Is your fatigue at its worst first thing in the morning?
We’ve all been there before — those days where even the thought of getting out of bed in the morning is overwhelming. But for some of you, this could be every morning. When your days start with such an intense level of fatigue, it’s hard to muster up any sense of carpe diem (seize the day).
Fortunately, there’s a lot of good science that can help explain why you experience such intense fatigue levels in the morning. In this post, I’ll explore each of them in-depth. By the end, you should have the knowledge needed to improve your AM energy levels!
What (exactly) is morning fatigue?
Fortunately, I won’t have to dive into a lengthy, scientific explanation of what exactly constitutes morning fatigue. Fatigue in its most general sense is the difficulty or inability to initiate activity. This tends to appear in three ways:
- A sense of weakness.
- An inability to take part in activities.
- Difficulty with concentration, memory, and emotional stability.
The time of day in which the above manifests is unique to you. From my clinical experience, fatigue seems to be the most prevalent first thing in the morning or in the late afternoon. Morning fatigue is (obviously) most prevalent first thing in the morning.
For many, morning fatigue results in an inability (or intense challenge) to get out of bed. Morning fatigue could also look like 10+ (this is an arbitrary number I chose) presses of the snooze button. I suppose morning fatigue could also look like a dependency on coffee (or, any other stimulant) to get going.
Bottom line: Morning fatigue is a sense of weakness, an inability to take part in activities, or challenges with concentration, memory, or emotional stability that is the most apparent first thing in the morning.
The more obvious causes of morning fatigue
Are you sleeping less than 7 hours per night? Is your sleep disrupted?
If you’re answering yes to either of the above questions, your morning fatigue could simply be caused by a lack of restful sleep. Lack of sleep has substantial negative effects on sleepiness, motor and cognitive performance and mood, as well as on some metabolic, hormonal and immunological variables. (1)
Perhaps even more alarming, sleeping less than 7 hours per night on a regular basis is associated severe (negative) health outcomes, including weight gain and obesity, diabetes, hypertension, heart disease and stroke, depression, and increased risk of death. Sleeping less than 7 hours per night is also associated with an impaired immune function, increased pain levels, impaired performance, increased errors, and a greater risk of accidents. (2)
In a study done on Australian teenagers, it was found that going to bed later and sleeping until later in the day was associated with negative health outcomes like an elevated body-mass index (BMI). Additionally, those that went to bed later also spent more time in front of the television and less time doing physical activity. (3) We’re not sure if these results will also carry over for adults. Anecdotally, I can certainly vouch that when I stay up late, I almost always engage in more screen time. And the odds of me working out in the morning are very, very low.
Research aside, I think it is safe to say that your body has evolved over many thousands of years to align itself with the light-dark cycle of your geography. Therefore, it is in your best interest to ensure that your 7–9 hours of sleep occur when it is dark outside. Night-shift workers, you’re at increased risk to develop fatigue, psychological and cardiovascular symptoms, and stress maladaptation/intolerance. (4, 5, 6)
How do you know you’re getting enough sleep?
This can be nearly impossible to determine subjectively. Instead, I recommend tracking your refluxes. Below, I’ve listed 4 easy steps to help you determine your optimal amount of sleep.
- Track your sleep duration — you’ll do this for every day of the experiment
- Test your reflexes — go to humanbenchmark.com and test your reflexes for the first three days
- Add 30 to 60 minutes of sleep for 30 days. You can do this by going to bed earlier (recommended if you tend to be a “night owl”) or by waking up later.
- Test your reflexes (again) — go to humanbenchmark.com and test your reflexes after 30 days of longer sleep duration and see how they’ve changed. If they’ve improved, you’re on the right track!
- 5. See how you feel — do you feel better now that you’re getting more sleep? Probably! Track your symptoms as you go through the experiment to determine how much better you feel with extra sleep.
Other tips for improving morning fatigue
Some people do well eating a smaller dinner (especially those with digestive issues). Others do better with a bedtime snack, such as those who tend toward low blood sugar. In general, though, it’s best to go to bed neither overly full nor hungry. You should also make sure your diet isn’t too low carb or low fat, as these types of diets can also lead to trouble sleeping.
Cut Caffeine and alcohol — these two items can have a profound effect on sleep, so they’re best left out if you’re having sleep problems. Remember that if you are currently drinking a lot of coffee, it’s best to wean yourself off rather than cutting it out cold turkey.
