​Fatigue a​nd Excessive Sleepiness

Tiredness and sleepiness is not a symptom that defines any one particular disease. Rather, it can be a symptom of many different diseases and conditions. Causes range from lack of sleep and over exercise to medical and surgical treatments. The lack of energy can sometimes cause difficulty with normal daily activities, leading to problems with attentiveness and concentration.

Fatigue is a lingering feeling of tiredness that is constant and limiting. With fatigue, you have unexplained, persistent, and relapsing exhaustion. It's similar to how you feel when you have the flu or have missed a lot of sleep. If you have chronic fatigue, or systemic exertion intolerance disease (SEID), you may wake in the morning feeling as though you haven’t slept. You may be unable to function at work or be productive at home and be too exhausted to manage your daily activities.

Excessive sleepiness is characterized by persistent sleepiness and often a general lack of energy, even after apparently adequate or even prolonged night time sleep. In most cases, there's a reasonable explanation for the fatigue and sleepiness. It might be a condition such as allergic rhinitis (nasal problem), anaemia (a deficiency of red blood cells or haemoglobin in the blood, resulting in tiredness), <fibromyalgia> (a disorder causing muscular pain and fatigue) <depression> or some other health condition.

When the fatigue and sleepiness doesn’t go away for long periods of time, it may be chronic fatigue syndrome or any of a number of sleeping disorders such as <sleep apnea> or <narcolepsy>.

Symptoms of chronic fatigue and excessive sleepiness may include:

  • Severe fatigue

  • Weakness

  • <Insomnia>

  • Muscle pain

  • Fatigue following exertion that lasts more than 24 hours

  • Impairment in short-term memory or concentration

  • Sore throat

  • Tenderness

  • Joint pain without swelling or redness

  • Headaches of a new type, pattern, or severity

  • Un-refreshing sleep

Secondary symptoms may include:

  • Abdominal pain

  • Alcohol intolerance

  • Bloating

  • Chest pain

  • Chronic cough

  • <Diarrhoea>

  • Dizziness

  • <Dry eyes> or mouth

  • Earaches

  • Irregular heartbeat

  • Jaw pain

  • Nausea

  • Night sweats

  • Psychological problems (<depression>, irritability, <anxiety>, <panic attacks>)

  • Shortness of breath

  • Tingling sensations

  • Weight loss​

If you are facing excessive fatigue and sleepiness during the day which makes it difficult for you to function, seek help from your doctor working with the <Mind and Brain Service Line> at The Aga Khan University Hospital. You can be assured of receiving the best quality medical care, additional information and medical advice from our expert, highly trained and internationally accredited staff. You can safely and privately discuss your symptoms, gain advice and receive personalized treatment and care.
Your time with your doctor may be limited, so make sure to prepare for your visit beforehand. Here are some tips to help get you started.

Fatigue and sleepiness can be difficult to diagnose, and also hard to define. A definite diagnosis is made when you have severe and chronic fatigue and sleepiness that lasts for six months or more, and other medical conditions that could cause it must be excluded. The disorder must significantly interfere with work or daily activities and present other symptoms listed above such as sore throat, headache, unexplained muscular pain etc.

There's no single test to confirm this diagnosis. Since the symptoms are related to many other health problems, it becomes difficult to diagnose. Your doctor will attempt to rule out a number of other illnesses before giving a definite diagnosis. These include:

  • Sleep disorders: chronic fatigue and sleepiness can be caused by sleep disorders. A sleep study can determine if your rest is being disturbed by disorders such as obstructive <sleep apnea>, <restless legs syndrome> or <insomnia>.

  • Medical problems: fatigue and sleepiness is a common symptom in several medical conditions, such as anaemia, <diabetes> and underactive thyroid (<hypothyroidism>). Lab tests may be conducted to examine your blood for evidence of some of the top suspects.

  • Mental health issues: fatigue and sleepiness is also a symptom of a variety of mental health problems, such as <depression>, <anxiety>, <bipolar disorder> and <schizophrenia>. A counsellor can help determine if one of these problems is causing your fatigue.​

Chronic fatigue and sleepiness affects people in many different ways, so your treatment will be tailored to your specific set of symptoms. According to your diagnosis your doctor may adopt either of the following treatments:

  • Antidepressants: many people who have chronic fatigue and sleepiness are also depressed. Treating your <depression> can make it easier for you to cope with the problems associated with chronic fatigue.

  • Sleeping pills: your doctor might suggest trying prescription sleep aids for depression related to excessive fatigue.

  • Therapy: this is one of the most effective treatments for sleepiness and chronic fatigue that combines psychological counselling with a gentle exercise program. Talking with a therapist or counsellor can help you figure out options to work around some of the limitations that it imposes on you. Feeling more in control of your life can improve your outlook dramatically.​

The Aga Khan University Hospital offers various support services to help with managing or recovering from the disease or condition. These include but are not limited to nutrition, physiotherapy, rehabilitation, specialized clinics and some patient support groups. Your doctor or nurse will advise you accordingly.
The Aga Khan University Hospital offers financial assistance to those who are in need and fulfil the eligibility criteria. For further information, you can contact the Patient Welfare Department. You can find the contact number of the Patient Welfare Department in the ‘Important Numbers’ section on the website homepage.
The financial counselling staff is available during office hours, at the main PBSD (Patient Business Services Department), to answer your financial queries on treatments’ costs and authorize admissions on partial deposit as per hospital policies allow. The financial counsellor in the emergency room is open 24/7. You can find the contact number of the Patient Business Services in the ‘Important Numbers’ section on the website homepage.

Your doctor and or nurse will give you specific instructions about the prescribed medication. Please ensure that you take or use the prescribed medicine as advised. It can be dangerous to your health if you self-prescribe. Please inform the doctor or nurse beforehand if you have experienced any adverse reactions to any medications in the past. If you experience any symptoms of drug poisoning, overdose or severe reaction please contact the Pharmacy Service at The Aga Khan University Hospital immediately. You can find the contact number of the Pharmacy Services in the ‘Important Numbers’ section on the website homepage.

The information provided on our website is for educational purposes and not intended to be a substitute for medical advice, diagnosis or treatment. You should always seek the advice of your doctor or other healthcare professional provider.