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What Causes Severe Fatigue?
Question: I get 8 hours of sleep every night, but I'm still tired, I sometimes have a nap during the day but I still find myself feeling exhausted
Brief Answer:
Read below
Detailed Answer:
I read your question carefully and I understand your concern.
If you get 8 hours of sleep that should be enough and exhaustion shouldn't be related to lack of sleep. Of course that is if you are sure that it is quality sleep. At times one might sleep for 8 hours but in cases like sleep apnea that sleep is of low quality and the patient is tired and sleepy during the day. Obstructive sleep apnea is the most common such disorder, means that airways collapse during sleep with breathing interruptions. It is more common in overweight people who snore, but may be also in the absence of overweight if there are airway issues like polyps or congenitally narrow airways. If there is such a suspicion a test called polysomnography is used for diagnosis.
If that is excluded then other causes may be responsible. Anemia is one possibility. Low thyroid function is also a common issue. Any other kidney, liver issues may also manifest with fatigue, heart problems as well. It is a very nonspecific symptom, meaning can be found in many conditions. At times it may be due to depression as well.
So I would suggest to start with some routine blood tests for most common issues such as blood count, erythrocyte sedimentation rate, glucose, liver and kidney function, electrolyte panel, thyroid function, vitamin B12 levels and an EKG. Such routine cheap tests would screen for the issues I mentioned above and provide an orientation in which direction further investigations might be needed.
I remain at your disposal for other questions.
Read below
Detailed Answer:
I read your question carefully and I understand your concern.
If you get 8 hours of sleep that should be enough and exhaustion shouldn't be related to lack of sleep. Of course that is if you are sure that it is quality sleep. At times one might sleep for 8 hours but in cases like sleep apnea that sleep is of low quality and the patient is tired and sleepy during the day. Obstructive sleep apnea is the most common such disorder, means that airways collapse during sleep with breathing interruptions. It is more common in overweight people who snore, but may be also in the absence of overweight if there are airway issues like polyps or congenitally narrow airways. If there is such a suspicion a test called polysomnography is used for diagnosis.
If that is excluded then other causes may be responsible. Anemia is one possibility. Low thyroid function is also a common issue. Any other kidney, liver issues may also manifest with fatigue, heart problems as well. It is a very nonspecific symptom, meaning can be found in many conditions. At times it may be due to depression as well.
So I would suggest to start with some routine blood tests for most common issues such as blood count, erythrocyte sedimentation rate, glucose, liver and kidney function, electrolyte panel, thyroid function, vitamin B12 levels and an EKG. Such routine cheap tests would screen for the issues I mentioned above and provide an orientation in which direction further investigations might be needed.
I remain at your disposal for other questions.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
I have recently had a blood test but the only thing that came up from that was low iron, I do have anxiety/depression and I am on medication for it.
How would that effect my sleep?
How would that effect my sleep?
Brief Answer:
Read below
Detailed Answer:
Thank you for the additional information.
Anxiety/depression may lead to low energy levels and lack of motivation, that can at times cause increased sleepiness.
On the other hand medication should be considered. You mentioned only melatonin (which if you sleep for 8 hours is not really necessary), but if you in addition take medication for depression some of those incite sleep as well. So it may at times be an issue of medication side effects as well.
Let me know if I can further assist you.
Read below
Detailed Answer:
Thank you for the additional information.
Anxiety/depression may lead to low energy levels and lack of motivation, that can at times cause increased sleepiness.
On the other hand medication should be considered. You mentioned only melatonin (which if you sleep for 8 hours is not really necessary), but if you in addition take medication for depression some of those incite sleep as well. So it may at times be an issue of medication side effects as well.
Let me know if I can further assist you.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
I am on a few medications, melatonin, nexium for my stomach problems and fluoxetine for anxiety/depression, ponstan for cramps and ranitidine
Brief Answer:
Read below.
Detailed Answer:
Hello again!
Medication like fluoxetine can have differing effects among patients, in some they cause insomnia but in about 10% (5-17%, numbers vary among studies) it may cause somnolence, so if it is something you've noticed after starting it should be considered.
If on the other hand you've started it only now and symptoms were present long before then perhaps you should give it some more time, it may take up to 6 weeks for its antidepressive/antianxiety effect to be achieved.
Melatonin doesn't cause that much somnolence, but however I wonder if you need it since you seem to sleep plenty.
Ranitidine may also cause some malaise, dizziness and somnolence. It is rare, but still since you are already on Nexium which has a similar if not better efficacy I wonder if it is really essential.
Read below.
Detailed Answer:
Hello again!
Medication like fluoxetine can have differing effects among patients, in some they cause insomnia but in about 10% (5-17%, numbers vary among studies) it may cause somnolence, so if it is something you've noticed after starting it should be considered.
If on the other hand you've started it only now and symptoms were present long before then perhaps you should give it some more time, it may take up to 6 weeks for its antidepressive/antianxiety effect to be achieved.
Melatonin doesn't cause that much somnolence, but however I wonder if you need it since you seem to sleep plenty.
Ranitidine may also cause some malaise, dizziness and somnolence. It is rare, but still since you are already on Nexium which has a similar if not better efficacy I wonder if it is really essential.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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