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Brandon Peters, M.D.

30 Days to Better Sleep: Learn the Difference Between Sleepiness and Fatigue

By January 7, 2013

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It may seem like semantics, arguing over the meanings of similar words, but it really does matter: What is the difference between sleepiness and fatigue? Not only may discriminating between these distinctive feelings identify different causes, but it may also help to treat insomnia.

Some people lose touch with what it feels like to be sleepy. Sleepiness or drowsiness is the extreme desire to fall asleep. Imagine that you are sitting after lunch in your most comfortable chair. You are cozy and relaxed. Your eyelids become heavy, each time they close they stay that way a moment longer. You are ready to doze off. You are sleepy.

Contrast this sleepiness with a different collection of words: fatigue, tiredness, exhaustion, and low energy. These sentiments are felt deep in the bones and muscles, a heaviness to the limbs, as if you just ran a marathon. You can't summon the energy to accomplish what you need to. You are physically and mentally dragging through the day. This may occur in the setting of other illness, such as anemia, hypothyroidism, or even cancer. It may even be labeled as chronic fatigue syndrome.

No matter how extreme the fatigue, it does not result in sleep. People who feel fatigued may lie down to rest or take a nap. They do not, however, fall asleep. People with extreme sleepiness or drowsiness will be able to sleep if given the opportunity. Why does this matter?

Sleepiness often occurs in sleep deprivation among those who get inadequate total sleep time. It may also be a symptom of sleep disorders such as sleep apnea or narcolepsy. In contrast, fatigue is a common complaint among those with insomnia.

Not only does distinguishing between sleepiness and fatigue lead to a different set of possible causes, but recognizing sleepiness can also contribute to improving insomnia. How might this work? This concept will be discussed more in the next article, but it is critically important for people to only go to bed when they feel sleepy. If fatigue is used as a prompt to go to bed, this may result in lying awake for prolonged periods of time at the start of the night, trying to fall asleep. This is a major contributor to insomnia.

Consider carefully whether you are having more difficulty with sleepiness or fatigue. It may point to a distinct underlying cause and correcting it will depend on a different set of treatments. As you work to sleep better, use this exercise to reflect on your own needs.

Check out the entire series, "How to Sleep Better in 30 Days."

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