Why Am I So Tired?5
Posted In Health
If you’ve ever asked this question, you’ve come to the right place. The importance of sleep can not be underestimated. Improving your sleep can, quite literally, change your life, if you’re sleeping poorly.
You may not even realize that you’re not sleeping well. If you’re always tired during the day, or having trouble falling asleep this guide can help you get better sleep as well as find ways to make time for more sleep. The improvement in quality of life can be substantial.
Why Am I So Tired? The Effects of Poor Sleep
Mild Sleep Deprivation or Poor Quality Sleep
The effects of sleep deprivation run along a continuum. Early stages include impact on how we feel:
- We’re more easily irritated
- We feel tired particularly after meals
- We experience a general mental fog
- Recall is slower
Everyone has experienced this. But what happens when we have a string of nights with less than ideal sleep? Real sleep deprivation occurs very quickly. Sleeping 7 hours per night for one week is enough to impair cognitive function, particularly when performing multiple tasks.
What would you do to be 10% smarter? An hour of sleep could do it.
Sleep deprivation also affects our physical performance:
- Poor recovery or loss of strength in the gym
- Greater likelihood of DOMS (delayed onset muscle soreness) post workout
- Lower growth hormone production which reduces our ability to repair injury
- Reduced ability to metabolize sugar resulting in increased fat and eventual heart disease
- Increases in general inflammation and sensitivity to pain
The time you spend in the gym can be undone by missing out on sleep.
I had no idea that I had sleep apnea until I saw a doctor about some chronic shoulder pain. With no other information, he took one look at me, and in an instant said “you have sleep apnea.” A sleep study confirmed his suspicion.
Years on the road, sleeping in hotels, a high pressure job, and eating on an expense account had taken their toll. I had put on 50 pounds and struggled to stay awake virtually all day long, despite sleeping for sometimes 10 hours per night. Though the sleep study showed that I would stop breathing several times per hour, and my blood oxygen would drop substantially, I was just outside the high risk category which would qualify me for a CPAP (sexy darth vader mask which makes breathing easier at night).
This meant I was on my own. Aside from a nasal spray, usually used for allergy sufferers, the doc couldn’t do anything for me. Many of the common treatments actually make the problem worse. Provigil, could keep me awake during the day (or allow me to fly a fighter jet after not sleeping for 5 days), but it only increased the amount of real sleep I needed and wasn’t getting.
Over the next two years I tried about everything I could come up with. I also learned seemingly unrelated things, like shoulder pain, go hand in hand with sleep quality.
What I developed was a system for optimizing each factor that I could control. Many of these factors aren’t often part of the sleep discussion. Even if your sleep is pretty good, this guide can make it better.
Although fat loss is usually the answer for a sleep apnea sufferer, it doesn’t happen over night, and without sleep, exercise is brutally difficult.
Severe Sleep Deprivation
Long term or consistent sleep deprivation can have wild effects. In many cases, sleep deprivation effects physical performance not unlike intoxication:
- Slurred speech
- Slowed reaction time
- Immune system failure and eventual death (in rats studies death occurs within 2-5 weeks)
In order to protect yourself, your body will eventually go into microsleep cycles, where you almost instantly fall asleep, for moments at a time, and may not even realize it.
We usually think of truck drivers when we think of dangerous sleep deprivation. People fall asleep at the wheel all the time. Just as dangerous though, is someone who simply works long hours. A 20 minute drive home can be just as dangerous for someone working 70 hours a week or someone working on a changing schedule.
What is Sleep Anyway?
Your body will tell you when you’re tired, but sleep is really for the brain. Without it, your brain just doesn’t work. Sleep acts as a reset for the brain, it restores brain function. Just as your muscles need repaired after exercise, your brain needs repaired after thinking and controlling your body all day.
We measure sleep via the brain. When you hook someone to a EEG you can watch their brain waves change as they pass from one stage to the next. Sleep is first divided into non Rapid Eye Movement (NREM) and Rapid Eye Movement (REM) sleep. NREM sleep is then comprised of three stages N1, N2, and N3 each of which is a progressively deeper sleep. Though out the night you will move between each of these stages.
When you get poor quality of sleep you are usually missing out on REM. Although you dream during all stages of sleep, REM dreams are usually longer, more emotional, and memorable. Generally REM occurs later in the sleep cycle and is more likely after waking briefly. Lack of dreaming may be an indicator of poor sleep quality.
While REM sleep gets a lot of attention, all the sleep stages seem to have a particular function. During the different stages, different parts of the brain are active or inactive, allowing different parts of the brain to rest and repair themselves. For example during REM the hypothalamus becomes less active. This part of the brain is responsible for tempreture regulation. As a result, you won’t shiver or sweat during REM.
