| Posted November 18, 2015 | By Aaron Milstone, M.D. | Categorized under , |

Think you are the only one who feels tired and lethargic throughout your day? Think again. 

You are definitely not alone. Fatigue is one of the top 20 complaints people present to their physicians. 

And although sleep issues such as sleep apnea are far more common in men, I have had 28-year-old and 72-year-old men come to me with fatigue issues, so it doesn't seem to be limited to any certain age. 



Fatigue, however, is caused by a number of common issues that many men face including an ever-increasing workday/workload, obesity, stress, overuse of alcohol, caffeine and sleep disorders such as apnea. 

With men in particular, I see that they tend to minimize the symptom of fatigue and when I ask them about it I see that it has been present for years.  We tend to push through it because of our lifestyle. Many men just live with that constant level of fatigue and grow used to it not knowing there is a better life out there.



WATCH: What is Apnea?


You can fix it 

Some of the causes of fatigue can be fixed with lifestyle modifications. For example, one initial intervention is to maintain
a normal body weight. There is a link between obesity and sleep apnea. Also, try to minimize alcohol use in the late evening. Ideally, no alcoholic beverages are best, but I recommend fewer than two glasses of wine per night. 

Reserve exercise to morning hours rather than late in the day and try to maintain same sleep/wake cycle. For the average middle-aged man, six to eight hours of quality, uninterrupted sleep is the ideal. If you are going to nap during the day, minimize it to 20 minutes or less. 

I see many men who rely on external caffeine to get them through the day. Some are excessive caffeine drinkers. It's not unusual to see someone drink a pot of coffee just to get through the day. This habit should be a huge red flag that there is a need to make some changes with sleep habits. 

These are some simple interventions you can try, and if those work, then you know you have just been dealing with poor sleep habits. If those behavior modi-fications don't improve your sleep, then you should be evaluated for sleep apnea.


Sleep apnea

Apnea is a Greek term that means "no air flow." Modern technology now allows us to evaluate the quality of your sleep and your air intake and we can determine if you are having episodes where you stop breathing during the night and how serious they are. This causes your body to move around so that you will resume breathing, but is cause for a very restless night and thus a lethargic energy level the next day. 

If you think you might have sleep apnea, talk it over with your general practitioner and many times, he or she will make a referral to a sleep specialist like myself. Once you are in my office, I will get a detailed history, do a physical exam and make a decision whether a sleep study is indicated. We can typically determine by a one-night observation if you have sleep apnea.



WATCH: Snoring vs. Sleep Apnea


Home study

We have an accredited sleep lab here on the Williamson Medical Center campus, but now we are able to conduct the same sleep study at your home. 

We offer loaner equipment that we show you how to set up and use. You borrow it for one night, bring it back the next day and we can usually have results to you in 72 hours. 

Another piece of technology many of us are wearing on our wrists right now that can help a physician determine one's level of sleep quality is the Fitbit or other fitness tracking device. The Fitbit can give you some indication of how you are sleeping because it measures movement during the night. Sleep apnea forces your body to move so that you will resume breathing, and that movement during the night is recorded by the Fitbit. 

There's no guarantee that it's truly sleep apnea, but knowing how much movement you have during the night can help a physician begin to determine sleep patterns. It's a very en vogue thing right now to get some data on your sleep patterns from a Fitbit, and physicians love it when patients have that data because although it isn't definitive, it can be helpful. 

Two great quick tests I recommend to patients all the time are the Epworth questionnaire or the STOP-BANG questionnaire. Both are great at quickly helping you determine if you might have a risk of sleep apnea and can be found with a quick internet search.

If you do end up with an apnea diagnosis, there are ways to get around it and give you back a quality night's sleep and maybe even a little more energy during the day that you didn't even know you were missing.

By Aaron Milstone, M.D.

Aaron Milstone, M.D., is a sleep medicine physician at Williamson Medical Group in Franklin, Tennessee. He is board certified in sleep medicine, internal medicine, pulmonary disease, and critical care and is part of the Williamson Medical Center family of physicians.