Reasons for Feeling Sleepy All the Time

Are you yawning and wondering, "Why do I feel so tired all the time?" If so, you may have excessive daytime sleepiness (EDS) or fatigue. These are among the most common complaints healthcare providers hear, and they're not an easy thing to fix—in large part because they have many potential causes.

EDS is defined as an "inability to maintain wakefulness and alertness during the major waking episodes of the day." If you have EDS, you may find yourself dozing off unintentionally or at inappropriate times. EDS isn't a passing thing—the official diagnostic criteria say it has to occur daily for three months or longer.

Fatigue is a "lack of physical or mental energy." The term is often used to mean tiredness that's not relieved by rest. For it to be clinical fatigue, meaning that it's medically significant and should be treated, it involves:

• Feeling too weak to start an activity
• Quickly tiring during activity
• Difficulties with concentrating, memory, and emotional stability

It's common for sleepiness, fatigue, and other terms like tiredness or low energy to be used interchangeably. They all overlap with each other and distinguishing between them usually isn't important for a diagnosis.

How Tired Is Too Tired

Excessive sleepiness and sleep deprivation can have significant impacts on your health. They increase the risk of falling asleep while driving, increase chronic pain, throw off hormonal balance, and lead to weight gain. Quality of life can be significantly compromised by poor sleep. Symptoms of being sleep deprived can include:

• Desire to rest or sleep
• General weakness
• Muscle pain
• Loss of interest, energy, and motivation
• Feelings of heaviness in your head or legs
• Feeling especially cold
• Sore eyes
• Sensitivity to noise
• Anxiety, impatience, and irritability

A night or two of poor sleep, heightened stress, or more exertion than usual can make anyone feel this way. When it's a constant or regular state for you over a period of several days without an obvious cause, it's impacting your life, and if it accompanies other symptoms, you should talk to your healthcare provider about it. The major possible causes your healthcare provider is likely to investigate include:

• Lifestyle factors
• Common medical causes
• Sleep disorders
• Medication side effects

Lifestyle Factors

Different aspects of your lifestyle can have a big impact on your EDS and energy levels. Expect your healthcare provider to ask about:

• Diet
• Sleep habits
• Sedentary lifestyle
• Overexertion
• Work schedule
• Stress levels

Diet

Food is where most of your energy comes from. if you skip meals, don't get enough nutritious food, or eat a lot of junk food, you may not be providing enough fuel for your body. You may also be consuming things that have a direct negative effect on how tired or fatigued you are. Diet-related causes of excessive sleepiness include:

• Vitamin and mineral deficiencies, especially of iron, vitamin B12, and vitamin D
• Blood sugar fluctuations—either too high or too low—which impair your body's ability to get energy to the cells
• Excessive alcohol consumption, which may help you get to sleep initially but impairs sleep quality
• Caffeine overconsumption, which impairs sleep

Once your healthcare provider identifies one of these factors as a possible cause of your fatigue or EDS, simple dietary changes and/or nutritional supplements may help you feel better.

Poor Sleep Habits

The most common cause of feeling too sleepy or drowsy during the daytime might be the most obvious: You're simply not getting enough sleep, and improving your sleep habits may help. Poor sleep habits include:

• Not setting aside enough time to sleep because you don't know how much sleep you need or have too many obligations
• Trying to sleep in an environment that isn't conducive to sound sleep (e.g., it's noisy or hot)
• Lacking a bedtime routine or having a routine that doesn't prepare you for falling asleep
• Exercising within a few hours of bedtime
• Napping late in the day

Any one of these things may leave you too sleepy the next day. Making better choices about your pre-sleep routines and sleep environment may help improve your sleep duration and quality. If adopting better habits doesn't improve your sleep quality, talk to your healthcare provider about what could be making you tired.

Sedentary Lifestyle

Being sedentary—not getting much physical activity—makes you more likely to have restless, poor-quality sleep that's interrupted by snoring and pauses in breathing, according to research. Several reasons have been proposed for this, including:

• Higher rates of depression
• Increased rates of metabolic syndrome
• Increased exposure to bright screens

Research also suggests that getting more physical activity can help you improve your sleep quality and feel less tired and sluggish.