Why Am I So Tired? Sleep Quantity
Before we address quality, we need to address the obvious. No amount of trickery will allow us to get around the fact that we need a certain amount of sleep, every night, at the same time. There is just no way around it.
The first barrier to getting that sleep is usually our jobs. We set an alarm to wake up at a specific time so we can get to work. The time we wake up is usually set in stone, while the time we fall asleep is not. This means that sleep is the lowest priority of the day. Anything that takes up too much time, is taking that time from our sleep.
To tackle the sleep quantity issue we usually have to tackle the biggest issue of all; what we do with our time. The simple answer is going to bed earlier but that’s not always easy. That extra time you spend sleeping has to come from somewhere. Until you eliminate some activity during your day, going to bed early will not happen. Unfortunately, that thing you must eliminate will almost always be something you like doing.
- Skip one TV show every day
- Eat a little earlier
- Spend less time on the internet
Certain parts of your day are mostly set in stone, at least for the short term. You have work to do. After the things you have to do, you’re left with a limited amount of time to do things you want to do.
“I don’t have time.” We all feel this way. But if we can make better use of this time, it gets a lot better.
In a perfect world we wouldn’t have to drive to work or use alarm clocks and for many people this may not be an option. However, it’s never the wrong time to evaluate how our long term career goals affect our health and happiness. For me, sleep was important enough to make a significant career change, because it permeated every other aspect of my health. I saw no other options, and that forced me to do what many people are afraid to do. A career change or simply a priority change is possible and easier than you might expect.
Often the issue is not how much sleep we get, the issue is how deeply you sleep.
The key to increasing your sleep quality is to direct the few factors that you can control. I’ve divided them into three broad categories:
- The quality of your environment
- Your state of mind
- The things you do during the day
The Quality of Your Environment
Where we sleep is important. Some people seem to be able to sleep anywhere, but being able to sleep and sleeping well are two different things.
As we fall asleep our body shuts down processes that respond to input from the world. We’re no longer closely listening for sound. We close our eyes to shut out light. We become less sensitive to touch. This gives the parts of our brain responsible for these senses a chance to rebuild and repair.
So, the most basic step to creating deeper sleep, is to remove as much distraction from our bedroom as possible. The most important of these distractions are those that change (blinking lights) rather than things that are static (a fan blowing).
Start by making your bedroom as dark as possible. Light is one of the key signals that tells our brain when we should be sleeping and when we should be alert.
- Get some heavy curtains.
- Tape over the lights on your gadgets, especially the blinking ones. This will make a surprising difference if you’ve got a clock, TV, DVD player, etc. You can place notepads or pillows over the TV lights in hotel rooms.
- Turn off any push notifications on your cell phone (social networks, email, etc.).
- If you leave the bedroom door open, make sure to address any light that comes from another part of the house.
- Toss a couple clothespins or binder clips in your luggage to hold curtains shut in your hotel room.
A quiet bedroom will help maximize restful sleep. We can’t control all the noise in our environment. Sometimes neighbors are just loud. There are a few tools you can use to reduce or cover up the noise in your environment.
- Earplugs aren’t always the most comfortable solution, but can be a life saver during travel. Earplugs have the bonus feature of protecting your hearing on planes.
- Use a static noise generator such as a fan to drown out dynamic noises such as neighbors, birds chirping early in the morning, or your loved one’s snoring.
- Turn off push notifications, email, etc. on your cellphone.
- If you can avoid using an alarm, do so. This prevents abrupt interruption of REM sleep, which is most common in the morning.
- Using timing to control noise. If you know that they birds start chirping or the garbage truck comes at a certain time, go to bed a little earlier allowing you to get in enough sleep before the noise starts.
The Magic Bullet: Air Quality and Humidity
For many people this is the holy grail. It don’t seem like huge thing, but for some people this will revolutionize sleep quality. The quality of your breathing greatly effects how you sleep. Dry air restricts nasal passages leading to poor breathing and increased snoring. When combined with a little dust or allergens, this could be the difference between great sleep and almost no sleep, particularly for those with mild sleep apnea.
- I recommend the simple “fan plus filter” style humidifiers over those that generate steam. They tend to be cleaner and act as a rough air filter. Be sure to buy one that has filters you can pick up locally. Also grab a couple spare filters. Humidifiers also act as white noise generators.
- Along with humidifiers and air filters, take a look at your home’s ventilation. Replacing the filters in your furnace on a regular schedule not only saves heating and airconditioning costs, it reduces dust in the air.
- Throwing out clutter or just cleaning up the house and bedroom will eliminate dust. Do you have potpourri, antiques, and fake flowers that have been sitting around for the last 5 years? They should probably go.
- In the summer time, opening the windows at night or during the early morning can bring in some added humidity as well as bring in some oxygen.
