Successful Aging: Sleep and the causes of fatigue and lack of energy

Q. I am a 68-year old man who has been physically active all of my life. I was a top athlete in high school, have been active hunting and fishing, raised and trained horses and for the last six years was active harvesting, cutting and splitting and stacking firewood – after my office job. My energy suddenly dropped off about a year ago. I had some physical problems which now are under control. My problem is – no energy and I sleep a lot, which is very frustrating. My doc wrote it off as just aging. I told him that was B.S. What’s my problem? Is it age? And where do I go for help?

Many thanks. T.B.

Dear T.B.

One of the frustrations of later life is not having the energy we had as a 20- or 30 year-old. We know that the loss of energy may be a symptom of a physical condition or part of the aging process. In some cases it may be both.

Recommendation No. 1: Seek an opinion from another health-care professional to rule out any medical problems.

Let’s first talk about energy. According to a Harvard Medical School Special Health Report, “Boosting Your Energy, the word “energy” can mean many things. It can describe the strength you need to meet a physical challenge and having the endurance to continue it for a period of time. This relates to muscles. Energy also is about the mind. If you are mentally energetic, you can readily absorb information by reading, listening and watching. In a sense you “are on.”

Lack of energy is referred to as fatigue. It includes feeling weary or weak, lacking concentration and motivation.

The view and acceptance of fatigue has changed over time. In medieval writings, fatigue was not always considered a negative. It was portrayed as a positive sign that a person had worked hard enough to reach the point when it was time to rest. During the industrialization period, fatigue was considered a negative as industry demanded “indefatigable” factory workers. Next came the study of fatigue which was a new science called “ergography.” Interest in the subject grew during World War I as the military wanted to know how to boost the energy and productivity of workers in munitions factories. Later, the military focused on mental fatigue since tasks such as piloting airplanes and operating radar required “sustained mental alertness.”

Although increased fatigue is not inevitable with age, we know certain age-related factors can lead to that feeling.

Here are a few as noted by the Harvard report:

Circadian changes (A rhythm of biological functions occurring in a 24-hour periodic cycle): Circadian cycles change, making us fall asleep early and get up early; they disturb sleep rhythms. In general, older persons spend less time in deep sleep, the most important type of sleep to restore energy. Also melatonin levels decline with age and disappear in older age. With less of it, it is harder to fall asleep and is one reason that insomnia is more prevalent in older persons. Lack of proper rest is one of the major causes of fatigue among older adults.

Physical changes: The onset of menopause can create fatigue because of hot flashes that can disturb women’s sleep. Loss of muscle mass can reduce energy. By age 70, we’ve lost about 30 percent of the muscle mass we had at age 20. That decrease translates into decreased strength and increase in fatigue when trying to do the same amount of activity from 10 or 15 years ago. It just takes more energy to do what we’ve always done.

Lifestyle Factors: Many caregivers responsible for the care of partners or aging parents suffer from fatigue. Doctor appointments, grocery shopping, food preparation, managing the medical care and attending to ongoing personal needs can be exhausting.

And then there’s just plain overwork. According to a 2015 study from the nonprofit organization Family and Work Institute, more than half of U.S. employees feel overworked or overwhelmed. Many are women serving a second work shift at home. Going to bed late and getting up early evolves as the norm. And there goes the seven to eight hours of needed sleep.

Fatigue is normal when working or playing hard without proper rest. Having too little to do also can lead to feelings of fatigue, as does consuming too much alcohol. Another possible cause is side effects from some medication.

For many of us, having a little less energy is something we get used to, but perhaps there is more we can do.

Next week we’ll discuss some natural sources of energy that can serve as a boost. And thanks T.B. for your good questions.