Around 2 p.m., the afternoon goes flat. Or a morning of errands takes more out of you than it used to, and you're running on fumes by lunch. Everyone feels tired now and then, but tiredness you can't explain, or tiredness that doesn't lift, is a reason to contact your health care provider. The National Institute on Aging (NIA) says that if you've been tired or low on energy for several weeks with no relief, call. While you wait for an appointment, keeping notes on your energy gives the visit something concrete to work from.
Tired or sleepy?
Waking up unrefreshed, hitting a wall, running out of steam on ordinary tasks: these can feel alike, but MedlinePlus separates two things. Drowsiness is feeling the need to sleep, and fatigue is a lack of energy and motivation. Noticing which one you mostly feel gives you better words for describing it to a clinician.
What can sit behind it
A few things are worth checking against your own week.
- Sleep: Older adults need about the same amount of sleep as other adults, seven to nine hours a night, according to the NIA. The sleep and energy after 50 guide covers sleep in depth.
- Activity: Regular exercise can help boost energy, while overdoing it without enough rest can lead to fatigue. Your own diary is the best place to see where your line falls.
- Medicines: MedlinePlus lists antihistamines for allergies, blood pressure medicines, sleeping pills, steroids and diuretics (water pills) as medicines that may cause drowsiness or fatigue. Don't stop or change any medicine without talking to your provider first.
- Mood: Depression can show up as decreased energy, difficulty sleeping, poor concentration and irritability, and anxiety can come with fatigue and sleep problems. If that sounds familiar, say so at your visit.
- Caffeine and naps: MedlinePlus says stimulants, including caffeine, are not effective treatments for fatigue and can make it worse when they're stopped. The NIA suggests avoiding naps longer than 30 minutes late in the day, since they can leave you groggy and make it harder to fall asleep at night.
Sleep apnea is worth knowing about because some of its signs happen while you're asleep, so someone else may be the one to notice. The National Heart, Lung, and Blood Institute lists frequent loud snoring, breathing that starts and stops, and gasping for air, and says you may not know about these until someone tells you. Daytime sleepiness and tiredness are also on its list of symptoms. If that sounds like you, talk to your health care provider; you may need a sleep study to diagnose the condition. Snoring on its own doesn't mean you have sleep apnea, since not everyone who snores has it.
A one-week energy diary
The NIA suggests a fatigue diary to help you spot patterns in when you feel more or less tired, and to plan activities that may give you more energy. Its sleep guidance names what to track when sleep is the problem: bedtime, waking during the night, and wake-up time. You don't need to finish the diary before you call; bring whatever you have.
Each day, jot down:
- Bedtime, any waking in the night, and wake-up time
- Caffeine and alcohol, and when you had them
- Any exercise, or an unusually busy stretch
- Your energy on a 1-to-5 scale in the morning, mid-afternoon and evening
- The medicines you took
At the end of the week, look for patterns. Do low-energy days follow short nights, a late coffee or a hard workout? Whatever you find is a set of leads to hand a clinician.
When to call
'Several weeks' is a rough guide, not a hard line. MedlinePlus adds that fatigue not relieved by enough sleep, good nutrition or a low-stress environment should be evaluated by a provider. It also lists unexplained weakness or fatigue together with fever, unintentional weight loss or regular sweats as a reason to make an appointment. If your instinct says something is off, calling is reasonable.
Expect questions about your sleep, daily activities, appetite and exercise, a physical exam, and likely some lab tests. Blood tests may check for anemia, diabetes, inflammatory diseases and infection; your clinician decides which tests fit. Bring the diary and a list of everything you take.
Where to start
Start with one number. After breakfast tomorrow, write down how your energy feels from 1 to 5. Leave the notebook on the table so you'll see it again.
