Everyone feels tired now and then. Sometimes you may just want to stay in bed. But, after a good night's sleep, most people feel refreshed and ready to face a new day. If you continue to feel tired for weeks, it's time to see your doctor. He or she may be able to help you find out what's causing your fatigue and recommend ways to relieve it.

Fatigue itself is not a disease. Medical problems, treatments, and personal habits can add to fatigue. These include

• Taking certain medicines, such as antidepressants, antihistamines, and medicines for nausea and pain
• Having medical treatments, like chemotherapy and radiation
• Recovering from major surgery
• Anxiety, stress, or depression
• Staying up too late
• Drinking too much alcohol or too many caffeinated drinks
• Pregnancy

One disorder that causes extreme fatigue is chronic fatigue syndrome (CFS). This fatigue is not the kind of tired feeling that goes away after you rest. Instead, it lasts a long time and limits your ability to do ordinary daily activities.

Exhaustion seems to be on the rise. Fatigue is one of the symptoms most often reported by people with COVID-19, and their tiredness can linger. Add this to the many other causes of fatigue that existed before the pandemic—such as lack of sleep, mental health concerns, and health conditions like anemia or heart disease. Overall, it seems, we are one weary nation.

Fatigue can be helpful. It can be a warning sign that you need to ease up after strenuous exercise. Or it can make you rest if you get sick. But more often, fatigue creates problems. It can be an overwhelming and lasting feeling of exhaustion that makes it hard to do everyday tasks.

“There are different aspects of fatigue. It’s generally agreed that the sensation of fatigue can involve difficulty in starting or continuing an activity,” says Dr. Vicky Whittemore, who is involved in NIH’s fatigue-related research programs. “It can involve the perception that the effort to perform an activity is more than should be needed.”

Fatigue itself is not a disease. Rather, it’s a symptom. It can be caused by viral infections, certain medications, unhealthy eating, cancer and its treatments, depression or anxiety, and more.

Because it has so many possible causes, it can be hard for doctors to diagnose the origins of someone’s fatigue. This can make it difficult to develop an effective treatment plan. But your doctor can help you figure out where to start.

Making lifestyle changes can provide some people with relief. But these changes may not be enough for everyone. Certain health conditions can contribute to exhaustion. Some are treatable, such as a vitamin or mineral deficiency. But not much is known about other causes of fatigue.

One cause of debilitating fatigue is a serious disease called myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS). ME/CFS causes long-lasting, severe exhaustion, along with flu-like symptoms (called post-exertional malaise). People with ME/CFS may also have sleep problems, pain, or “brain fog.” Brain fog is when you have trouble thinking or concentrating. Physical or mental activity can make ME/CFS symptoms worse.

Researchers have not yet found an effective way to diagnose or treat ME/CFS. However, its symptoms overlap with those seen in people with Long COVID. Long COVID arises when COVID-19 symptoms last weeks or months after infection. Experts estimate that around 20% of individuals with Long COVID will also be diagnosed with ME/CFS.

These similarities create new opportunities for scientists to uncover the biology behind fatigue. So, NIH is bringing together researchers from different fields and is providing new funding to help scientists tackle the mysteries of these and other forms of fatigue.

“The study of Long COVID is bringing light to many issues that the ME/CFS community has been exploring for years,” Whittemore says. “I think this research will help us better understand fatigue and get at the underlying mechanisms.”

How Can I Feel Less Tired?

Healthy lifestyle changes may help you regain energy:

• Eat a healthy diet. Nutritious foods can give you energy to do things you enjoy.
• Get physically active. Experts recommend healthy adults get at least 150 minutes of moderate physical activity a week. Those with ME/CFS or Long COVID should talk with their health care provider before exercising.
• Get enough sleep at night. Adults need at least seven or more hours of sleep each night.
• Quit smoking. Smoking is linked to many conditions that can drain your energy. You can get free help at 1-800-QUIT-NOW or smokefree.gov.
• Limit alcohol. Experts suggest no more than one drink per day for women and two for men.
• Talk to a health care provider if you’ve been tired for several weeks with no relief.