Overexertion

Exercising too much or overexerting yourself in other ways can leave your body too depleted to recover overnight, leaving you feeling tired, unmotivated, and possibly even dealing with insomnia. Other symptoms that can go along with overexertion include:

• A decline in your ability to perform
• Depression or mood swings
• Sore, heavy limbs
• Overuse injuries
• Getting sick more often
• Anxiety
• Unintended weight loss

Cutting back on exercise or giving yourself a week or two off to rest and recover may eliminate your EDS and sleep problems.

Stress

Psychological stress can have a big impact on how much and how well you sleep, and, compounding the problem, lack of sleep can make you feel more stressed. According to a survey by the American Psychological Association:

• 43% of adults said stress had kept them awake at night in the prior month
• 21% reported feeling more stressed after not getting enough sleep
• Among those with higher stress levels, 45% said losing sleep increased their stress level
• 37% reported being tired or fatigued due to stress

Research published in 2020 found that getting a good night's sleep helped people maintain positive emotions in the face of a stressful event and allowed them to get more joy from positive experiences.

Lowering your stress levels or learning how to better manage your stress may help you reduce your daytime sleepiness. If you're unable to do this on your own, bring it up with your healthcare provider. You may benefit from talking to a therapist.

Common Medical Causes

Sleepiness, fatigue, and feeling weak are among the most common symptoms of many medical conditions. Common causes of excessive daytime sleepiness include:

• Anemia
• Autoimmune disease
• Cancer
• Chronic fatigue syndrome
• Chronic obstructive pulmonary disease
• Depression
• Diabetes
• Fibromyalgia
• Heart disease
• Infection
• Menopause
• Pregnancy
• Thyroid disease

Some of these illnesses drain your body's resources, while others may impair the cellular processes of energy creation. Some may impair your sleep, either directly or as a consequence of their symptoms—or even treatments.

Anemia

In anemia, you have low levels of red blood cells, which are responsible for carrying oxygen to all of the organs in your body. Common symptoms include:

• Tiredness
• Weakness
• Feeling cold
• Dizziness
• Headache
• Rapid heartbeat

The most common type of anemia comes from iron deficiency, but there are many other causes. It may be caused by an inadequate diet, pregnancy, blood loss, some inherited blood disorders, or chronic illnesses that impact red blood cell creation (such as lupus or advanced kidney disease).

Your healthcare provider can diagnose most forms of anemia through blood tests. Let them know if you're on a restrictive diet, pregnant, or have a family history of anemia or conditions that may cause it. Treatments include nutritional supplements, dietary changes, or in more serious cases, intravenous iron infusion or red blood cell transfusion.

Autoimmune Disease

In autoimmune diseases, your immune system mistakenly identifies normal parts of your body as dangerous pathogens (viruses, bacteria, or fungi) and launches an attack against them, causing tissue damage and chronic inflammation. Common autoimmune diseases include:

• Rheumatoid arthritis
• Lupus
• Multiple sclerosis
• Sjögren's syndrome
• Inflammatory bowel disease

Multiple aspects of autoimmunity and inflammation are believed to contribute to fatigue, including problems with oxygen and nutrient supply, metabolism, and central nervous system impairments. Specific diseases may also contribute to sleepiness because of what systems they disrupt.

Researchers also suspect that dysregulation of chemicals involved in inflammation, called cytokines, may contribute to fatigue. Cytokines play a role in regulating sleep, mood, and cognitive processes.

If your healthcare provider suspects you have an autoimmune disease, expect to receive blood tests and possibly imaging studies as well. Treatment for most autoimmune diseases includes immunosuppressant medications and other drugs to manage symptoms.

Cancer

More than 80% of people with cancer experience cancer-related fatigue. Extreme fatigue that isn't relieved by rest is often an early sign of cancer. Many factors can contribute to the fatigue and weakness of cancer, including:

• Low blood counts or electrolytes
• Altered hormone levels
• Altered cytokine and inflammation levels
• Toxic substances created by cancer that affect cellular function

Cancer treatments can also cause fatigue, including:

• Chemotherapy
• Immunotherapy
• Targeted therapy
• Radiation
• Surgery (during the recovery process)

Your medical team should be able to help you combat fatigue, so be sure to bring it up.

