I crash later in the day, and need this to stop.
December 23, 2013 8:19 AM   Subscribe

I wake up at 7 am, and am very sleepy by around 6pm. This occurs whether I work or have the day off, and is screwing with my hygiene and social life. I would appreciate advice on what could be the problem, or in the case that there is nothing fixable, raise my energy levels naturally.

My 6 pm I start winding down. I start dinner early, since I know that I won't be up to make anything after 7:30 or so. By 10 pm I am so tired that if I have not already brushed my teeth and gotten ready for bed, there is a good chance that I will simply neglect to do so and plop down to sleep. I know how important brushing is, but I crash so hard that I seemingly cannot will myself to do it.

This is also taking its toll on my social life. Making spontaneous plans to leave the house in the evening do not happen very much anymore. I get invited to go somewhere anytime in the evening, I usually decline as I am just not feeling up to it. If I had evening plans that I made earlier, I force myself to go. I can usually enjoy myself but in the back of my mind is a voice screaming 'go to sleep already!' I sometimes get invited to bars/clubs by one of my buddies, and I am always the first to leave (around 11, 12 or so) while they are out partying until 2 or 3 am.

I'm not sure why this is going on. I mean, I'm still pretty young. I'm not exercising as much as I should, but am trying to eat right. I'm taking a low dose of Vyvanse (30mg) for ADD, and besides that am taking a multivitamin, fish oil, allergy medication (zyrtec) and calcium and magnesium supplements.

I guess I have a few ideas, but have no clue how to pinpoint what could be making me so tired. I used to be on antidepressants (lexapro, zoloft and wellbutrin), and wonder whether or not they permanently screwed with my energy levels. I also wonder if the Vyvanse could have anything to do with it. I checked my thyroid, which is fine. I am also thinking of getting a sleep study done, since I often wake up in the middle of the night to go to the bathroom even though I am careful not to drink fluids after 8:30 pm.

Does anyone have any other ideas what I could attempt to try and pinpoint a reason for my torpor? Or maybe suggestions to raise energy levels naturally? Could I possibly just need more sleep than other people?
posted by Thanquol180 to Health & Fitness (31 answers total) 16 users marked this as a favorite
I was much sleepier when I used to eat high-carb meals. I also used to let myself get very hungry, which made me tired too, even after I ate. I don't know what kind of diet you have, but make sure you're eating for high energy--lots of protein!
posted by chaiminda at 8:24 AM on December 23, 2013 [2 favorites]

Magnesium is a natural sleep aid. Maybe you're taking too much?
posted by kythuen at 8:27 AM on December 23, 2013 [1 favorite]

I try to eat healthy carbs (bananas, quinoa, etc), and really the only carbs I have in the evening come from veggies. Maybe there's too big a break in between lunch and dinner. I'll try and throw a snack in between there and see if that does anything. Also, I take the magnesium in the evening after dinner, and am usually pretty tired before then.
posted by Thanquol180 at 8:28 AM on December 23, 2013

Get the sleep test. Frequent nocturia (night-time urination) is one of the primary symptoms of sleep apnea. According to the linked article, it's as diagnostic as heavy snoring.

I have sleep apnea, and before I got my CPAP, I was always waking up to pee during the night. Now I rarely do. I'm also much more energetic and focused during the day and I don't lose energy so early in the evening. At my age, I don't party into the wee hours, but I can stay up to a normal hour, and I only (!) need eight-and-a-half to nine hours sleep to function.

Seconding chaiminda about the protein, as well. Your blood sugar may be taking a dive during the night. I'm much more energetic in the morning if I have a light protein snack - a glass of milk or a couple of crackers spread with peanut butter - an hour or so before I go to sleep.

Ask your doctor for a sleep test, a thyroid hormone test, and a blood sugar test as well, to cover all the bases.
posted by Rosie M. Banks at 8:29 AM on December 23, 2013 [1 favorite]

You should absolutely see a sleep specialist. It could be that you're not getting enough REM sleep, which can really mess with your mental faculties and alertness. No downside to this--worst-case scenario, the sleep specialist rules out any sleep disorders, which narrows down your list further.

