Sleepiness vs. Fatigue

Sleepiness vs. Fatigue: What’s the Difference?

Do you feel tired all of the time? Is getting out of bed in the morning difficult, or getting through the day a constant struggle? 

It turns out low energy is one of the most common symptoms that drive patients to see their doctors. And although we often use words like “sleepy” or “fatigued” interchangeably, they are actually very different.  While both results in low energy and feeling sluggish throughout the day, sleepiness and fatigue are a result of different underlying causes and are treated very differently by your doctor. 


Sleepiness is best defined as the feeling of low energy you get due to poor sleep. Often, sleep issues, such as troubled sleep,  difficulty falling or staying asleep, and not getting enough sleep, causes sleepiness. When you’re sleepy, you’ll notice that the longer you are awake, the more your energy diminishes, but when you finally get a good night’s sleep, you feel refreshed and energized.  

Most people understand why sleep is so vital, even without knowing the specific physiology behind it. During sleep, our body produces several hormones that are necessary to control most of our bodily functions. These include healthy energy levels, metabolism, sugar regulation, appetite control, digestion, and more. But if you lack sleep, your body can’t produce the hormones necessary for proper function, resulting in feeling sleepy and eventually contributing to chronic fatigue and diseases.

Many factors can contribute to poor sleep, including insomnia, sleep apnea, and lifestyle factors. While sleepless nights may not be in your control, there are many things that you can do to optimize the quality of sleep that you get, such as: 

Set A Bedtime

Similar to how you probably wake up at the same time every morning, try to go to bed at the same time every night. Establishing a bedtime helps your body maintain its normal circadian rhythm (a.k.a. sleep and wake cycle), making it easier for you to fall asleep each night.

Get At Least 7 Hours

Each night, aim to sleep seven or more hours. Studies show that this is the ideal amount of sleep that adults should be getting each night. But laying down for seven hours is not necessarily the same as sleeping for seven hours. If you are still feeling sleepy during the day, then go to bed earlier so you can get enough sleep at night.

Go Offline

Ditch the electronics for at least one hour before bed. The blue light in electronics alters our circadian rhythms, making it hard for our bodies to know when it is time to go to sleep. Watching television, playing video games, scrolling through emails, and social media are also stimulating, making it harder to quiet your mind when it is time to fall asleep. Try to make it a habit to turn off your electronics early enough to let yourself relax and get the proper sleep you need.

Quiet Your Mind

Make it a point to spend 10 to 20 minutes each night before bed to do something relaxing right before bed. Whether this is enjoying a calming herbal tea while journaling, meditating, writing your gratitude journal for the day, or reading a book, it will allow yourself to make a bedtime routine that relaxes you before you try to sleep.

Get Comfortable

If you are uncomfortable, then most likely, your sleep will be interrupted at some point throughout the night. Create the ultimate sleeping environment by making sure your room is quiet, not too hot or cold, and without any lights that might wake you up.

Although poor sleep hygiene is one of the most common contributors to sleepiness, there are also many other causes. And if you have already tried the recommendations on this list and are still not noticing changes in how you feel, then it is time to call your doctor. Another common cause is hormonal imbalances. At Livewell, our physicians often find that when these imbalances are corrected, our patients tell us that they fall asleep faster, sleep better, and can finally stay asleep throughout the night. 


Fatigue is similar to sleepiness in that it involves an extreme lack of energy. However, the causes and experiences are very different. Often a result of mental, physical, or emotional stress, fatigued people will wake up feeling tired and notice that their energy does not seem to improve throughout the day and is not relieved with sleep. This lack of energy can often make a person feel lethargic and as if they have brain fog. 

At Livewell, fatigue is one of the most common symptoms patients complain about when they make their initial visits. When our experts start to look for the root of the problem, we find that the causes can range from hormonal imbalances to chronic stress to nutritional deficiencies to hidden infections. However, these are just a few of the common causes of fatigue that we see in our office. We have many patients who come in who have a combination of many of these factors contributing to their low energy.

Hormonal Imbalance

Our hormones are highly interconnected, and when one starts to become imbalanced, it will often trigger other hormonal imbalances later on. For example, our sex hormones, estrogen, progesterone, and testosterone naturally decline in both men and women as they age, contributing to a wide variety of symptoms, most often including fatigue. In these cases, hormone replacement therapy is one of the many treatments available.

Similarly, our thyroid, a small gland that sits at the bottom of the neck, is responsible for producing and secreting thyroid hormones. These include triiodothyronine (T3) and thyroxine (T4). But often, our bodies do not produce enough of these hormones, causing hypothyroidism, a condition that causes fatigue, low metabolism, hot or cold intolerances, brain fog, digestive issues, and mood swings. When your thyroid does not produce the right amount of hormones, you will start to feel like you have noticeably low energy, and your metabolism will decrease, resulting in weight gain. 

At Livewell, we have a lot of patients who have had undiagnosed thyroid imbalances for years. By adding in nutrients that support the thyroid gland and medications to help boost thyroid hormones, our patients often notice tremendous improvements in both their energy and metabolism. 

Chronic Stress

Stress, of any intensity or duration, can wreak havoc on our energy levels. Our adrenal glands, which sit on top of our kidneys, are responsible for secreting cortisol, our stress hormone. However, cortisol is an essential hormone in our body, even when we are not under stressful situations.

When you first wake up, this hormone is secreted in high amounts to help you feel energized and again at night, in lower quantities to help you sleep.  But, the longer you are exposed to stress, the less effective our adrenal glands become at secreting cortisol. If your adrenals are not able to secrete cortisol efficiently, you will find that you will not have this energy surge in the morning, resulting in fatigue and low energy throughout the day.

Nutritional Imbalances

Nutritional imbalances are another common culprit that can cause fatigue. Iron and B12 are two of the most common nutrients that can become deficient, resulting in fatigue. When either of these becomes too low, it can result in anemia, a condition where your body is not able to produce enough red blood cells. A healthy diet is the best way to make sure you are getting the nutrients that you need to keep you healthy. However, some patients will require supplementation. Although the first sign of a nutritional imbalance will be symptoms such as fatigue, the best way to determine this through routine blood tests, including a complete blood count (CBC).

Hidden Infections

Another cause of fatigue, one which is frequently overlooked by general health practitioners, is reactivated viral infections. Once exposed to a virus, our immune system strengthens enough to keep the virus controlled. But the virus remains in our body forever. During periods of stress or illness, our immune system becomes weakened, sometimes allowing for these viruses to reactivate.

One of the common infections our experts see reactivated is Epstein-Barr Virus (EBV), which is responsible for causing mononucleosis (commonly referred to as mono) and fatigue. There are many treatments available to help fight EBV, which can be diagnosed by a simple blood test.

Whether you are sleepy or fatigued, there is no reason you should be living your life feeling tired and sluggish every day. At Livewell, we have many patients visit our office complaining of low energy, who can feel better and live their life vibrantly again with the proper treatment. 

If you suffer from low energy, fatigue, or just want to learn more, we invite you to join us on February 8th at 10 AM at Live Well Wellness Center for our free informational forum hosted by Dr. Jessica Turner. This forum will teach you more about what may be causing your symptoms and how you can reclaim control of how you feel. 

If you are unable to attend the event but would like to learn more about the information covered, please call our office to schedule a complimentary 15-minute consultation with one of our doctors and discover how we can help you feel your best. 

Register for our Free Fatigue Workshop