We all feel tired sometimes, so how do you know when it’s appropriate, and necessary, to see a doctor about fatigue or other sleep-related issues?
Here are five symptoms to never ignore.
1. Heavy snoring
It might seem harmless but heavy snoring may be a sign of sleep apnoea. “This is an often-missed cause of poor sleep, responsible for chronic tiredness during the day, and even road traffic accidents if sufferers fall asleep at the wheel,” says GP Dr Claire Morrison.
“It’s caused by the throat repeatedly closing off during sleep, making oxygen levels fall, and resulting in frequent waking. It’s most common in those who are overweight and who have a thick neck.”
Other signs include waking with a dry mouth and/or headache, and feeling very tired and irritable during the day, she says. Or your partner might notice long pauses between breaths when you’re asleep, and then a gasping or choking sound when breathing resumes. While mild cases don’t always need to be treated, in extreme cases sleep apnoea can be dangerous as there’s a higher chance of having a stroke and a serious accident caused by tiredness.
2. Extreme tiredness all the time
It could be a sign of anaemia, says GP Dr Ross Perry. “Other symptoms [of anaemia] include a lack of energy, pale looking skin, headache, dizziness, light headedness, cold hands and feet and brittle nails.”
Extreme tiredness can also be a key sign of undiagnosed or insufficiently treated thyroid disease, he adds. The condition occurs as a result of a decrease in thyroid hormone production. “You may sleep more than usual but still feel completely exhausted. At times, you may fall asleep during the day or very quickly at night. In the morning, you may find it difficult to get out of bed.
“Extreme tiredness [also] could be a symptom of coeliac disease, and for some, it may be the only symptom,” says Dr Perry. “The gut damage caused by coeliac disease results in poorer absorption of essential food nutrients involved in energy metabolism, including iron, folic acid and vitamin B12.”
3. Restless legs
This is a nervous system condition associated with an uncomfortable “tingling or fizzing sensation” in the legs, eased only by moving the legs constantly, says Dr Morrison. “It tends to be worse in the evenings and at night, sometimes making it impossible to sleep properly. It can affect the arms too.”
It’s thought to be caused by a lack of the dopamine chemical in the brain, she explains, and it can be triggered by a number of underlying causes – so it’s important to work out what. It may come about during pregnancy or happen without any obvious reason at any age, though women are twice as likely as men to develop it and it’s also more common in middle age. However, restless legs may also be triggered by “iron deficiency, kidney impairment, diabetes, under-active thyroid, fibromyalgia or Parkinson’s disease”.
“Drugs that aggravate the condition include anti-histamines, anti-sickness medication, and anti-depressants, so do tell your doctor about your symptoms before being prescribed anything,” Dr Morrison says.
4. A complete loss of interest in sex
“[For men] testosterone deficiency is another common problem associated with tiredness and one of the trademark symptoms of low testosterone in men is chronic fatigue – the type of tiredness that doesn’t improve after rest,” explains Dr Perry.
It can be part of the normal ageing process – testosterone levels are likely to decrease in all men with age (“Typically about 1 to 2 per cent per year after the age of 40,” says Dr Perry), so interest in sex may decline slightly too. “However, it’s not normal for testosterone levels to get so low that fatigue impacts daily activities or for there to be a complete loss of interest in sex, so do visit your GP,” he adds.
5. Mental health concerns affecting sleep
It goes without saying that it’s worth chatting to your GP if you’re struggling, but many mental health conditions can cause difficulty sleeping, so it’s not uncommon for issues to come to light at night.
“There is a close link between sleep and mental health, and poor sleep can aggravate mental illness, so it’s very important to address sleep problems early on,” says Dr Morrison. “Mental health problems that commonly affect sleep include depression, anxiety, stress, panic disorder, post traumatic stress disorder, and obsessive compulsive disorder, for example.”
Signs of mental illness include low mood, excessive worrying, tearfulness, irritability, low self-esteem, lack of motivation, inability to concentrate, intrusive thoughts, loss of pleasure in life, poor appetite, and/or binge-eating, she adds.
“You may benefit from talking therapy such as ‘cognitive behavioural therapy’, and/or medication, but make sure your doctor knows about the insomnia, as some anti-depressants can help promote sleep, whereas others may make it worse and are best avoided if possible.”
– With PA
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