Chronic Fatigue Syndrome

Chronic fatigue syndrome, also called myalgic encephalomyelitis or ME/CFS, is a condition of extreme fatigue that isn't relieved by rest and is associated with flu-like symptoms and cognitive dysfunction ("brain fog"). It's characterized by worsened fatigue and other symptoms in response to even small amounts of exertion (called post-exertional malaise). It can lead to significant impairment and disruption of your life.

The potential causes of ME/CFS aren't fully understood. Some subgroups of people with this disease may have developed it in response to infection, a physical response to chronic stress, or autoimmunity. Research suggests the possible mechanisms of fatigue in ME/CFS involve:

• Depleted adenosine triphosphate, which stores energy in your cells
• Long-term infection
• Dysregulated sleep
• Disrupted energy production on a cellular level
• Dysregulated cytokines and inflammatory activity
• Imbalances of hormones and neurotransmitters involved in sleep and wakefulness
• Disturbed circadian rhythm
• Activated white-matter brain cells (microglia) that create inflammation in the brain, which is linked to fatigue

Someone with ME/CFS may have some or all of these known factors. According to the diagnostic criteria, you have to experience profound, unexplained fatigue for at least six months for ME/CFS to be considered. Even then, this condition is difficult to diagnose, so expect a long process.

No drugs for ME/CFS are approved by the Food and Drug Administration, but it's often treated with a combination of antivirals, antidepressants (for neurotransmitter dysregulation), sleep medications, and other drugs or nutritional supplements to manage specific symptoms. Cognitive behavioral therapy is a common but controversial ME/CFS treatment.

Chronic Obstructive Pulmonary Disease

Chronic obstructive pulmonary disease (COPD) causes wheezing, shortness of breath, and excess mucus in the airways, all of which make it hard to breathe. The disease gets worse over time and is especially common in current or past smokers.

The assumption has long been that difficulty breathing led to fatigue, but some research indicates it's more complicated than that and calls for more investigation into other possible causes. Once those are understood, it should become easier to manage COPD-related fatigue. For now, the primary focus is on breathing exercises and establishing healthy habits.

Depression

Depression, also called clinical depression or major depressive disorder, is more than just feeling sad: It's a mood disorder that makes you have ongoing feelings of sadness and loss of interest in activities. Beyond that, it causes physical symptoms, including EDS and fatigue.

In some people, depression-related fatigue may be due to insomnia or other sleep disturbances. Some researchers have even suggested that fatigue, insomnia, and concentration problems should be considered warning signs of depression.

Fatigue in depression may have some underlying mechanism in common with ME/CFS, including:

• Altered activity of neurotransmitters that help regulate both mood and sleep
• Activated microglia causing neuroinflammation
• Energy dysregulation at the cellular and mitochondrial levels

These commonalities not only explain fatigue as a symptom of depression, but they could also help explain why so many people with ME/CFS have depression as well.

Depression is typically treated with antidepressant medications, including tricyclic and selective serotonin or serotonin-norepinephrine reuptake inhibitors (SSRI/SNRIs). If you believe you may be depressed, it's important to talk to your healthcare provider and get proper treatment.

Diabetes

Fatigue is extremely common in people with diabetes, enough so that in 2018 some researchers made a case for a newly defined condition called "diabetes fatigue syndrome." The possible reasons for the prevalence of fatigue in this disease include:

• Low blood sugar levels impairing the delivery of nutrients to muscles
• Hormonal imbalance
• Nutritional deficiencies
• Side effects of treatment
• Overlapping medical or psychological conditions
• Diet and other lifestyle factors

Diabetes is generally treated with medications that stabilize blood-sugar levels and/or insulin.