Being bored can make you feel tired. That may sound strange, but it's true. If you were very busy during your working years, you may feel lost about how to spend your time when you retire. When you wake up in the morning, you may see long days stretching before you with nothing planned. It doesn't have to be that way.

Engaging in social and productive activities that you enjoy, like volunteering in your community, may help maintain your well-being. Think about what interests you and what skills or knowledge you have to offer and look for places to volunteer.

Are you fearful about the future? Do you worry about your health and who will take care of you? Are you afraid you are no longer needed? Emotional stresses like these can take a toll on your energy. Fatigue can be linked to many conditions, including:

• Anxiety
• Depression
• Grief from loss of family or friends
• Stress from financial or personal problems
• Feeling that you no longer have control over your life

Not getting enough sleep can also contribute to fatigue. Regular physical activity can improve your sleep. It may also help reduce feelings of depression and stress while improving your mood and overall well-being. Yoga, meditation, or cognitive behavioral therapy could also help you get more rest. Talk with your doctor if your mental well-being is affecting your sleep or making you tired.

Fatigue is a feeling of weariness, tiredness, or lack of energy. It can be a normal response to physical activity, emotional stress, boredom, or lack of sleep, but it can also signal a more serious mental or physical condition.

Everyone feels tired now and then. If you feel tired continuously for multiple weeks, you may want to see your doctor, who can help discover what’s causing your fatigue and identify ways to relieve it.

What causes fatigue?

Sometimes, fatigue can be the first sign that something is wrong in your body. For example, people with rheumatoid arthritis, a painful condition that affects the joints, often complain of fatigue. People with cancer may feel fatigued from the disease, treatments, or both.

Many medical problems and treatments can add to fatigue. These include:

• Having medical treatments, like chemotherapy and radiation, or recovering from major surgery
• Infections
• Chronic diseases like diabetes, heart disease, kidney disease, liver disease, thyroid disease, and chronic obstructive pulmonary disease
• Untreated pain and diseases like fibromyalgia
• Anemia
• Sleep apnea and other sleep disorders
• Recent stroke
• Parkinson’s disease
• Taking certain medications, such as antidepressants, antihistamines, and medicines for nausea and pain

Talk with your doctor about any concerns you may have about fatigue and your health condition. Treating an underlying or known health problem may help reduce fatigue.

• Parkinson’s disease and fatigue

  Fatigue can be a non-movement symptom of Parkinson’s disease. It is common early on in Parkinson’s, but a person can experience fatigue at any point during the disease. If you or someone you know with Parkinson’s is experiencing fatigue, it’s important to talk with your doctor.

Emotional exhaustion: Can emotions cause fatigue?

Do you worry about your health and who will take care of you? Have you recently lost a loved one? Or have you lost your mobility and independence? Emotional stresses like these can take a toll on your energy. Fatigue can be linked to many conditions, including:

• Anxiety
• Depression
• Grief from loss of family or friends
• Stress from financial or personal problems
• Feeling that you no longer have control over your life

Not getting enough sleep can also contribute to fatigue. Regular physical activity can improve your sleep, help reduce feelings of depression and stress, and boost your mood and overall well-being. Yoga, meditation, deep breathing, and stretching may help reduce stress and anxiety and help you get more rest. Therapy or certain medications may also help relieve anxiety and depression that may be contributing to fatigue.

Talk with your doctor if your mental health seems to be affecting your sleep or making you tired.

• What is chronic fatigue syndrome?

  Chronic fatigue syndrome (CFS), also known as myalgic encephalomyelitis (ME) or ME/CFS, is a condition in which fatigue lasts six months or longer and is not related to other diseases or conditions. People with CFS experience symptoms that make it hard to do daily tasks like dressing or bathing. Along with severe fatigue that doesn’t get better with rest, CFS symptoms can include problems with sleep, memory and concentrating, pain, dizziness, sore throat, and tender lymph nodes.

