Sleepiness: Why am I always sleepy?

We know that adequate sleep is essential for good health. People who lack both quantity and quality of sleep may experience intense tiredness and daytime sleepiness in their daily lives.

However, is insufficient sleep the only cause, or are there other reasons someone may experience daytime sleepiness?

Why do I want to sleep all the time?

Factors that can lead to fatigue, resulting in a greater need and desire for sleep, include:

1. Not getting enough sleep or having difficulty falling asleep

Lack of sleep is one of the most common causes of daytime sleepiness. Sleep deprivation can be short-term or long-term. The loss of sleep for the sake of other activities can lead to chronic sleepiness, as the need for daytime sleep is considered a given. This leads to the insufficient sleep syndrome . However, sleep deprivation is characterized not only by quantity but also by quality.

Inadequate sleep can result in fatigue because it affects various hormones, such as cortisol, thyroid hormones, and more. During sleep, the body releases significant growth hormones, contributing to cell regeneration.

Remember, adults should aim for at least 7 hours of sleep during the night for optimal health.

2. Unhealthy lifestyle

The absence of a balanced diet and exercise can contribute to feeling tired throughout the day.

3. Dehydration

A lack of water in the body can lead to additional fatigue or a lack of energy.

4. Sedentary lifestyle

Research has shown that lack of exercise and inactivity are linked to poor sleep quality, fatigue, and sleepiness. Physical activity can improve our sleep.

5. Overtraining

On the other hand, excessive exercise can lead to exhaustion, preventing proper recovery during sleep. This can result in unexpected weight loss, mood swings, decreased performance in daily activities, and work.

6. Work schedule

Shift work can disrupt sleep patterns and lead to severe fatigue. Those who work permanent night shifts often have poor quality sleep during the day and experience hormonal changes, making them prone to daytime sleepiness.

7. Consuming excessive caffeine

Caffeine, as well as energy drinks, can cause overstimulation and nervousness, affecting sleep quality. This can contribute to increased fatigue and sleepiness the next day.

8.Anxiety and depression

Anxiety and depression are conditions that can make falling asleep difficult, often leading to more anxiety. Managing stress or positive thoughts before bedtime can help achieve better and more restful sleep.

9. Hormonal changes

Hormonal changes are commonly seen during puberty, pregnancy and menopause in women.

Regarding menopause, but also perimenopause, symptoms are often observed, such as night sweats, hot flashes, headaches, etc., which cause fatigue and sleep disorders. Fatigue during menopause is mainly caused by night sweats. [1] [2]

Pregnancy is accompanied by many demands on the body and this causes fatigue, especially in the first and third trimesters of pregnancy. The energy required, increased metabolism, hormonal changes are some of the characteristic symptoms during pregnancy that can affect sleep.

10. Illnesses

Diseases such as COVID-19, the flu, or infections can lead to fatigue, which may persist even after the illness is treated. In the case of COVID-19, it has been observed that even after recovery, patients often experience intense fatigue that can last for several weeks.

11. Medication

Some medications can cause sleepiness and daytime disorientation. In such cases, it is advisable to consult your doctor and be informed about possible side effects. Your doctor can guide you and adjust the treatment as needed.

12. Medical Treatments or Therapy

Many times, we hear someone wondering, “Why am I so sleepy even though I’ve slept?” Fatigue, general weakness, and drowsiness can be associated with various medical conditions. Some of these include:

• Sleep Apnea

Characterized by brief breathing pauses during the night, sleep apnea is often linked with snoring or choking at night and can lead to poor-quality sleep. As a result, it can cause daytime sleepiness.

• Iron Deficiency

Iron deficiency can result in low energy, shortness of breath, pale skin, headaches, and irregular heartbeats.

• Diabetes

Diabetes can lead to weight loss, excessive thirst with frequent nighttime urination, and significant fatigue (uncontrolled diabetes). People with diabetes may experience sleepiness and lethargy throughout the day. Possible reasons for fatigue include low blood sugar levels, diet, potential side effects of treatment, and hormonal imbalances.

• Hyperthyroidism/Hypothyroidism

Hyperthyroidism can result in hyperactivity, nervousness, anxiety, muscle weakness, and irritability as all body processes speed up. Consequently, sleep disturbances often occur. Conversely, hypothyroidism can lead to easy fatigue. This feeling of exhaustion may cause sleepiness and a sensation of waking up tired. Thyroid hormones, as regulators of the body’s energy balance, can influence sleep. Other symptoms include high cholesterol, weight gain, dry skin, and depression.

• Chronic Fatigue Syndrome

Chronic fatigue syndrome is characterized by fatigue lasting for at least three months, leading to difficulties in concentration, memory problems, and trouble performing daily activities.

• Autoimmune Diseases

Autoimmune diseases affect the immune system and can cause tissue damage or chronic inflammation. Prominent examples include rheumatoid arthritis, lupus, multiple sclerosis, and inflammatory bowel disease. Such conditions can disrupt the nervous system and lead to fatigue. Additionally, they can cause imbalances in cytokines, which play a crucial role in sleep regulation.

• Chronic Obstructive Pulmonary Disease (COPD)

COPD results in difficulty breathing and excess mucus in the airways, making breathing more challenging. These breathing difficulties can lead to fatigue, which also affects sleep quality.