Fibromyalgia

Fibromyalgia is a chronic pain condition involving a dysregulated central nervous system that amplifies negative sensations (hyperalgesia) and turns harmless sensations into pain (allodynia). Fatigue and EDS are also major symptoms of fibromyalgia. The suspected causes of fatigue in fibromyalgia include:

• High pain levels that make it hard to sleep
• Sleep irregularities such as unrefreshing sleep and commonly overlapping sleep disorders
• Abnormal activity of neurotransmitters involved in regulating sleep
• Energy dysregulation at the cellular and mitochondrial level
• Widespread activation of white-matter (glial) brain cells leading to neuroinflammation and fatigue

Some of those are similar to causes of fatigue in ME/CFS and depression, which may be why these three conditions often occur in the same people. Treatment of fibromyalgia typically involves antidepressant drugs (tricyclics and SSRI/SNRIs) or anti-seizure drugs along with low-impact, moderate exercise.

Heart Disease

If you have fatigue that's new and constant, it may be an early warning sign of heart failure or, less often, coronary artery disease. These conditions limit the amount of oxygen-rich blood that gets to your muscles or to the heart itself. To keep the heart and brain functioning, your body sends less blood to less important areas, such as your limbs. That leaves them with oxygen deprivation, saps your energy, and leaves you feeling fatigued and weak.

Other symptoms of heart failure, which involves a weak heart muscle, include:

• Shortness of breath
• Irregular heartbeat that may be fast or feel pounding
• Swollen legs and feet

Treatments for heart failure typically include medications such beta blockers, ACE inhibitors, diuretics, implanted devices such as a defibrillator, valve replacement, or heart transplant surgery.

Coronary artery disease involves plaques in your arteries. Common symptoms are the same as those for heart failure but accompanied by chest pain or discomfort. Common treatments include statin and beta-blocker drugs, angioplasty, and sometimes coronary artery bypass surgery.

Infections

Fatigue frequently accompanies infectious illnesses such as:

• COVID-19
• Influenza
• Mononucleosis (mono)

Your fatigue may be due to an illness like this if you also have:

• Fever
• Diarrhea
• Coughing
• Muscle aches

Typically fatigue from infections clears up with the illness, which, depending on the source and severity, may be treated by antibiotics, antiviral medications, symptom management, or simply time and rest.

In some cases, though, fatigue lingers well after the illness itself is gone. This is sometimes referred to as post-viral fatigue, persistent fatigue after infection, or, in the case of COVID-19, post-COVID syndrome, long-COVID, or long-haul COVID. Post-viral fatigue and ME/CFS are sometimes used interchangeably.

More than half of people who've been hospitalized with COVID-19 still have fatigue several weeks after being discharged. Some researchers have begun looking into whether the coronavirus disease can lead to ME/CFS, as the long-haul symptoms are extremely similar.

The Epstein-Barr virus (EBV), which causes mono, is known to linger or reactivate later and cause fatigue, among other symptoms. It's implicated in ME/CFS and several autoimmune diseases.

Treatment for post-viral fatigue depends on the virus involved, the full range of symptoms, and what damage may have been left behind by the original illness. Common treatments are anti-viral medications and immunotherapy.

Menopause

The transition to menopause, starting with perimenopause and continuing into the early post-menopausal stage, is associated with fatigue along with:

• Hot flashes
• Night sweats
• Menstrual irregularities
• Mood swings
• Headaches
• Cognitive problems

The fatigue of menopause may be related to sleep disruptions caused by hot flashes and night sweats. Other causes could be related to hormonal fluctuations, aging, and stresses associated with that time of life. Some research points to a complex relationship between menopausal fatigue and stress.