Lifestyle habits and fatigue

Some lifestyle habits can make you feel tired, such as:

• Staying up too late. A good night’s sleep is important to feeling refreshed and energetic. Try going to bed and waking up at the same time every day.
• Having too much caffeine. Drinking caffeinated soda, tea, or coffee, or even eating chocolate, can keep you from getting a good night’s sleep. Limit the amount of caffeine you have during the day and avoid it in the evening.
• Drinking too much alcohol. Alcohol is a central nervous system depressant that changes the way you think and act. It may also interact negatively with certain medicines.
• Getting too little or too much exercise. Regular exercise can help boost your energy levels. Overdoing it without proper rest can cause stress and lead to fatigue.
• Boredom. If you were busy during your working years, you may feel lost about how to spend your time when you retire. Engaging in social and productive activities that you enjoy, such as volunteering in your community, can help maintain your well-being.

Tips to feel less tired

Making changes to your lifestyle may help you feel less tired, for example:

• Exercise regularly. Almost anyone, at any age, can do some type of physical activity. If you have concerns about starting an exercise program, ask your doctor if there are any activities you should avoid. Moderate exercise may improve your appetite, energy, and outlook. Some people find that exercises combining balance and breathing (for example, tai chi or yoga) improve their energy.
• Try to avoid long naps (over 30 minutes) late in the day. Long naps can leave you feeling groggy and may make it harder to fall asleep at night. Read A Good Night’s Sleep for tips on getting better rest at night.
• Stop smoking. Smoking is linked to many diseases and disorders, such as cancer, heart disease, and breathing problems, all of which are associated with fatigue.
• Ask for help if you feel swamped. Some people have so much to do that just thinking about their schedules can make them feel tired. Working with others may help a job go faster and be more fun.
• Participate in activities you enjoy. Socializing with friends and family or volunteering in your community can help you feel more engaged and productive throughout the day.
• Eat well and avoid alcohol. Eating nutritious foods can give you energy throughout the day. Staying away from alcoholic drinks can help you avoid negative interactions with medications.
• Keep a fatigue diary. This can help you find patterns throughout the day when you feel more or less tired. It can also help you plan out activities that may give you more energy.

When should I see a doctor for fatigue?

If you’ve been tired or been experiencing low energy for several weeks with no relief, call your health care provider. They will ask questions about your sleep, daily activities, appetite, and exercise, and likely provide a physical examination and order lab tests.

Your treatment will be based on your history and the results of your exam and lab tests. You may be prescribed medications to target underlying health problems, such as anemia or abnormal thyroid function. Health care providers also may suggest therapy or certain medications to help reduce depression, anxiety, or other emotional contributors that are associated with fatigue. They may also advise that you eat a well-balanced diet and begin an exercise program.

Cancer fatigue is a condition caused by cancer or cancer treatment in which you feel exhausted or extremely tired. Some people with cancer have extreme fatigue most of the time and are unable to carry out day-to-day tasks. Others feel only very tired. Cancer fatigue may also be called cancer-related fatigue or cancer treatment–related fatigue.

Cancer fatigue is different from fatigue you may have felt in the past. When a healthy person is tired, fatigue is usually caused by activity and goes away after resting or sleeping. However, cancer fatigue is not completely relieved by sleep or rest and may happen after no or minimal activity.

Cancer fatigue is common

Cancer fatigue is one of the most common side effects of cancer treatment. More than 80% of people with cancer experience fatigue while receiving chemotherapy or radiation therapy.

Cancer fatigue can occur at any time

Fatigue can begin at any time—before, during, or after cancer treatment. Sometimes it’s an early symptom of cancer, or it can be brought on by the stress of a cancer diagnosis. Fatigue may worsen gradually as you go through treatment, or it may come on suddenly. Fatigue usually decreases after cancer treatment ends, but some people may still feel fatigue for months or years.