I use a CPAP machine due to sleep apnea, and take melatonin supplements to help get me through the night without interruptions. It's done me a lot of good, but talking to your primary care doctor about seeing a specialist should be your starting point.
posted by duffell at 8:31 AM on December 23, 2013

When the Vyvanse wears off you will feel tired. If you take the extended release that claims 12 hours and you take it at 7am it will be gone by 7 pm but many people report it only lasts anywhere from 5-8 hours. So by 6 pm you have had 11 hours effect which is longer than most. Doubtful it was caused by anti-depressants if you came off them some time ago. An idea is to split the dose-not extended release. Try half on waking and half around 1 and then move timing of that one around depending on how it works. Good luck.
posted by claptrap at 8:31 AM on December 23, 2013 [2 favorites]

Talk to your doctor about this. It could be a 100 things (including depression). It is nice to think you can fix it with a vitamin or evening jog or some natural fix, but until you know what is going on you're just guessing.

One note, when do you take the zyrtec? It's a "non-drowsy" antihistamine, but that just means "less drowsy than benadryl". You should take it just before bed.
posted by fontophilic at 8:36 AM on December 23, 2013 [2 favorites]

OP – you say you are trying to eat well, but what does that mean? Eating a few more salads and drinking less soda? I suggest you consider tracking what you eat for a week or two and then posting it here so we can review it with you. I suffer from this same sort of exhaustion a lot, and it is primarily due to being overly stressed and not eating correctly. I have had insulin resistance in the past and I try to follow a diet based on the ‘link and balance’ method. The link and balance method recommends that for every 15 grams of carbohydrates you eat 8 grams of protein. But in more basic terms, every time you eat carbs make sure you match it with a protein. Protein is digested slower and prevents blood sugar spikes. When you come down from a blood sugar spike is when you feel tired. If you feel like you could take a nap after a meal, this is what is happening in your body most likely.

I highly recommend adding the Myfitnesspal app if you have a smart phone. Allows you to record what you are eating on the go and can really help keep you on track. Sometimes it sucks to have to be so vigilant, but trust me you will feel much better if you really hit that protein and cut back on sugar. I certainly notice the difference in my ability to focus and my energy levels if I eat too many carb based foods.

I also want to warn you away from taking too many vitamin supplements. You seem ok for now, but MAKE SURE you check with your doctor before taking anything. I am on a mild dose of sertraline (anti depressant) and I started taking ginkgo biloba to help with memory and hopefully aid circulation. That was an incredibly dumb thing to do as it interacts with sertraline. I had headaches and felt an unpleasant ‘floating’ sensation in my head.

posted by Driven at 8:49 AM on December 23, 2013

Could be the Vyvanse. When I was on Ritalin and then Dexedrine, I had the same; I got more tired by 9pm-10pm, whereas usually I can't sleep before 2am.

It could also be that you're sleeping too much, I find that when I sleep in I tend to feel drowsy and tired for most of the day. My personal ideal is 6-7 hours, more than that and I feel drunk and groggy.

Calcium is a magnesium antagonist, so taking them together won't do much. You also seem a bit overstuffed on the pill side; it would be a good idea to discuss this with the doctor, there could be some strange stuff happening in that drug cocktail.

Besides, if you eat well, you wouldn't need any of those as you get them from your diet, especially since magnesium and calcium are good sleeping aids, so there might be a bit too much of it in your system, hence, sleepy.
posted by ahtlast93 at 8:55 AM on December 23, 2013

It could be your Vyvanse scheduling and you should discuss with your doctor ASAP, but I think you should also get bloodwork done as soon as you can and then sleep study if the issue persists. Nutritional deficiencies very rarely manifest as daily sunsetting like you're describing.
posted by Lyn Never at 8:56 AM on December 23, 2013

Nthing the meds as the most likely suspects. That's where I'd start with my doctor before pursuing anything else. Drowsiness appears to be a known side-effect of Vyvanse, and a close friend of mine gets just as drowsy from Zyrtec as Benadryl, but does really well with Allegra.
posted by gimli at 8:56 AM on December 23, 2013

Zyrtec makes some people really drowsy even though it claims not to. I know I could barely stay awake when I tried to take it.
posted by Jess the Mess at 8:58 AM on December 23, 2013 [2 favorites]

In high school I ended up on Zyrtec for allergies and it wiped me out utterly. I slept maybe 20 hours a day. I slept so much I was conscious while I was asleep, lying there thoughtless but aware in my leaden body. I slept through all my classes at school, came home and slept, got woken up for dinner and sat there, head drooping, until they would let me go back to sleep. This lasted for two weeks until we figured it out. So Zyrtec is definitely a possibility for creating an overwhelming tiredness.
posted by foxfirefey at 9:04 AM on December 23, 2013 [1 favorite]

I spent some time having the same problem and mucking about wondering whether I should be eating better or sleeping more or whether it was a million different things.