While menopause isn't a disease that needs to be treated, you do have options for managing symptoms and making yourself more comfortable, including:

• Hormone replacement therapy
• SSRI antidepressants such as Paxil (paroxetine) or Effexor (venlafaxine) for hot flashes, night sweats, and mood issues
• Exercise, including walking, swimming, and yoga

Pregnancy

When you're pregnant, a lot of extra demands are placed on your body, and that can lead to fatigue. It's most common and typically most severe in the first and third trimesters, but some people are exhausted throughout their pregnancies. Causes of pregnancy-related fatigue include:

• Energy needed to create the placenta and nourish the baby
• Metabolic increase
• Hormonal fluctuations
• Low blood sugar
• Low blood pressure
• Digestive changes
• Stress
• Sleep disruption due to pain, needing to urinate during the night, or (later on) the baby's activity

Some research indicates that resistance-training exercise may help alleviate pregnancy fatigue. Other ways to cope with it include:

• Getting lots of rest
• Scaling back on activities or responsibilities
• Eating a balanced diet
• Staying active without pushing yourself too hard

If your fatigue suddenly increases at any point during your pregnancy, it could be a sign that something is wrong, such as depression, iron-deficiency anemia, or gestational diabetes.

Thyroid Disease

An imbalance of your thyroid hormones can cause EDS, and that's true whether your levels are high (hyperthyroidism) or low (hypothyroidism). Your thyroid gland, which sits at the front of your neck, produces several hormones that regulate your metabolism and have a major effect on your health.

Hyperthyroidism

In hyperthyroidism, all the processes in your body are sped up. This causes anxiety, a racing heart, shaking hands, unintended weight loss, and sleep problems. It can also lead to excessive sweating, which can disrupt your sleep. These sleep issues can leave you tired during the day.

Early in hyperthyroidism, you may have a lot of energy. It's not sustainable, though, and as the disease goes on, your body can become depleted and leave you fatigued.

Treatments for hyperthyroidism include:

• Anti-thyroid drugs such as Tapazole (methimazole) or beta blockers
• Radioactive iodine, which lowers hormone levels by strategically damaging hormone-producing cells
• Surgical removal of part or all of the thyroid gland

Surgery and iodine treatments typically drop your thyroid hormone levels to low levels, meaning you'll then need to take synthetic hormones to maintain a healthy level.

Hypothyroidism

In hypothyroidism, all the body's processes are slowed down, and that slowdown itself causes fatigue. Other symptoms include:

• Weight gain in spite of a decrease in appetite
• Becoming easily chilled
• High blood pressure
• High cholesterol
• Dry skin and brittle nails
• Concentration and memory problems
• Loss of interest in things you used to care about

Hypothyroidism is treated with synthetic thyroid hormones.

Sleep Disorders

Excessive daytime sleepiness and fatigue are the primary symptoms of sleep disorders, which include:

• Circadian rhythm disorders
• Insomnia
• Kleine-Levin syndrome
• Narcolepsy
• Restless legs syndrome
• Sleep apnea

If your healthcare provider suspects you have a sleep disorder, they may ask you to keep a log of how long and how well you sleep or send you for a sleep study (polysomnography). Many sleep disorders can be successfully treated once they're identified.

Circadian Rhythm Disorders

Various circadian rhythm disorders can leave you feeling too sleepy during the day. The circadian rhythm is your body's natural clock and it helps coordinate your activities based on when it's light and dark in your environment. If your internal timing is misaligned, you may find yourself with excessive daytime sleepiness. Six common circadian rhythm disorders are:

• Advanced sleep phase syndrome: The distinguishing feature is falling asleep and waking up earlier than desired, usually by about 3 hours.
• Delayed sleep phase syndrome: Similar to insomnia, this causes difficulty falling asleep and makes it extremely hard to wake up.
• Irregular sleep-wake rhythm: Occurs when the circadian rhythm becomes completely disconnected from the natural day-night cycle; sleep is fragmented, with short spells scattered throughout the day.
• Jet lag: A temporary rhythm disorder associated with travel across several time zones; to adjust, it may take one day for every time zone you crossed.
• Nonentrained (non-24) disorder: Usually occurring in people with blindness, the sleep cycle is typically a little longer than average and thus becomes more out of sync every day.
• Shift-work sleep disorder: Poor sleep is caused by working at night and sleeping during the day, which can lead to increased accidents and possibly a heightened risk of some forms of cancer.

Effective treatments for circadian rhythm disorders include light therapy, melatonin, sedatives or stimulant medications, and behavioral changes that improve your sleep habits.

