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Tired All the Time (TATT): Sleep Expert Shares How to Fix It

Published
2024-02-16
Updated
Man sleeping at desk in front of laptop because he is tired all the time

TATT Syndrome: What It Is & How to Fix It

  • TATT syndrome is when you feel tired all the time. The most likely causes are high sleep debt and being out of sync with your circadian rhythm. 
  • You can also feel tired all the time because of stress, a lack of exercise, nutritional deficiencies, and hormone fluctuations, such as around your period or during pregnancy or menopause. 
  • These other causes of TATT can make sleep debt and being out of sync with your circadian rhythm more likely. And sleep debt and being out of sync with your circadian rhythm can make these problems worse.
  • Lowering your sleep debt and getting in sync with your circadian rhythm can help you stop feeling tired all the time and help you manage other causes of tiredness. 
  • The RISE app can help make this happen. RISE works out how much sleep debt you have, predicts the timing of your circadian rhythm, and gives you personalized daily guidance to help you get more energy.

Ask a room full of people if they’re feeling tired and you’ll probably see quite a few nodding heads. And for many of us, feeling tired is nothing new. The UK’s National Health Service (NHS) even has an acronym for this: TATT, or tired all the time. 

Tired all the time syndrome is when you feel tired all the time — no surprises there. But despite the official-sounding name, TATT syndrome is probably something you can fix.

Advice From a Sleep Doctor

Advice From a Sleep Doctor

"I come across many patients in my practice who complain of feeling tired all the time,” says Dr. Chester Wu,a double board certified doctor in psychiatry and sleep medicine, and one of our Rise Science sleep advisors and medical reviewers.

“It sounds obvious, but my best advice is to focus on getting enough sleep. The less obvious thing is you may need more sleep than you think. To get started, try heading to bed 15 minutes earlier or scheduling a few afternoon naps this week to see if that makes a difference to your energy levels. And overall, try to sleep on as regular a schedule as you can.”

What Is TATT Syndrome?

TATT syndrome is when you feel tired all the time. It’s an acronym used by the UK’s NHS, among others. Despite the official-sounding name, it’s not really a condition in its own right, but there are many things that can cause TATT syndrome. 

It’s hard to determine how common TATT syndrome is. A 2023 meta-analysis published in Frontiers in Public Health looked at 91 studies and found 20% of adults felt fatigue lasting up to six months, while 10% felt fatigue lasting more than six months. That number jumped to more than 42% in specific occupations. 

But this is likely an underestimation — fatigue affects many more people. Some research in that same meta-analysis suggests it can affect almost 70% of people, and the report also claims fatigue is one of the top five most frequently presented health complaints in primary care. 

Determining the exact percentage of the population that is tired all the time is challenging due to the subjective nature of fatigue and variations in individual reporting and perception. Additionally, factors like differing lifestyles, health conditions, and lack of a standardized measurement for fatigue add to the complexity of accurately quantifying its prevalence.

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What Are the Symptoms of TATT Syndrome?

While there’s no official list, the common symptoms of TATT syndrome include: 

  • Feeling tired all the time (you might have guessed this one!) 
  • Low motivation  
  • Brain fog 
  • Poor concentration   
  • Low mood  
  • Feeling weak 

What Causes TATT Syndrome? 

TATT syndrome can be caused by many things, but the two biggest culprits are sleep debt and being out of sync with your circadian rhythm. 

They can leave you feeling TATT independent of each other as well as together. And they can often coincide with other more obvious causes of tiredness, like stress or medical conditions, and make these problems worse or be obscured by them.

It’s easy to have sleep debt or be out of sync with your circadian rhythm as many of us don’t know how much sleep we individually need or are aware that getting out of sync can lead to low energy (or that it’s even something to be aware of in the first place). 

Sleep Debt 

Sleep debt is the running total of how much sleep you owe your body. The more sleep debt you have, the more tired you’re going to feel. 

And even if you got a full night’s sleep last night, lingering sleep debt from previous nights can still leave you feeling tired. 

You might have built up sleep debt if you’ve been working long hours, getting up in the night with a newborn, or if you purposefully stay up late to get some more me-time (aka revenge bedtime procrastination). 

Poor sleep hygiene — the daily behaviors that impact your sleep — can also cause you to wrack up sleep debt. This can include drinking coffee too late in the day, using alcohol to help you drift off (it wakes you up in the night), or not getting enough bright light during the day. These habits can also affect your energy levels independently of sleep.