- Try opening up your patio door or some windows to let in fresh air if the temperature is right. Even opening a window in another part of the house will let some humidity in, while keeping noise in the bedroom to a minimum.
The Best $300 I’ve Ever Spent
I bought a repo house a few years back. The previous owner had cats. The ducts had a solid half inch of cat hair around the vents. Not an exaggeration. After tearing out the carpet and cleaning the ducts it was like a new house.
For about $300 you can have your ducts cleaned. A pro will connect a giant Bissell vacuum to your furnace and then manually dislodge dust and gunk from each of the vents with compressed air and a cleaning solution. Chances are your house has never had the ducts cleaned. If you or the previous owners ever had pets this will make a huge difference in air quality. The same applies to that old carpet you’ve been meaning to get rid of (here’s the best tool for high pile carpets).
You’ll easily save that $300 on your heating and A/C bill so it’s not a bad idea to have it done every 5 years or so.
How old is your mattress? Sleeping is more difficult if you’re not comfortable. We spend a third of our life in bed, but usually don’t give it a second thought.
- Evaluate the age and comfort of your bed. In genera, if you sleep on your side or stomach you’ll want a softer mattress than those that sleep on their backs. Take some time to decide on what feels right.
- $10 will buy a decent pillow. Get one that matches your preference and don’t be afraid to try a few to get it dialed in.
- Get some high thread count sheets and pillow cases that feel comfortable. Pay attention to how they respond to tempreture. I personally need sheets that stay cool, while others may love flannel.
- Don’t share a blanket. Tug of war isn’t a great way to get some rest.
- Wash your pillow cases, blankets, and sheets, on a regular schedule. As an aside, one of the more popular acne treatment regimens also recommends rotating pillow cases every few days. Also, replace your pillow if it’s more than a year old.
- Many people sleep best flat on their back with no pillow as it keeps their spine and neck in better alignment.
Temperature affects how we sleep, and body temperature drops in preparation for sleep.
- Generally most people sleep better with the thermostat slightly cooler. Try a few degrees cooler than usual.
- Use multiple lighter blankets to allow you to regulate temperature more effectively at night. This is much better than one giant comforter as an on/off button.
Get Your Mind Right
Often night time is the only time we get to actually think. The days distraction keeps us from thinking about or addressing those doubts, fears, and problems that seem to come alive at night. Worse yet, in our half asleep half awake state, we tend not to get much resolved. There are a few ways to fix this problem:
- Take a half hour during the day to do nothing. Go for a walk, take a long bath, turn off the TV, and relax for a bit. If you have things that are bothering you, this will give you time to plot that revenge email, decide what to wear tomorrow, or get ready to take over the world. A plan will ease your mind at night. If you don’t have anything to plot, it can give your mind a break from the constant buzz of the day.
- Don’t watch inflammatory semi-news that gets you fired up before bed. We all love the gossip, but politicians will still be politicians tomorrow, and serial killers are few and far between. Spend that time getting more sleep or doing something really relaxing.
- Read humor or something technical and interesting. When you go to bed you should be thinking about something that makes you happy. If I read technical stuff, I try to keep it related to vacationing (ultralight backpacking, travel, etc.). Boring plus positive equals fall asleep fast.
- Remove bright lights a couple hours before bed. TVs, cell phones, etc. Light tells the brain that it’s time to be awake. Watching bright screens reduces sleep quality even when you don’t have trouble falling asleep.
- Set up some rules about what can be discussed in bed (nothing negative). That thing that your alcoholic second cousin did with a samurai sword can wait untill tomorrow. Adrenaline before bed is not your friend.
While You’re Awake
The things you do during the day are just as important as your sleep environment. Living a healthy lifestyle is usually the first step.
- Exercise. If you’re not a gym rat, even a half hour of elevated heart rate will help you sleep. Go for a walk, do some body weight movements, or better yet, get a real trainer. If you have sleep apnea a small reduction in body fat can make a significant or total change in symptoms.
- Get some UV light during the day. While there are special blue lights designed to be used after waking, it’s difficult to beat good old fashioned sunlight. Light controls those circadian rhythms that allows us to stay awake during the day and quickly fall asleep at night.
- Diet influences our sleep. Eating cleaner (more green vegetables and whole foods) will reduce inflammation and generalized pain that makes us uncomfortable at night.
- Consuming foods high in L-Tryptophan, an amino acid found in meat, sunflower seeds, walnuts, and almonds, can help you fall asleep. Tryptophan is a precursor to serotonin which is metabolized into melatonin (melatonin regulates the sleep cycle, covered in brief below).
