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The Royal College of Psychiatrists Improving the lives of people with mental illness

 

Sleep and tiredness: key facts

 

Sleeping well

Sleep

One or two bad nights will make you tired the next day, but won't harm you. If you don't sleep well for weeks or months, if can affect your health.

 

You:

  • feel tired all the time
  • drop off during the day
  • can't concentrate
  • can't make decisions
  • start to feel depressed
  • can be dangerous if you are driving or operating heavy machinery.  

Poor sleep makes you more likely to get high blood pressure, diabetes and to be overweight.

 

Tiredness

At any given time, 1 in every 5 people feel unusually tired and 1 in 10 have prolonged fatigue. It is often due to poor sleep, but not always. Other reasons can be:

Physical

  • Being overweight - your body has to work harder just to do everyday things.
  • Being underweight - your muscles aren't strong enough to do everyday things.
  • Doing too little and getting unfit.
  • Doing too much and tiring yourself out. If you carry on doing things, whether physical or mental, even when you feel tired, you may find it harder to recover, and get even more tired.
  • Any illness can make you tired. They include:
    • anaemia
    • chronic infections
    • cancer
    • liver, heart or long-term chest problems
    • diabetes or thyroid problems: hypothyroidism
    • muscular: Myositis; Multiple sclerosis
    • narcolepsy or sleep apnoea.  
  • Treatments - serious operations, medications like beta-blockers and strong painkillers and radiotherapy and chemotherapy. 

  • Pregnancy and breast feeding.

Psychological

  • Worry or stress, especially if you can't see a way out of your problems.
  • Depression tends to make you feel tired all the time, especially if you are waking too early in the morning.
  • Everyday difficulties – but even positive events, like moving home or getting married, can be exhausting.
  • Emotional shock such as bad news, bereavement or the break up of a relationship.
  • Expecting too much of yourself – you find yourself repeatedly failing, feeling frustrated and tired.
  • Habits – you sleep during the day, sleep too much or do too much then rest too much.

Life

  • If your child doesn't sleep through the night, it can be really hard work just to keep going with the daily routine. 
  • Night work will often make you tired, especially if shifts are often changed.

Other reasons for tiredness

A small number of people suffer from severe and disabling tiredness that goes on for a long time and for which there is no clear cause. This is called Myalgic Encephalomyelitis (ME) or Chronic Fatigue Syndrome (CFS).

 

Helping yourself

To sleep better, make sure that you:

  • Have a comfortable bedroom - not too hot, not too cold, not too noisy.
  • Have a mattress that supports you properly.
  • Get some exercise. Start slowly with some regular swimming or walking, best in the late afternoon or early evening.
  • Take some time to relax before going to bed.
  • Don't take alcohol, slimming tablets, or street drugs like Ecstasy, cocaine and amphetamines.
  • Try writing any worries down before going to bed, and then tell yourself to deal with them tomorrow.
  • Get up if you can't sleep, and do something you find relaxing. Read, watch television or listen to quiet music. After a while you should feel tired enough to go to get back to sleep.
  • If your sleep routine has been disrupted by shift work, jet lag, or having a small baby, try to  wake up quite early, at the same time every morning, whatever time you fell asleep the night before. Make sure that you don't go to bed again before about 10 pm that night. After a few nights you should start to fall asleep naturally at the right time.

If you try these tips and still can't sleep, see your doctor.

 

Things that may help with fatigue include:

  • Try and be more physically active, cut out caffeine and get back to a normal weight.
  • Plan your week and spread your chores so that you don’t get exhausted.
  • Have realistic expectations for yourself.
  • If you have been tired for a long time, don't expect to be back to normal overnight. Take small steps and don't expect too much too soon. Any progress is good, however small it may seem at the time.

Treatments for sleep problems

  • Sleeping tablets don't work for very long. They can make you tired and irritable the next day, and lose their effect quite quickly. They can be addictive and should only be used for short periods (less than two weeks). Antidepressants can be helpful, but have their own side-effects.
  • Over the counter medicines often contain an anti-histamine. These do work, but can make you sleepy well into the next morning.  You also tend to need to take more and more to get the same effect. It is best not to take anti-histamines continuously for a long time. Herbal remedies (eg Valerian) work best if you take them every night for two to three weeks or more, rather than just taking them occasionally.
  • Cognitive behavioural therapy can help. It involves looking at unhelpful ways of thinking that can make you more anxious.

For more in-depth information see our main leaflet: Sleeping Well.

This leaflet reflects the most up-to-date evidence at the time of writing.

Produced by the RCPsych Public Education Editorial Board.

Series Editor: Dr Philip Timms

Reviewed by Dr Amy Green

© January 2014. Due for review: January 2016. Royal College of Psychiatrists. You can link to, download, print, photocopy and distribute this leaflet free of charge. But you must not change it or repost it on a website.

For a catalogue of public education materials or copies of our leaflets contact: Leaflets Department, The Royal College of Psychiatrists, 21 Prescot Street, London E1 8BB. Telephone: 020 7235 2351 x 2552.

Charity registration number (England and Wales) 228636 and in Scotland SC038369.

 

Please note that we are unable to offer advice on individual cases. Please see our FAQ for advice on getting help.

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