• Fibromyalgia

This particular condition is caused by dysfunction in the central nervous system and leads to a state of chronic pain. Among the characteristics of fibromyalgia, fatigue is also included, which can cause disruptions in sleep, biochemical changes, and inflammation.

Other medical conditions related to sleep problems that result in excessive daytime sleepiness include the following:

• Mental health disorders
• Neurological diseases
• Neurodegenerative conditions
• Injury and infection
• Neurodevelopmental disorders
• Restless Leg Syndrome
• Nocturia

13. Sleep Disorders

There are various sleep disorders that, although not very common, affect a portion of the population:

• Advanced Sleep Phase Syndrome

The characteristic feature is falling asleep and waking up earlier than desired, usually by about three hours. The result? Many individuals find it difficult to engage in social activities, especially when they are scheduled late in the afternoon or evening.

• Delayed Sleep Phase Syndrome

What is it? It is characterized by difficulty waking up at the desired time, and in some cases, insomnia or daytime depression. Similar to insomnia, this syndrome disrupts sleep and makes waking up extremely difficult.

• Narcolepsy

Narcolepsy is characterized by uncontrollable and sudden sleep episodes, despite adequate nighttime sleep, as well as excessive daytime sleepiness. It is accompanied by features of both sleep attacks and the body’s inability to regulate sleep. As a result, it can lead to brief episodes of sleep at unexpected times.

Why Do I Get Sleepy in the Afternoon?

There are many reasons that can lead a person to experience sleepiness, especially during the hours between 1:00 PM and 4:00 PM. During this time frame, our bodies naturally experience reduced alertness, which appears to be due to the circadian rhythm.

The circadian rhythm is the body’s natural clock and helps synchronize activities with light and darkness. Therefore, if the circadian rhythm is not aligned, it can lead to excessive daytime sleepiness during the day.

Sleepiness in Infants and Children

At every stage of a child’s development, changes occur, and therefore the sleep process can often become a problem. A baby may feel separation anxiety from their mother during the sleep process. Other times, even the need to stretch their arms or legs can be a reason to stay awake all night.

Furthermore, a very tiring day can lead to irritability and affect their sleep. Other common causes include:

• Illnesses
• Allergies
• Restless Leg Syndrome
• Sleep apnea
• Nightmares

The aforementioned causes can lead both infants and children to experience daytime sleepiness.

Which vitamin deficiency can cause insomnia?

Apart from the iron deficiency mentioned earlier, there are some vitamins whose insufficiency affects the quality of sleep.

For example, vitamin D contributes to sleep regulation as it is involved in pathways that regulate melatonin. Additionally, studies have shown that individuals with low levels of vitamin C in their bodies slept for shorter periods.

Moreover, a deficiency in vitamin B6 has been shown to promote psychological discomfort, affecting sleep. Specifically, the following vitamins and minerals can affect our sleep:

• Iron
• Riboflavin (Vitamin B2)
• Niacin (Vitamin B3)
• Pantothenic Acid (Vitamin B5)
• Pyridoxine (Vitamin B6)
• Folic Acid (Vitamin B9)
• Vitamin B12
• Vitamin D
• Vitamin C
• Magnesium

Are There Vitamins to Prevent Sleepiness?

There are vitamins and minerals that play a crucial role in achieving quality sleep:

• Vitamin D3: Inadequate vitamin D3 can lead to fatigue as it affects hormonal balance and supports neurotransmitter production.
• B-Complex Vitamins: They act as coenzymes in various metabolic processes, helping convert food energy into a usable form for the body.
• Iron: If the body lacks enough iron to produce hemoglobin, fatigue will be evident, and sleep quality will be dramatically affected.
• Magnesium: Low magnesium levels in the body can lead to muscle fatigue and weakness.
• Zinc: It contributes to various conditions, including immune system health and bone health. Therefore, low levels can cause various disturbances and fatigue.

If the problem is due to nighttime insomnia, there are now dietary supplements available with melatonin and herbs such as valerian, chamomile, ashwagandha, etc.

What Can You Do to Prevent Sleepiness?

Energy levels will stabilize with efforts to maintain a consistent sleep schedule, even on weekends.

If you feel a slump during the day, try not to sleep for too long.

Getting up and engaging in an activity, especially outdoors, will help boost vitamin D and alertness.

For an energy boost, a protein bar is a good choice. Even chicken or a few almonds can provide the energy you need.

What to Do

• Maintain a healthy diet and exercise regularly.
• Try to stick to the same sleep schedule, aiming for 7-9 hours.
• Try to relax a few hours before bedtime (by reading a book or listening to relaxing music).

What Not to Do

• Avoid smoking.
• Avoid excessive alcohol consumption.
• Avoid eating, drinking caffeine, or exercising shortly before bedtime.
• Avoid screens at least one hour before bedtime.

When should I see the doctor?

The doctor is responsible for doing the necessary tests on you in order to identify the reason for your sleepiness, especially if:

• you feel tired all the time
• you have excessive sleepiness during the day to such an extent that it affects your daily life

If a sleep disorder is suspected it is advisable to do blood tests and refer you to a sleep specialist. [7]

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