In the end I went to the doctor and it was something I wouldn't have figured out on my own (in my case, an arthritis thing, but I'm sure there's a million others) and really I was wasting my time playing guessing games.

Go to the doctor!
posted by emilyw at 9:10 AM on December 23, 2013

I sometimes get invited to bars/clubs by one of my buddies, and I am always the first to leave (around 11, 12 or so) while they are out partying until 2 or 3 am.

Are you by any chance in your mid 20s? This happened to me, and ultimately to most of my friends, around that age. It used to be that we'd all party till the wee hours every weekend, but at some point in our mid-late 20s we started calling it a night closer to midnight. At first it seemed "lame" -- and in fact I was the first of us to go through this change and felt like a social pariah for a while -- but as everyone caught up to it, it became the normal way of things. At this point in my life (I'm 32), I'll stay out past 1 AM maybe once or twice a year. If even. And that's fine.

My real concern is your evening habits. It seems weird that, by 6PM, you're basically done in terms of any useful activity, and that you're so exhausted by 10:30 that you can't get ready for bed properly. Even in my old age where nobody parties all night anymore, I often have to remind myself that I'd best be in bed by 11 or I'll regret it in the morning.

Thoughts about this:

1. If you're taking medications in the afternoon, I would definitely consider drowsiness side effects.

2. Do you eat at all between lunch and dinner? I hit a wall every day somewhere between three and five, so I've started making time for an afternoon snack and maybe something lightly caffeinated like a cup of tea. This really improves both my mood and my energy levels for the end of the day.

3. After you've eaten dinner, do you get a burst of energy at all, or is it all downhill from there?

4. What do you typically do in the evenings? Is it mostly watching TV or otherwise staring at screens?

5. What's work like? Are you going at a breakneck pace all day? Are things stressful?

6. Do you feel well-rested in the morning?
posted by Sara C. at 9:10 AM on December 23, 2013 [2 favorites]

> Could I possibly just need more sleep than other people

Yes? What you've said sounds like me, pretty much, especially during the phases where I take small (even smaller than yours) doses of Vyvanse.

Is this something that came on suddenly? That would be my only concern. Otherwise, I'd think you're just someone who needs nine hours of sleep a night.
posted by The corpse in the library at 9:12 AM on December 23, 2013 [1 favorite]

You absolutely need to talk to your doctor about your medication. And this probably goes without saying, but don't start adjusting your dosage like some have mentioned without talking to your doctor first.
posted by inertia at 9:12 AM on December 23, 2013

I take zyrtec when I can't sleep. It knocks me out and I'm still sluggish the next day.
posted by fshgrl at 9:13 AM on December 23, 2013

> My real concern is your evening habits. It seems weird that, by 6PM, you're basically done in terms of any useful activity

Oh, good point. I glossed over that. I think the hours you're sleeping are fine, but you shouldn't be tired for so much of the evening.
posted by The corpse in the library at 9:13 AM on December 23, 2013

Seconding the Zyrtec as a possible culprit! It knocks me the hell out: if I take it at night, I can (sometimes) stay awake for a few hours, but then I'm useless for the whole next day because I'm so dopey, while my husband takes one every day and has no side effects. His allergist says that about 2% of people exhibit this unusual sleepiness on Zyrtec.
posted by telophase at 9:21 AM on December 23, 2013

Yes I took it for granted the doctor would be consulted as I mentioned getting a non-extended- release which would require a dose adjustment and a prescription. Sorry if I needed to make this clearer.
posted by claptrap at 9:29 AM on December 23, 2013

Zyrtec completely and utterly knocks me out. Like "I cannot get off the couch" level of exhaustion. I had no idea it was supposed to be non-drowsy because it so dependably makes me pass out! I'd cut out the magnesium for awhile too, unless you're taking it on doctor's orders.
posted by barnone at 9:36 AM on December 23, 2013

Zyrtec made me so sleepy I once fell asleep on the floor of my husband's office. Try switching allergy meds.
posted by mai at 9:48 AM on December 23, 2013

A while back I was having epic crashes at about 4pm every day along with a slew of other vexing symptoms and it turned out to be the beginning of the end of my ability to take Ritalin. I switched to Adderall and have not had any similar issues thus far. You might have some luck switching up your meds, I guess?