Insomnia

Probably the best-known sleep disorder, insomnia can make it hard for you to fall asleep, stay asleep, or get quality sleep. Just about everyone has an occasional bout of insomnia, but for some, it's a chronic problem that leaves them with EDS and fatigue.

Insomnia can be caused by a combination of genetics; environment; working at odd hours or keeping an unusual sleep schedule; use of stimulants (caffeine, nicotine), depressants (alcohol), or illegal drugs; being sedentary; high stress levels; and getting too much light exposure (such as from screens) close to bedtime.

Treatments for insomnia include:

• Cognitive behavioral therapy to improve sleep habits
• Lifestyle changes
• Sedative medications
• Light therapy

Kleine-Levin Syndrome

Although quite rare, Kleine-Levin syndrome is a condition that may affect young adults, especially men, and can cause recurrent episodes of excessive sleepiness. These episodes can last for days, weeks, or even months at a time, and the tiredness can be incapacitating.

Moreover, the syndrome often interferes with school attendance and basic daily functions. Associated symptoms may include:

• Hallucinations
• Hypersexual or compulsive behaviors
• Binge eating
• Cognitive and mood disturbances

The only treatments thought to be beneficial in Kleine-Levin syndrome are lithium and carbamazepine to help shorten episodes and stimulants to alleviate EDS.

Narcolepsy

In narcolepsy, the body has a disordered regulation of sleep and wakefulness so that characteristics of sleep may suddenly occur when you're awake and elements of wakefulness may intrude upon sleep. Narcolepsy is best known for attacks of EDS that may cause you to doze off for short periods at unexpected times.

Another major symptom of narcolepsy is cataplexy, which is the sudden loss of voluntary muscle control often associated with an emotional response such as surprise or laughter. In a mild instance, your knees may buckle or your jaw will hang open, while in a more severe episode you may collapse onto the floor and be unable to move for several minutes.

Other symptoms of narcolepsy include:

• Vivid and often frightening hallucinations while falling asleep or waking up
• Recurrent episodes of sleep paralysis, characterized by the inability to move with waking or falling asleep, often with associated hallucinations
• Frequent awakenings at night
• Continuing to perform routine actions during sleep attacks and having no memory of it afterward

The EDS associated with narcolepsy is sometimes treated with stimulants, such as Ritalin, Provigil, and Nuvigil. The drug Xyrem (sodium oxybate) treats both EDS and cataplexy. Tricyclic antidepressants and SSRIs may help with cataplexy, hallucinations, sleep paralysis, and overnight sleep disruptions.

Restless Legs Syndrome

Disorders that cause excessive movements during sleep can disrupt your sleep and leave you tired the next day. The most common of these conditions is restless legs syndrome (RLS). This disorder is characterized by an uncomfortable sensation in the legs associated with an urge to move. It often develops in the evening as you are lying down to rest and is relieved by movement.

The commonly associated condition periodic limb movement syndrome (PLMS) involves sudden jerking movements that occur during sleep. These may be repetitive and disturb your sleep and potentially that of your bed partner.

Drugs commonly prescribed for RLS include:

• Anti-seizure medications: Neurontin (gabapentin), Horizant (gabapentin enacarbil), Lyrica (pregabalin)
• Dopamine agonists: Requip (ropinirole), Mirapex (pramipexole), Neupro patch (rotigotine)
• Benzodiazepines: Klonopin (clonazepam) in severe cases

Other treatments are:

• Regular exercise
• Good sleep habits
• Avoiding caffeine
• Using heat, cold, or massage to relieve leg discomfort
• Massage, acupuncture, or relaxation techniques
• Stress reduction or management
• Iron supplements
• Medications including anti-seizure drugs and dopamine agonists

Sleep Apnea

Sleep apnea is a condition in which your breathing pauses partially or completely while you sleep. It can occur dozens of times an hour or even hundreds of times a night. It's common for witnessed pauses to be followed by a loud snort and brief awakening as you gasp for air.