- Despite the advice of the latest fad diet, adding carbohydrates to dinner can help you sleep as well. We’ve all experienced drowsiness on Thanksgiving or after a large meal. Although often attributed to turkey and L-tryptophan, turkey contains only an average amounts of L-tryptophan. It’s the combination of carbohydrates that spikes insulin, which in-turn increases the uptake of L-tryptophan in the brain.
- Eliminate bad stress in our life, particularly before bed. Easier said than done. Follow this blog for more on stress.
Caffeine and Other Drugs
Stimulants are all around. They help us to concentrate and focus. We run faster and process more. However, they also keep us awake when we want to sleep.
Caffeine is an amazing drug. It supercharges the brain, allowing us to do more in less time. Unfortunately it has two problems.
- First, we develop a tolerance for it very quickly. A dose that initially has us bouncing off the walls, has no effect after regular use. Once we develop a tolerance we also become dependant on caffeine, and the consequence for not getting our morning coffee is grogginess. No longer are we getting a boost, but we need it just to be normal.
- The second problem with caffeine is that it keeps us awake. Because we now have more energy, we can do more work, use more energy, become more tired, requiring us to get more sleep. However, caffeine keeps us awake, particularly when taken late in the day (caffeine has a half life of about 9 hours). So we need more sleep, but get less. When you put all this together, consistent caffeine use makes you more tired than no caffeine at all.
To eliminate caffeine we must address two issues:
- We must address the reason why we need caffeine in the first place; we’re tired. Getting more sleep and better sleep will make you feel more energetic in the morning, but sometimes other factors such as overall health or diet are making us tired. Sometimes we just hate our jobs and don’t want to get up. Find something you love and getting up becomes much easier.
- Caffeine usually comes packaged with a fair amount of calories. A Starbucks Grande Carmel Macchiato alone is 240 calories. If you replace 4 Cokes per day with water for example, that’s 560 calories and 156 grams of sugar; an entire meal. So you’re tired, and have a headache, but now your blood sugar has dropped to nothing. Without replacing these calories with something of value, you will be crushed. I see this all the time with those who don’t each much but drink cokes all day long. Almost half of their calories come from sugar so when they try to give up cokes they feel terrible because they’re hungry.
Other drugs have various influences on our sleep. One of the most common are pain killers. Anything operating in the brain is likely to have side effects. Many of these directly effect serotonin and other neurotransmitters that control mood and arousal. The key here is to pay attention to changes.
- If you are prescribed something new, how does it affect your sleep?
- Are their alternatives that don’t affect sleep?
- Are their ways to fix the underlying problem through diet, corrective exercise, soft tissue work, manual therapy, etc? An anti-inflammatory diet goes a long way.
I was able to reduce chronic shoulder and hip pain about 90% with corrective exercises, soft tissue work, and a slightly cleaner diet. Better sleep was both a result and a solution.
Some people just need chemical solutions. For whatever reason, some people have chemical imbalances that interrupt their sleep cycle. This should always be a last resort, but if you’ve tried everything else, talk to your doctor. My friend can easily stay awake all night, sleeping only 1-2 hours. He’s exhausted but can’t fall asleep. Nothing he did would help. He finally started taking Ambien and it changed him completely. Ambien comes with its own side effects, but for him, they are more than worth it.
A milder alternative to prescriptions sleep aids is Melatonin. For those with sleep cycle disorders, low dose melatonin supplementation with light therapy may be a viable option. A doctor can provide guidance and diagnosis.
All things improve with consistency, but with sleep, consistency is the name of the game. You can’t save up sleep, and you can’t compensate for lack of sleep quickly by sleeping in. You need it each day.
Circadian rhythms are the natural cycles of the brain and body that control how we operate through the day. Neurotransmitters such as melatonin regulate body temperature and arousal so that we can fall asleep quickly and stay awake all day. These rhythms are influenced by light.
Changes in our schedules interrupt those circadian rhythms. We can interrupt this schedule by staying up too late, going to bed at different times, etc. If done consistently, our performance decreases, we get less sleep overall, and the quality of our sleep suffers.
Even if we try to compensate by sleeping in, this doesn’t change the fact that we’ve forced our brain to adjust its clock.
We can not only improve our sleep but also improve our life by implementing small daily rituals. By having a default plan for each day we reduce the number of decisions we need to make. Our body becomes used to a certain schedule. Examples:
- Eat consistent food at consistent times each day
- Go to bed at the same time each day
- Take a hot or cold shower before bed
- Plan your evenings to wind down a couple hours before bed. Turn off the TV, read a book, etc.
Take action now!
There’s a lot to digest here. Pick something small and make a change. Small improvements in sleep quality can make large differences in the quality of our life. Stop asking why am I so tired and do something about it.
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Disclosure: Talk with your doctor, attorney, psychiatrist, shaman, pet, and gardener before implementing any of the ideas in this or any other article. Lead image courtesy lrargerich
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