle bedtime yoga or stretching.Yes, vigorous exercise before bed might keep you up, but consider grabbing your yoga mat and doing some gentle exercises to help you relax before bed. Why? Static stretching encourages deep breathing, which encourages your relaxation response, SELF previously reported. Looking for a few ideas? We have a 5-minute bedtime stretching routine you can try tonight.10. Avoid dozing off during a TV show.Remember, as the sun goes down, your pineal gland begins to pump melatonin into your bloodstream. When you keep any lights on, even if it’s just a seemingly small bit of light emitted from your iPad screen while streaming your favorite TV show, it can interfere with this melatonin signaling and make it a little more challenging to fall asleep fast, SELF previously reported. And even if you do feel knocked out, there’s also some evidence that the variances in TV light throughout the night can keep you from getting quality sleep.11. Put an end to your “doom scrolling” habit.We’ve already discussed how light from your phone can interfere with melatonin production, but we haven’t addressed how scrolling through your phone, reading new coronavirus updates, checking email, or chatting with your friend in Hong Kong can keep your mind active.Dr. Malow suggests turning off your phone and other devices a full hour before bed to help you wind down. You can also set your phone to go into sleep mode or get a screen for your computer that blocks blue light, she says. Some people also find it helpful to wear blue light-blocking glasses in the evening to reduce eye strain, too.If you find that racing thoughts or mindless phone use is to blame, consider switching it out for a good book before bed.12. Eliminate other light, too.While you’re at, get rid of all light sources where you can. “If we have too much light at the wrong time, it can tell your body to wake up and stay awake,” Dr. Augelli explains. “So we have to be careful about the timing of our light consumption.”Perhaps you can get curtains that block street light or get a door stopper to prevent light from coming in through the gap. If you can’t control the amount of light in your room, think about getting an eye mask to help ensure it’s as dark as possible in your sleeping environment.13. Consider the sound quality in your room.Much like light can keep you awake, sounds—like from your TV or your loud neighbors—can keep you up longer than you’d like. If ambient sounds are an issue, try to use a fan or white noise machine to help alleviate that. The consistent whir of a sound machine can help soften the impact of other erratic noise that could keep you awake, the CDC suggests. If that doesn’t help, earplugs are another option to consider.14. Regulate the temperature in your room.Light gets a lot of credit for encouraging your circadian rhythm to do its job, but temperature also plays a role. As SELF previously reported, a room that’s between 60 and 67 degrees Fahrenheit tends to be most people’s sleepy-time sweet spot. If you can’t regulate the temperature in your room, consider switching up your bedding or sleeping in lighter (or heavier) pajamas to get your ideal sleep temperature.15. Stop watching the clock.Even if you’re having trouble sleeping, quit checking the time. This will make you feel more anxious (and awake, if you’re using your phone), which only makes it harder to fall back asleep. If you find yourself doing this often, try turning the clock away from you or keeping it out of reach so you’re not tempted to watch the time pass, the Cleveland Clinic suggests.16. Do something calming if you find yourself tossing and turning.If you’re tired but can’t sleep, it’s natural to move around in bed to bide your time. But this isn’t very productive. More often than not, tossing and turning leads to frustration that works against falling asleep faster. Instead of huffing and puffing, try getting out of bed and leaving your bedroom for about 20 minutes to do something relaxing, the Mayo Clinic suggests. Read, listen to soothing music, or engage in another calming habit until you’re feeling more tired, then climb back into bed and give it another try.Do I need to see a doctor to figure out why I can’t sleep at night?There are so many reasons why you might have trouble falling asleep fast (and staying asleep once do nod off). But there’s a difference between tossing and turning due to lifestyle factors you can change and feeling tired or not sleeping because of a sleep disorder, like insomnia, narcolepsy, or sleep apnea.
Chronic insomnia, on the other hand, means you have trouble falling and staying asleep at least three times a week for three months or longer. It can also be triggered by things like never-ending stress, difficult emotions you haven’t worked through, or constant travel that’s throwing your schedule out of whack. However, this type of insomnia can present as a side effect to a deeper issue as well, like an underlying health condition, medication plan, or substance use.What causes insomnia?Let’s dive deeper into the most common reasons you may be missing out on sleep:1. You’re anxious about falling asleep.“In some ways, insomnia is like an anxiety disorder about not getting enough sleep,” Jason Ong, Ph.D., director of behavioral sleep medicine at SleepCharge by Nox Health and adjunct associate professor of sleep medicine at Northwestern Feinberg School of Medicine, tells SELF. “Anxiety about sleep and the attempts to try and make sleep happen actually perpetuate the problem by inadvertently disrupting your body’s regulation of sleep.”A common response is to try to fix the issue by trying harder to fall asleep. However, moves like hopping in bed when you believe you should be sleepy (but aren’t) just turn up the pressure. In turn, you tend to feel even more restless and awake.2. You have an off-kilter sleep schedule.If you’re a jetsetter traveling across time zones for work, for example, or a shift worker trying to sleep during the day, disturbed sleep could follow. The root of the problem is known as circadian misalignment, or trying to sleep at times that don’t match your internal body clock, which regulates your sleep-wake cycle, says Dr. Ong.3. You’re stressed to the max.An overwhelming work schedule, looming debt, caregiving, the loss of a loved one—any number of stressful life events could trigger insomnia. That’s because chronic stress flicks on your fight-or-flight response, Ash Nadkarni, M.D., an associate psychiatrist at Brigham and Women’s Hospital and an instructor at Harvard Medical School, tells SELF. This cues a flood of stress hormones like adrenaline and cortisol into your bloodstream. When your stress doesn’t subside and that “on” switch gets stuck, these hormones keep surging through your body at night to keep you alert, blocking your ability to relax and ease into sleep.4. You have a mental health condition.Insomnia is a symptom of many psychiatric disorders, including depression, anxiety, obsessive-compulsive disorder (OCD), bipolar disorder, and post-traumatic stress disorder (PTSD), per the National Alliance on Mental Illness (NAMI). While the relationship is complicated and more research is needed, researchers hypothesize the link is due to changes like a heightened stress response, issues with neurotransmitters or chemical messengers like serotonin, norepinephrine, and dopamine, plus associated problems with the internal body clock and sleep cycle, says Dr. Nadkarni.5. Or you have another underlying health condition.This brings us back to that “canary in the coal mine” comment: Insomnia may stem from numerous health problems including other sleep disorders like restless legs syndrome, narcolepsy, or sleep apnea, chronic pain due to conditions like arthritis or headaches, cancer, gastrointestinal disorders such as heartburn or GERD, hormone fluctuations during your period or due to thyroid disease, or even neurological disorders like Parkinson’s disease, per the Cleveland Clinic.6. You’re taking medications or drugs that keep you up.Insomnia can also be an unwanted side effect of certain medications or drugs. Stimulants, for example, cause a release of certain neurotransmitters, which in turn may disrupt your ability to fall and stay asleep, says Dr. Nadkarni. Others cause a change or reduction in sleep quality.