Sleep and tiredness: key facts
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.
- 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
Poor sleep makes you more likely to get high
blood pressure, diabetes and to be overweight.
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:
- Being overweight - your body has to work harder just to do
- Being underweight - your muscles aren't strong enough to do
- 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:
- chronic infections
- 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.
- Worry or stress, especially if you can't see a way out of your
- 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
- 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.
- 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
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).
To sleep better, make sure that you:
- Have a comfortable bedroom - not too hot, not too cold, not too
- 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
- 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
- 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
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.
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
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.
a catalogue of public education materials or copies of our leaflets
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