Also in general I always think you should always take anything drowsy-making at night instead of in the morning. Can you switch the allergy meds to a bedtime dose?

Also look at your daily caffeine intake and think about not having any after noon. Daytime exhaustion can definitely be due to restless sleep at night, and it doesn't always show up first thing in the morning.
posted by elizardbits at 10:08 AM on December 23, 2013

Zyrtec, while being amazing for my allergies, makes me so exhausted it's not worth taking. This happens whether I take it at night or in the morning - doesn't matter, while I'm on it I seem to need about 15 hours of sleep a day. N-thing many that this might be (at least part of) the culprit. Allergy-wise, I do much better on Allegra. If switching is an option, you may want to try that.
posted by augustimagination at 10:57 AM on December 23, 2013

I wake up at 6 a.m. or 7 a.m. usually, and by 5 p.m. I'm dragging. A 30-minute nap between 4:30 (particularly in winter) and even as late as 6:30 p.m. is magical. You'll need to establish your own napping protocols (alarm, no alarm, TV, no TV, dark, semi-dark, quiet, loud) but once you hit the magic recipe you're gold.

If I don't stop work at 5 p.m. and Friday and go to bed for an hour my weekend is ruined. If I don't pause my day on weekends around 2 p.m. or 3 p.m., I'm hosed.

There could be other things, depending on what you mean by "trying to eat right." Sometimes when people do that, they're starving themselves. If your carb input consists of bananas... um, that's not a lot of carbs.
posted by RJ Reynolds at 11:21 AM on December 23, 2013

Nthing the suggestions to pursue this with your doctor.

In the meantime...

Are you eating enough? I get exhausted when I don't eat enough. I need lots of protein and fat to keep my energy levels up, but also carbs at the beginning of my day and again when I start to yawn, around 3pm.

Have you tried melatonin? I don't take it every night, but I do take it if I've been particularly tired during the day. It helps me get a better night's sleep and wake up feeling "together."

You should also think about exercising more. Light exercise can really temporarily energize you, and help you sleep more soundly at night.
posted by schroedingersgirl at 11:45 AM on December 23, 2013

Are you low iron? I take a liquid iron supplement and it is like night and day. Without it I am exhausted as soon as I get up and could fall asleep at any time as though I have narcolepsy. With iron a few times a week I am much better rested.
posted by St. Peepsburg at 5:50 PM on December 23, 2013

This is the kind of symptom that could be nothing (side effect of meds), something minor (mono or anemia), or the first sign of something serious (cancer, as an extreme example). Go to a doctor, at least if changing the allergy med doesn't help.
posted by Comet Bug at 2:49 PM on December 24, 2013

I know I'm late here, but I'll put this anyway, just in case you see it & it's helpful. Is this, by any chance much worse in the winter?
This is pretty much how I was every winter until I tried a SAD lamp. SAD (seasonal affective disorder) doesn't always affect mood. I don't have any difference in mood when the daylight hours are shorter, it just feels like my body thinks bed time is about 2 hours after sunset. It feels like you describe, including the trying to force myself to have a social life, despite the almost irresistible pull of sleep. This is now my 2nd winter with a SAD light & I can't believe I didn't try this for the first 40 years of my life! Now I use the light for about an hour when I get in from work, from September until the clocks change, then I find I need about 2 hours. You can do other things at the same time, so I chop veg for dinner prep or mess about on the Internet, just with the light on the table in front of the chopping board or beside the laptop. With this routine I am comfortably awake & alert until 10pm, when I start getting a bit tired & I sleep well from 11pm or so until morning. If I'm doing something interesting, or I'm out with friends I can be comfortably awake until later. The effect builds up over about 3 days & takes about the same to wear off, so I can miss a day once a week with no loss of effect.

I have 2 lights, this one & this one.
posted by cantthinkofagoodname at 1:03 AM on January 5, 2014

I used to feel like this when I was going through depression and didn't eat meals consistently. I also did not have enough protein or iron in my diet. I nth the record your diet suggestion and look into your medication.
posted by Hawk V at 6:02 AM on June 11, 2014

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