Cancer fatigue can affect many areas of your life

Fatigue can affect not only your daily activities but also your family, work, and social life. Although cancer fatigue can feel overwhelming, your health care team can help you find ways to manage, treat, and cope with fatigue that are tailored to you.

Some lifestyle habits can make you feel tired. Here are some things that may be draining your energy:

• Staying up too late. A good night's sleep is important to feeling refreshed and energetic. Try going to bed and waking up at the same time every day.
• Having too much caffeine. Drinking caffeinated drinks like soda, tea, or coffee late in the day can keep you from getting a good night's sleep. Limit the amount of caffeine you have during the day and avoid it in the evening.
• Drinking too much alcohol. Alcohol changes the way you think and act. It may also interact with your medicines.
• Eating junk food. Say "no thanks" to food with empty calories, like fried foods and sweets, which have few nutrients and are high in fat and sugars. Choose nutritious foods to get the energy you need to do the things you enjoy.
• Getting too little or too much exercise. Regular exercise can boost your energy levels, but don’t overdo it.

Chronic fatigue syndrome (CFS), also known as myalgic encephalomyelitis (ME) or ME/CFS, is a condition in which fatigue lasts 6 months or longer and is not related to other diseases or conditions. People with CFS experience symptoms that make it hard to do daily tasks like dressing or bathing. Along with severe fatigue that doesn’t get better with rest, CFS symptoms can include problems with sleep, memory and concentrating, pain, dizziness, sore throat, and tender lymph nodes.

Caring too much can hurt. When caregivers focus on others without practicing self-care, destructive behaviors can surface. Apathy, isolation, bottled up emotions and substance abuse head a long list of symptoms associated with the secondary traumatic stress disorder now labeled: Compassion Fatigue

Compassion fatigue, often referred to as secondary or vicarious trauma, is the emotional and physical exhaustion that results in a reduced ability to empathize or feel compassion for others. Healthcare workers, even the most dedicated, are prone to compassion fatigue.

Signs and symptoms of compassion fatigue include:

• Irritability, anger, anxiety
• Disturbances in sleep, such as insomnia or nightmares
• Feeling burdened by the suffering of others
• Reduced career fulfillment
• Isolation
• Physical and mental fatigue
• Loss of pleasure in life
• Difficulty concentrating
• Bottling up your emotions
• Dreading care for another and subsequent guilt
• Numbness, hopelessness or powerlessness
• Excessive use of drugs or alcohol
• Poor self-care
• Denial, which can prevent individuals from recognizing the condition and seeking help

Self Assessment:

Denial has been noted to be one of the most dangerous symptoms of compassion fatigue. Self assessments for Compassion Fatigue (ProQoL ), Life Stress and Empathy are available at: http://www.compassionfatigue.org/pages/selftest.html

What Can You Do to Manage or Prevent Compassion Fatigue:

• Be kind to yourself and recognize what you DO.
• Be proud of what you do and recognize limitations.
• Evaluate boundaries, when it is appropriate to say no or set limits and delegate. You don’t have to do it all!
• Access coworkers as supports.
• Use healthy coping strategies such as
  • talking to others who are supportive of you expressing your feelings and experiences
  • exercise
  • eat healthy
  • take breaks and get enough sleep
• Seek professional help for significant and/or persistent distress.

Fatigue can result when you do not get enough sleep or do not get quality sleep. It can impair your driving, similar to alcohol impairment. A survey of the U.S population found that 37% of workers got less than the recommended minimum of 7 hours of sleep.

What causes fatigue?

• Being awake for many consecutive hours
• Not getting enough sleep over multiple days
• Time of day: Your body has a sleep/wake cycle that tells you when to be alert and when it’s time to sleep. The urge to sleep is the most intense in the early morning hours.
• Monotonous tasks or long periods of inactivity
• Health factors such as sleep disorders or medications that cause drowsiness

What are the effects of driver fatigue?