It’s important to get adequate amounts of physical exercise for proper sleep. Make sure to pay special attention not only to exercise, but also the time that is usually spent being sedentary. Try a standing or treadmill desk, take the stairs, and walk more!
For those of you experiencing morning fatigue, the very first thing you should look at is your sleep quality and sleep quantity. Many of you will not be able to sleep in longer. Therefore, going to bed earlier is often the only way to increase sleep duration.
If you struggle to fall asleep, ensure your electronic devices have the blue light blocker enabled. You download one for free here. In the hours before bed, try your best to limit your exposure to bright lights. Bright lights (and electronic devices) block melatonin secretion.
The less obvious causes of Morning fatigue
The hormone, cortisol, is intimately tied to your body’s circadian rhythm. High cortisol levels throughout the day help to produce a sense of wakefulness. Low cortisol levels at night assist you in falling asleep. Irregularities in your cortisol rhythm and/or levels are commonly tied to fatigue. If an abnormality in your cortisol hormone occurs in the morning, it’s likely you’re going to experience morning fatigue. I’ll explain exactly what occurs below.
Cortisol is a steroid hormone that is produced within your body’s adrenal glands. The popular topic of adrenal fatigue describes a condition of low levels of cortisol. The low levels of cortisol found in adrenal fatigue is specific to circulating levels. But did you know that cortisol follows a diurnal rhythm?
20–30 minutes after you wake up, your cortisol levels should surge to levels 50–75% higher than they were prior. (7) This phenomenon is called the cortisol awakening response (CAR). And a suppression of this could be the reason you can’t get out of bed in the morning. Check out the image below for more clarity on the cortisol awakening response.
The cortisol awakening response (CAR)
The first dot on the image shows the cortisol level upon waking. The green dots indicate a suppressed (low) cortisol awakening response. The blue dot represents an elevated cortisol awakening response. The grey dots represent a normal cortisol awakening response. If you have a suppressed/lowered CAR, you’re not going to have an easy time getting out of bed in the morning.
It is the CAR that gives you the morning surge of energy to get out of bed. Should your CAR not occur, you’re going to want to stay under the covers. It is thought that the morning surge of cortisol is to help prepare your body with energy to start the day. Remember, cortisol has a profound effect on your blood sugar.
The surge of cortisol in the morning pulls sugar out of your cells and brings it into your blood. This raises your blood sugar which helps to give you the energy to complete morning tasks. Rewinding the clock to the days of your paleolithic ancestors, the cortisol awakening response could also be what kept you alive. If you awoke to danger, having sugar in your blood to use as energy to run away could have been the difference between living and dying.
High CARs were observed in relapsing-remitting multiple sclerosis (8), visceral obesity (9), and women with metabolic syndrome (10). In contrast, low CARs were observed in patients with type 2 diabetes mellitus (11), chronic fatigue syndrome (12), depression (13), and high blood pressure. (14)
If you’ve tried my above recommendations to improve your morning fatigue without success, your morning cortisol levels could be to blame. An altered cortisol awakening response is generally a response to your body undergoing a stress response. Remember, stress isn’t what you think it is. The stresses that affect your cortisol levels are generally hidden stresses.
How to improve your CAR
Cortisol is greatly affected by the light-dark cycle. Night time suppresses cortisol production. Exposure to sunlight increases cortisol production. To get a healthy surge of cortisol in the morning, make sure you expose yourself to the sun (or, a full spectrum light) as soon as you wake up.
For those of you living at latitudes resulting in minimal hours of sunlight during the winter season, it becomes imperative to purchase a full spectrum light. Expose yourself to this light upon waking for 10 minutes. This will simulate exposure to the sun which should help cause a surge of cortisol. In the evening, you’ll want to do the opposite — avoid exposure to bright lights as best you can.
If you find that the light therapy is not improving your morning fatigue, low circulating levels of cortisol could be to blame. I recommend seeking out a knowledgeable functional medicine practitioner to help you asses and treat your cortisol levels. If a practitioner is not available in your area, you could try supplementing adaptogens like ashwagandha or rhodiola first thing in the morning.
Ok, now you know my best strategies for improving your morning fatigue!
Now, I want to hear from you!
What strategies help you overcome morning fatigue?
Leave your answers in the comment box below.
Want to know for than your doctor about fatigue?
Originally published at Fatigue to Flourish.