Chronic Fatigue in Students: Sleep Issues and Solutions - Family Medicine

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Constantly feeling sleepy?


Hello doctor, I am a student and I have been accustomed to going to bed between 12:30 and 1:00 AM and waking up at 6:30 AM.
However, recently I have been unusually tired and can't help but doze off in class (this has been happening more frequently...
I even slept through two periods today).
I thought it might be due to insufficient sleep, so I adjusted my bedtime to just after 12:00 AM, but I still feel very tired and sleepy.
What could be causing this? What should I do? It feels like I spend a lot of my day sleeping (and I still feel tired when I wake up).
On weekends, I sleep for seven and a half hours, and if I'm very tired, I take a nap in the afternoon.
I also tend to nap for about half an hour at school.

By the way, I didn't get my period last month...
could this be related? If not, why did it not come? (I haven't had it for five years).
I usually do not consume cold food or drinks.

vivian, 10~19 year old female. Ask Date: 2016/04/11

Dr. Gao Qingyun reply Family Medicine


Hello: Amenorrhea and excessive sleepiness are systemic issues that require a clinical evaluation to determine the underlying causes.
Please visit the obstetrics and gynecology outpatient department as well as the family medicine outpatient department for assessment and treatment by a specialist.
Thank you! Wishing you peace and health.
Sincerely, Dr.
Gao Qingyun, Director of Family Medicine, Taoyuan Hospital, Ministry of Health and Welfare.

Reply Date: 2016/04/11

More Info


Chronic fatigue among students is a growing concern, particularly in the context of sleep issues. Your situation, where you feel excessively tired despite adjusting your sleep schedule, is not uncommon among students. There are several factors that could contribute to your fatigue, and understanding these can help you find effective solutions.

Firstly, it’s important to recognize that sleep quality is just as crucial as sleep quantity. Even if you are in bed for a sufficient number of hours, if the quality of your sleep is poor, you may still wake up feeling tired. Factors that can affect sleep quality include stress, anxiety, and environmental disturbances. For students, academic pressures, social dynamics, and lifestyle changes can lead to increased stress levels, which in turn can disrupt sleep patterns.

In your case, you mentioned that you have been feeling increasingly tired and have even fallen asleep during classes. This could indicate that your body is not getting the restorative sleep it needs. It’s also worth noting that sleep disorders, such as insomnia or sleep apnea, can lead to chronic fatigue. Insomnia can manifest as difficulty falling asleep, staying asleep, or waking up too early, while sleep apnea involves interruptions in breathing during sleep, leading to fragmented sleep.

Another important aspect to consider is your menstrual health. You mentioned that you have not had your period for the past month, which could be related to various factors, including stress, hormonal imbalances, or changes in body weight. Irregular menstrual cycles can sometimes be a sign of underlying health issues, such as polycystic ovary syndrome (PCOS) or thyroid dysfunction, which can also contribute to fatigue. It would be advisable to consult a healthcare provider about this issue, as they can perform the necessary evaluations and tests to determine if there is an underlying condition that needs to be addressed.

To improve your situation, here are some strategies you might consider:
1. Sleep Hygiene: Establish a consistent sleep routine by going to bed and waking up at the same time every day, even on weekends. Create a relaxing bedtime routine to signal to your body that it’s time to wind down. This could include reading, listening to calming music, or practicing relaxation techniques such as deep breathing or meditation.

2. Limit Screen Time: Reduce exposure to screens (phones, computers, TVs) at least an hour before bedtime, as the blue light emitted can interfere with the production of melatonin, the hormone that regulates sleep.

3. Optimize Your Sleep Environment: Ensure your sleeping environment is conducive to rest. This includes a comfortable mattress and pillows, a dark and quiet room, and a cool temperature.

4. Physical Activity: Regular physical activity can help improve sleep quality and reduce feelings of fatigue. Aim for at least 30 minutes of moderate exercise most days of the week, but try to avoid vigorous exercise close to bedtime.

5. Nutrition: Pay attention to your diet. Eating a balanced diet rich in fruits, vegetables, whole grains, and lean proteins can help support your overall health and energy levels. Avoid heavy meals, caffeine, and alcohol close to bedtime.

6. Seek Professional Help: If your fatigue persists despite making these changes, it may be beneficial to consult a healthcare professional. They can help assess your symptoms, rule out any underlying medical conditions, and provide tailored advice or treatment options.

In summary, chronic fatigue in students can stem from a variety of factors, including sleep quality, stress, and hormonal changes. By implementing good sleep hygiene practices, optimizing your environment, and seeking medical advice if necessary, you can work towards improving your energy levels and overall well-being.

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