Are you a woman who wakes up unrefreshed, wishing you had another hour (or two) to snooze? According to a recent survey from the AASM women report never-rarely feeling refreshed after waking up, 1.5x more frequently than men. If this sounds like you, there may be a reasonable medical condition to explain why your energy levels are low. Below is a list of 10 medical conditions that can explain why women are tired.
1. Undiagnosed Obstructive Sleep Apnea
Adults are advised to sleep 7-9 hours a night and according to the CDC 1/3 of adults are getting less than the seven hours of recommended sleep. There is no gender difference between the amount of sleep women vs men need. A big concern in sleep medicine is that nine out of ten women are don’t know that they have obstructive sleep apnea, a treatable condition leading to excessive sleepiness that is associated with snoring, gasping for air or pauses during sleep (apneas). A potential reason why women are underdiagnosed is that their symptoms may be more subtle than men and instead of snoring or have apneas they wake up feeling unrefreshed, irritable, or with a morning headache. If you have symptoms of sleep apnea talk to your doctor about getting a sleep study which can be run in the comfort of your own home.
2. Hormonal Issues
Common medical concerns associated with hormones are thyroid conditions and perimenopause or menopause. Symptoms of hypothyroidism (low thyroid function) include dry skin, constipation, decreased energy, fatigue, or depression. Changes in women’s sex hormones during perimenopause and menopause can also lead to low energy and disrupted sleep. Listen to this podcast with menopause expert, Dr. Heather Hirsh, where we discuss the ins and out of sleep during perimenopause and menopause. A blood test can detect if your thyroid levels are off. During perimenopause your hormones levels may be normal however in menopause levels estrogen and progesterone are often very low or undetectable.
3. Vitamin Deficiencies
Vitamins are absorbed in our body from the food we eat however, depending on the amount of fruit and veggies you consume, your vitamin levels may be low or deficient. Two vitamin deficiencies associated with feeling tired are B12 and D.
- Vegans and vegetarians need to supplement their diet with B12 as most sources of vitamin B12 are from meat.
- Exposure to the sun helps our body increase vitamin D levels however if you avoid the sun to prevent skin cancer or wrinkles or live in an area with limited amounts of sun during the wintertime you made need to take a vitamin D supplement.
Ask your doctor to check your blood for vitamin B12 and D if you are feeling exhausted.
4. Heart conditions
High blood pressure and irregular heart rhythms and the medications used to treat these conditions may zap your energy levels. The heart is vital organ that transports oxygen to different parts of your body. If your heart isn’t working efficiently due to issues with blood pressure or heart rate it can decrease the delivery of oxygen which can leave you feeling more tired and drained. Home blood pressure machines are readily available at your local drug store. Apps such as QALY and Kardia can measure if you have an irregular heartbeat from a wearable fitness tracker and the data can be directly sent to your doctor to analyze.
Having extra weight on your body can lead to sleepiness because of the increased energy required needed to carry a heavier load around. People who are obese have higher rates of obstructive sleep apnea as the extra weight around the neck can affect one’s breathing. If not treated this can lead to waking up tired and feeling of somnolence throughout the day. Obesity is also linked to increased inflammation and decreased level of physical activity which can also affect your energy levels. To find out if your BMI is elevated check out this BMI calculator from the CDC.
Fibromyalgia is a rheumatologic condition associated with muscle pain, memory issues, poor sleep, and fatigue. This condition is more common in women than men. Fibromyalgia disrupts your sleep quality by causing alpha intrusions or periods of arousals when during the night that can leave you feeling worn out in the morning and throughout the day. To learn more about fibromyalgia read this article from the Mayo Clinic.
Women have higher rates of mood disturbances such as depression, which may be related to changes in hormones and social factors such as caregiving for children and/or elderly parents. Feeling down and having a depressed mood, can put a damper on your motivation to do things you normally enjoy. Depression can also lead insomnia, or the opposite oversleeping also known as hypersomnia. Mood disturbances are something not to take lightly and if you have symptoms of depression, please seek care from your doctor or visit Psychology Today to find a therapist in your area.
Acute or chronic pain can disrupt your sleep and affect your mood which can make you mentally and physically exhausted. Some of the pain medications (specifically opioids) can affect your breathing at night and may lead to a medical sleep condition called central sleep apnea. If you are taking long-acting opioid medications and have difficulty breathing during sleep, ask your doctor to order an overnight in-laboratory sleep study. Weaning off opioid medications or being on a machine to help you breathe during sleep are treatment options for central sleep apnea.
Menstruating women with heavy periods are at risk for developing anemia, which is defined as having lower than normal levels of red blood cells. Low iron levels from blood loss, vitamin B12 deficiencies, or hereditary conditions are several causes for anemia. Anemia is diagnosed from a blood test your doctor can order.
According to the Office of on Women’s Health one in nine adult women have diabetes, a medical condition where blood sugar levels are elevated. This results in lowered energy levels and nocturia, waking up at night to urinate to rid your body of excess sugar. Diabetes is an inflammatory condition for your body and complications of it include an increased risk for heart disease and stroke. Women with diabetes can have difficulties with fertility and pregnancy. A fasting blood test to test your glucose level or your hemoglobin A1c (blood sugar levels over the past 2-3 months) is how diabetes is diagnosed.
What do you do if you are tired and suspect you have one (or more of the above 10 medical conditions? Talk to your doctor about it. Also bring in a diary of when your symptoms started, how frequent they are, and what you have tried to help. Check out our free checklist on the 4 questions to ask your doctor if you are chronically exhausted.