Are You Tired All the Time?

Culprit: A Stealth Sickness

When nothing else seems to be at the root of your fatigue, consider seeing a doctor. Fibromyalgia and chronic fatigue syndrome commonly cause intense tiredness, in addition to poor sleep quality, brain fog, and/or muscle pain. (Hypothyroidism, an underactive thyroid, often occurs with the disorders.) Much is not understood about fibromyalgia and chronic fatigue syndrome, but doctors estimate that up to 14 million Americans suffer from one or the other. And women are more likely than men to experience them. “There’s usually a genetic predisposition,” says Kent Holtorf, a Los Angeles thyroidologist and the founder of the National Academy of Hypothyroidism.

Some doctors surmise that fibromyalgia is a result of abnormalities in the central nervous system and that chronic fatigue syndrome is linked to infection. Other experts think both conditions are a result of a dysfunction of the hypothalamus and the pituitary and adrenal glands. Most standard blood tests fail to identify the disorders, so the conditions are typically diagnosed through a physical exam and a detailed medical history. Standard treatment may include an SSRI or a muscle relaxant.

Another disorder that may be to blame: obstructive sleep apnea. A person who suffers from it experiences repeated pauses in her breathing while sleeping, often because she has narrow airways in her nose, mouth, or throat (some telltale clues: loud snoring or gasping for breath while sleeping). If your doctor suspects sleep apnea, he will send you to a sleep clinic for an overnight evaluation. Treatment may be as simple as changing your sleeping position or wearing an oral appliance, or as complex as sleeping in a mask attached to a C-PAP (continuous positive airway pressure) machine. In extreme cases, surgery may be necessary.