I’m a GP – seven surprising reasons you might be waking up tired

Research shows that one in eight of us report feeling tired all the time, and although it might seem like a low-level symptom and can become the “norm” when we open our eyes in the morning, it really shouldn’t be. How alert and energetic we feel has an impact on everything – from what we feel like doing physically to how well we function mentally and how we respond emotionally to challenge and problems. In short, tiredness makes life feel harder to manage, less productive and less happy. It affects our cognitive focus and memory, it affects our ability to use and move our bodies, and it can have a significant negative impact on our relationships. Shorts Research shows that having adequate levels of physical, mental and emotional energy is an absolute essential for high levels of life satisfaction and to live life meaningfully. Sometimes we can pinpoint the reason why we feel tired; not enough sleep, being too busy or not enough self-care. But there are some more subtle and more surprising reasons why we wake up feeling tired. The good news is, that once we are aware of what those reasons are, we can change things. And, if we do, we might just find that we actually wake up feeling refreshed, ready for the day, and a lot happier.Here are seven surprising reasons as to why you might be waking up tired… Alcohol You might think you drop off more easily after a few glasses of something in the evening, but actually the opposite is true. We might look like we are sleeping well and often soundly asleep after drinking alcohol, but the nuance is in how alcohol affects our very delicate and scheduled cycle of sleep phases. Alcohol stops us from dropping into the most restorative cycle of sleep – the REM cycle – which helps us with memory, being able to focus mentally, and processing things emotionally. Alcohol splits our sleep cycle routine into fragments and also works as a diuretic, which makes us need to go to the toilet more during the night, further interrupting good sleep. It depresses our central nervous system in the long term, but in the short term acts as a stimulant, raising our stress hormones and heart rate, which can also affect how we sleep and rest. Alcohol also relaxes our airways, so we are more likely to snore and get even more fragmented and poor-quality sleep. Reflect on how much you are drinking and when, and how you feel the morning after any alcohol. Nutritional essentials and hormones Our bodies and brains need certain vitamins, minerals and hormones in order to be able to work well. Inside cells and organs we have something akin to production factories that make energy, but they need raw materials to work with. If we are low in minerals such as iron, vitamin B12, vitamin D or hormones such as our thyroid hormone, then we can feel tired even if we are sleeping enough and sleeping well. Think about what is going on inside you. Thyroid hormone, for example, dictates the rate at which every system in the body works; it is produced in gland in your neck after a trigger from another hormone in your brain. If you have a low thyroid level, you may have symptoms of constipation, dry skin, hair loss or thinning, change in periods, and importantly, feel tired and sluggish in energy levels. Low iron from our diet, or loss of iron through heavy periods, can lead to anaemia, while low vitamin D affects energy levels and low vitamin B12 affects how well our bodies can produce red blood cells and carry oxygen – all of which makes us feel more tired. It is important to check with your doctor if you are feeling tired all the time. Dehydration In order for us to enter deep sleep, our body temperature needs to fall. When we don’t drink enough during the day, blood flow to the skin is affected and we can’t sweat as usual to help our body temperature regulate. Dehydration can also result in physical symptoms that affect sleep quality and quantity, such as reduced saliva production, headaches and a dry mouth, throat and dry nose passages, which causes coughing and snoring, and ultimately frequent waking at night. Don’t think you can make it all up at the end of the day, because that will just lead to more bathroom trips at night, so make sure you are drinking regularly through the day, and eat foods with high water content such as cucumber, celery and watermelon. Keep an eye on your urine colour through the day and make sure it is light and the amount is good, which shows that you are hydrating well. Our sleep structures This includes both internal and external “structures”. The “external structures” may be easier to sort. It is really important to have good ventilation in your bedroom, while the NHS advises that the ideal ambient room temperature is between 16°C and 18°C. Make sure you avoid night-time sweating and getting too hot by wearing light pyjamas and turning down the heating if it’s on. Internal structures relate to the physical mechanics of what we need to work well for us to sleep. Nasal and sinus conditions such as allergic rhinitis, a deviated septum or sinus congestion can all result in mouth-breathing, snoring and blocked airflow, which triggers our brains to pull us out of deep restorative sleep into lighter sleep. Sleep apnoea, meanwhile, is a common sleep disorder where your breathing stops and starts repeatedly for periods during sleep, which can lower your blood oxygen level and disrupt your sleep, and thereby cause daytime sleepiness. You may have symptoms such as loud snoring, gasping or snorting, as well as morning headaches. Make sure you talk to your doctor about any of these symptoms. Addressing what could be causing poor sleep can help to feeling refreshed in the mornings (Photo: Witthaya Prasongsin/Getty/Moment RF) Not enough outdoors time This is an especially common problem at this time of year, when the days shorten in length and it becomes colder. We naturally tend to become less active physically, which doesn’t tire us out enough to want to sleep well, and we also shy away from being outside in the cold. But, ironically, we need to be outside even more. Our sleep-wake cycle responds very sensitively to natural daylight. Our internal body clock – the circadian rhythm – runs on natural daylight hitting the back of our eyes and setting off a chain of hormonal and chemical events which lead to our sleep hormone, melatonin, being regulated. Make sure you get some natural daylight within the first hour of waking, take a walk at lunchtime, sit by a window, and ensure you move your body, without sitting too much. These steps will ensure you feel more energetic and less tired. Clear your brain Sometimes we know we are stressed, but often small things that happen to us during the day or even through a week can build up and we don’t have time to step back and realise that our brain is chock-full of problems, worries and conflicts. Our subconscious brains churn over these things while we are asleep, sometimes making us have strange or frightening dreams, but also sometimes by waking us up early in the morning, stopping us from falling asleep in the first place, or stopping us from getting back to sleep once awake, and we feel exhausted. You can help yourself by writing down all the things you are worried about well before you approach sleep, so they are out of your head. You could also journal about your feelings, talk problems through with someone you trust, and actively solve them, delegate them or ask for support. If you feel it is affecting your mood and what you are able to do day to day, it is important you see your doctor. Eating too late How late do you eat? It is hard, isn’t it, when work is busy, you may be commuting and you have childcare responsibilities to control this. But eating too late could be the reason you are waking up tired. Aim to finish eating by 7.30pm. When we eat our food, blood moves to our stomachs and bowels to digest, and this process raises our body temperature, which can delay us from falling into deep sleep. Make sure you eat well within three hours of sleep, so during sleep your body can focus on repairing and restoring rather than digesting.