Why Am I Tired All the Time? Fatigue vs. Sleepiness

If you truly want to understand why you’re so exhausted and determined to find a solution, it helps to know the difference between sleepiness and fatigue.

why am i tired all the time

Fatigue and sleepiness are actually different conditions.

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If you’ve been wondering “Why am I tired all the time?” you may be chronically sleepy, or fatigued, or both. If you truly want to understand why you’re so exhausted, and find a solution, it helps to know the difference between the two. Often some detective work is needed before you can regain your energy.

Tiredness symptoms are often used to describe both fatigue and sleepiness. In fact, the terms are often confused and, in reality, have plenty of overlap between them. The definitions and distinctions between them are blurry and difficult to make, even by doctors. However, fatigue and sleepiness are actually different conditions, and tiredness is more of a general word that can describe either fatigue or sleepiness.

Excessive Daytime Sleepiness

Sleepiness is normal when it functions as the signal that triggers onset of sleep. Normal sleepiness or tiredness symptoms are part of healthy physiological functioning, depend on previous sleep, and occur at regular intervals following a circadian rhythm.

Abnormal sleepiness is associated with falling asleep or fighting to stay awake at inappropriate times. If it persists for a few months or more, sleepiness is considered chronic and abnormal.

In the medical world, these persistent tiredness symptoms are often referred to as “excessive daytime sleepiness” or “hypersomnia”. Excessive daytime sleepiness is defined as “the inability to stay awake and alert during the major waking episodes of the day, resulting in unintended lapses into drowsiness or sleep.”

Excessive daytime sleepiness is one of the most common complaints made to sleep specialists. The excessive tiredness symptoms are not to be taken lightly. Excessive daytime sleepiness results in reduced quality of life and is associated with an increased risk of diseases such as coronary heart disease and strokes, and even with an increased risk of dying from any cause.[1,2]

The severity of daytime sleepiness is typically determined using a short standardized questionnaire called the Epworth Sleepiness Scale. A score of greater than or equal to 10 indicates excessive daytime sleepiness.


Fatigue is defined as an overwhelming sustained sense of exhaustion and decreased capacity for physical and mental work at the usual level. Obviously, life itself becomes difficult when your body is too tired to move and your brain is too tired to think.

Unless you’re also suffering from disrupted sleep, fatigue is not usually accompanied by excessive daytime sleepiness that results in unintended lapses into sleep. In order to recover from fatigue, you need rest, not just sleep.

The severity of fatigue can also be determined using a standardized questionnaire called the Fatigue Symptom Inventory. An average score of greater than or equal to 3 indicates significant fatigue.

How to Boost Your Energy Levels

There are a variety of natural remedies that help boost energy levels without the side effects associated with the use of pharmaceutical drugs or the harmful stimulants found in many over-the-counter energy products. To learn more about these natural remedies and whether they may help you regain your vitality, see these posts:

[1] Ann Neurol. 2011 Oct 31.

[2] J Am Geriatr Soc. 2000 Feb;48(2):115-23.

This article was originally published in September 2012 and has been updated.

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Kathleen Jade, ND

Dr. Kathleen Jade is a naturopathic physician and served for many years as the Medical Director and Editor-In-Chief of Natural Health Advisory Institute. She has been licensed as a primary … Read More

View all posts by Kathleen Jade, ND

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  • Hi,My mom was recently daegnosid with severe sleep apnea. She has been fitted with two different masks (nasal pads, and nasal mask) over the past couple of weeks and is still complaining of the feeling of pressure building up to the point of burping as well as EXTREME anxiety with relaxing with her gear on to fall asleep. She is beyond frustrated and exhausted and is longing for a good night’s rest. Any thoughts, suggestions on these issues would be greatly appreciated.Thank you!

  • Im a 30 year old male. I sleep fairly well at night. But still all through the say I am so exausted. I dont have too much energy to do much. It is frustrating. Its putting a burden on my relationship. I just dont know what to do any more. Energy drinks and coffee just makes me more tired.

  • I’ve felt exhausted all the time for years though doctors said I was healthy and hormone levels normal. It really takes a toll on relationships. Finally at age 39 I saw a naturopath who diagnosed adrenal exhaustion, and I’m getting some help.

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