• Nodding off
• Reacting more slowly to changing road conditions, other drivers, or pedestrians
• Making poor decisions
• Drifting from your lane
• Experiencing “tunnel vision” (when you lose sense of what’s going on in the periphery)
• Experiencing “microsleeps” (brief sleep episodes lasting from a fraction of a second up to 30 seconds)
• Forgetting the last few miles you drove

What can employers and workers do to prevent driver fatigue on the job?

Employers:

• Implement policies that set overtime limits and maximum allowable consecutive shifts.
• Ensure sufficient staffing levels across operations.
• Provide employee training on sleep health and fatigue management.
• Implement a workplace sleep disorder screening and management program.
• Allow for rest breaks and napping during extended work shifts.
• Give supervisors and workers fatigue-symptom checklists and encourage self-reporting.
• Encourage peer monitoring of fatigue symptoms among co-workers.
• Review data from in-vehicle monitoring systems to detect signs of possible fatigue episodes, such as lane departures.
• Consider using wearables such as an instrumented wristband to monitor driver fatigue.
• Train incident investigators to assess the role of fatigue in incidents and near-miss incidents.

Workers:

• Get enough sleep (7-9 hours each day). If fatigue persists after adequate sleep, get screened for health problems that may be affecting your sleep.

• Plan your activities outside work to allow enough time for adequate sleep.
• Create a sleeping environment that helps you sleep well: a dark, quiet, cool room with no electronics.
• If you feel fatigued while driving: pull over, drink a cup of coffee, and take a 15-30 minute nap before continuing. The effects are only temporary – the only “cure” for fatigue is sleep.
• Watch yourself and your co-workers for signs of fatigue.
• Report instances of fatigue in yourself and others to your direct supervisor, who can help to determine the safest course of action.
• Speak honestly if you are questioned about a fatigue-related incident. Fatigue is a normal biological response – it is not a reflection of how well you do your job.

The bottom line:

No amount of experience, motivation, or professionalism can overcome your body’s biological need to sleep. Employers and workers can take steps to prevent the chain of events that could lead to a fatigue-related crash. Employers, learn more about starting a fatigue risk management system.

Fatigue has been broadly described as “a feeling of weariness, tiredness or lack of energy”. In workplace settings, it is commonly associated with nonstandard schedules, such as night shift work and extended work hours, which disrupt or shorten sleep. Fatigue can also be associated with other workplace factors such as stress, physically or mentally demanding tasks, or working in hot environments. It can stem from a number of different factors and its effects extend beyond sleepiness. Fatigue can slow down reaction times, reduce attention or concentration, limit short-term memory and impair judgement.

High levels of fatigue can affect any worker in any occupation or industry with serious consequences for worker safety and health. Learning the risks for fatigue-related events, identifying the sources of fatigue, and using strategies to manage fatigue will help keep workers safe and healthy.

Some changes to your lifestyle can make you feel less tired. Here are some suggestions:

• Keep a fatigue diary to help you find patterns throughout the day when you feel more or less tired.
• Exercise regularly. Almost anyone, at any age, can do some type of physical activity. If you have concerns about starting an exercise program, ask your doctor if there are any activities you should avoid. Moderate exercise may improve your appetite, energy, and outlook. Some people find that exercises combining balance and breathing (for example, tai chi or yoga) improve their energy.
• Try to avoid long naps (over 30 minutes) late in the day. Long naps can leave you feeling groggy and may make it harder to fall asleep at night.
• Stop smoking. Smoking is linked to many diseases and disorders, such as cancer, heart disease, and breathing problems, which can drain your energy.
• Ask for help if you feel swamped. Some people have so much to do that just thinking about their schedules can make them feel tired. Working with others may help a job go faster and be more fun.

If you've been tired for several weeks with no relief, it may be time to call your healthcare provider. He or she will ask questions about your sleep, daily activities, appetite, and exercise and will likely give you a physical exam and order lab tests.

Your treatment will be based on your history and the results of your exam and lab tests. Your doctor may prescribe medications to target underlying health problems, such as anemia or irregular thyroid activity. He or she may suggest that you eat a well-balanced diet and begin an exercise program.