With each awakening, you shift briefly into lighter stages of sleep. You may wake completely and fall back asleep without even remembering it. The frequently disrupted sleep leaves you with EDS and its associated symptoms. Other symptoms of sleep apnea include:

• Snoring
• Dry mouth and sore throat in the morning
• Teeth grinding (bruxism)
• Morning headaches
• Sexual dysfunction
• Frequent nighttime urination

Treatment for sleep apnea includes:

• Using a CPAP (continuous positive airway pressure) machine or other types of PAP while sleeping
• Dental devices
• Hypoglossal nerve stimulator implant in the chest
• Surgery in the case of malformations that interfere with breathing, including especially large tonsils, abnormally small jaw and overbite, or deviated nasal septum

Medications That Cause Drowsiness

Drowsiness, EDS, and fatigue are common side effects of medications. Your healthcare provider will likely look into what medications you're taking if you frequently have fatigue. Drugs that can make you tired include:

• Analgesics: Painkillers including opioids such as Vicodin (hydrocodone-acetaminophen), OxyContin (oxycodone)
• Anticonvulsants: Seizure-prevention drugs such as Neurontin (gabapentin) and Lyrica (pregabalin)
• Antidepressants: Tricyclics and SSRIs/SNRIs including Elavil (amitriptyline), Prozac (fluoxetine), Cymbalta (duloxetine)
• Antiemetics: Drugs for nausea, vomiting, and motion sickness such as Dramamine (dimenhydrinate), Anzemet (dolasteron), Zyprexa (olanzapine), Reglan (metoclopramide)
• Antihistamines: Allergy medications including Zyrtec (cetirizine), Claritin (loratadine), Benadryl (diphenhydramine)
• Antipsychotics: Drugs for schizophrenia, psychosis in bipolar disorder, depression, and Alzheimer's disease including Abilify (aripiprazole), Risperdal (risperidone), Seroquel (quetiapine)
• Benzodiazapines: Tranquilizers and sedatives such as Librium (chlordiazepoxide), Valium (diazepam)
• Blood pressure drugs: Diuretics, ARBs, calcium channel blockers, beta-blockers including Lasix (furosemide), Avapro (irbesartan), Calan (verapamil HCL), Toprol-XL (metoprolol succinate)
• Muscle relaxants: Including Soma (carisoprodol), Lorzone (chlorzoxazone), Flexeril (cyclobenzaprine)
• Sedatives: Non-benzodiazepine sedative/hypnotics such as Ambien (zolpidem), Sonata (zaleplon), Lunesta (eszopiclone)
• Statins: Especially fat-soluble drugs including Lipitor (atorvastatin), Mevacor (lovastatin), Vytorin (ezetimibe/simvastatin), Zocor (simvastatin)
• Steroids: Used for inflammation, allergies, skin diseases, certain cancers, and after organ transplants; some may cause insomnia, including prednisolone, methylprednisolone, dexamethasone

Frequently Asked Questions

Why am I so tired all the time? 

Excessive daytime sleepiness can be caused by lifestyle factors or health conditions. Poor sleep habits, nutritional deficiencies, excessive consumption of alcohol or caffeine, and too much or too little exercise can all contribute to daytime fatigue. Sleep disorders, autoimmune diseases, diabetes, other health conditions, and certain medications may also play a factor.

Is excessive sleepiness a symptom of a disease? 

Fatigue and tiredness are common symptoms of many illnesses, including anemia, autoimmune disease, cancer, chronic fatigue syndrome, COPD, diabetes, fibromyalgia, heart disease, and thyroid conditions. It can also be caused by depression, pregnancy, menopause, or an infection. 

How can I stop feeling tired and sleepy during the day? 

Start by talking to your healthcare provider. A routine physical can identify many treatable causes of fatigue, such as iron or vitamin D deficiencies, thyroid disorders, and diabetes. A sleep study can rule out a sleep disorder. Lifestyle changes such as eating more fruits and vegetables, getting moderate exercise, and practicing good sleep hygiene can ease daytime sleepiness.

A Word From Verywell

If you struggle with persistent sleepiness or fatigue, talk to your healthcare provider or ask for a referral to a specialist who can figure out the underlying cause and get you started on the right treatment. You have a lot of treatment options, so you don't have to just live with the risks and lowered quality of life caused by EDS.