Fatigue and Sleep

Fatigue is the #1 complaint of my patients. There are a myriad of reasons someone can be fatigued, but my first set of questions revolve around sleep. If you aren’t sleeping enough hours because you can’t get to sleep, can’t stay asleep, wake too early, or wake up feeling unrested, then that is the first thing that needs to be addressed.

Everyone’s need for a certain number of hours of sleep is different, but there are some generalities we can apply. For example, I had a teen who was staying up until 11 or 12 to finish her homework after her extracurricular activities, then trying to get up at 6 for school the next day. Teens need 8-10 hours of sleep a night, adults need at least 7.

Not being able to get to sleep is another big issue. If you haven’t already applied sleep hygiene techniques, then you need to get started immediately. Turn off your electronics and turn down the lights in your home as early as you can to signal to your brain that sleepy time is coming. Try meditating or calm, deep breathing before bed to set yourself up for the parasympathetic state you need to be in in order to fall asleep. Calcium may be a beneficial nutrient to help sedate the mind before bed.

In Traditional Chinese Medicine, waking 1-3 AM is caused by an imbalance in the liver. Some of the situations that can cause a liver imbalance include anger, alcohol, or conditions of the eyes or tendons. Waking 3-5 AM is a disturbance in the lung, which can be caused by grief/sadness, or conditions of the nose and skin. I’ve also seen insufficient Magnesium cause waking throughout the night.

B12, Inositol, and melatonin may also be needed to help with falling and staying asleep.

But the biggest and most controversial issue is caffeine. It’s not controversial because it’s not true, but because you won’t want to admit that it’s true. Consumption of more than 250 mg of caffeine will cause restless sleep and early waking, even if you only consume it in the morning. Most people only consider that late day consumption could make it difficult to fall asleep.

Believe it or not, a serving of regular brew is 6 ounces. So the smallest portion you will get anywhere is 12 ounces, and is already at the 250 mg threshold of insomnia. And that doesn’t count any caffeinated teas, soda, chocolate, or coffee flavored foods. I love black coffee and unsweetened iced tea, but learning this tidbit has revolutionized my sleep. I have personally noticed that days when I consume less than 250 mg, my sleep is much more restful.

Here’s a chart of common sources of caffeine: https://cspinet.org/eating-healthy/ingredients-of-concern/caffeine-chart

​The good news is that as you cut back on your caffeine consumption, your sleep will improve so you won’t feel the need to consume caffeine to excess. I personally found an unsweetened energy drink that has about 105-150 mg of caffeine, so that I can still get that little boost in the morning without fearing that an iced tea with lunch is going to wreck my sleep. Runa’s Clean Energy Drinks in Unsweetened Blood Orange and Lime flavors have no added sweeteners, natural or otherwise.