You may also have sleep debt or without even realizing it if you don’t know how much sleep you need. And you might need more sleep than you think.

The amount of sleep you need is known as your sleep need. The seven-to-nine-hour guideline is just that: a guideline. In reality, we all have different sleep needs that can vary quite a bit. 

For example, when we compared the sleep needs of 1.95 million RISE users aged 24 and up and found it ranged from five hours to 11 hours 30 minutes, and 48% of users needed eight hours of sleep or more a night.

Check RISE to find out how much sleep you need and how much sleep debt you have. 

The RISE app can tell you how much sleep you need
RISE users' sleep needs.

We also cover how to find out how much sleep you need here.

You also, unfortunately, can’t hack sleep and get more sleep in less time, or rely on good quality sleep to make up for too little quantity. And all sleep stages are important for maximum energy each day. So if you’ve been trying to shortcut a good night’s sleep, you might have sleep debt making you feel TATT.

It’s not just about getting enough sleep, though. Research from 2020 suggests how you feel about your sleep is a strong predictor of fatigue levels. So you want to get sleep you feel good about — that’ll be natural, unbroken sleep at the right time for your body (more on that next).

As one RISE user puts it, “been using this app for the last week and it’s really helped me get a grip on why I feel tired most of the time. I had no idea about sleep debt or how little late nights here and there really add up.” Read the review.  

RISE users on iOS 1.202 and above can view their sleep need here and view their sleep debt here.

Being Out of Sync With Your Circadian Rhythm

Your circadian rhythm is your internal body clock. It helps to dictate your sleep-wake cycle, when your body temperature fluctuates, and when your body produces certain hormones, among other things. It’s a complex system that thrives on consistency in our sleep times, light exposure, and meal and exercise times. 

Being out of sync with your circadian rhythm can lead to low energy, trouble sleeping, impaired mental performance, and mental and physical health problems — all of which could contribute to feeling drained all day long. 

You can get out of sync with your circadian rhythm by: 

  • Having an irregular sleep schedule (about 87% of us do)
  • Working night shifts 
  • Ignoring your chronotype — maybe you’re a night owl forcing yourself up early  

Other Causes of Feeling TATT 

Beyond these two main culprits, there are many other reasons you may always feel tired. Many of these can cause you to build up sleep debt and get out of sync with your circadian rhythm, adding to or causing that TATT feeling. This can create a vicious cycle of worsening sleep and fatigue. 

And you may be affected by more than one of these factors, making it tricky to figure out what exactly is causing your tiredness. Luckily, lowering your sleep debt and getting in sync with your circadian rhythm should always help.  

Here’s what could be causing you to feel TATT:

  • Stress: Including anxiety, burnout, and mental exhaustion.
  • A lack of exercise: Or too much exercise. 
  • Dehydration or nutritional deficiencies: Like iron or vitamins B12 and D.
  • Environmental factors: Like poor air quality from wildfire smoke and even noise pollution.
  • Hormone fluctuations: Like when pregnant, going through menopause, or around your period. Hormonal birth control may even make you tired, as can low testosterone. TATT is most commonly reported by women (and there are many reasons for female fatigue). 
  • Sleep disorders: Like insomnia, sleep apnea, or restless leg syndrome. 
  • Medical conditions and illnesses: Like hypothyroidism (underactive thyroid), hypertension (high blood pressure), fibromyalgia, anemia, low blood sugar, depression, COVID, or chronic fatigue syndrome (this is different to TATT, by the way, as sleep doesn’t help it). 
  • Medication: Like antidepressants, weight loss drugs like Ozempic, or allergy meds like Benadryl.

We’ve covered more reasons you’re always tired here.

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How to Treat TATT Syndrome? 

You can treat TATT syndrome by lowering your sleep debt and getting in sync with your circadian rhythm. These are the two biggest factors affecting your energy levels. 

Working on these two things will be the starting point to getting more energy, both because most of us have either sleep debt or are out of sync with our circadian rhythms (or both), but also because any improvements you make will likely positively impact other causes of feeling TATT.

Lower Your Sleep Debt 

The good news about sleep debt is you can pay it back. 

We found RISE users with more than five hours of sleep debt are able to reduce this by two hours within the first two weeks of using the app.

Lower your sleep debt as much as possible to feel more energy each day. 

You can lower your sleep debt by: 

  • Taking short afternoon naps
  • Heading to bed a little earlier 
  • Sleeping in a little later 
  • Improving your sleep hygiene (more on this soon) 

We’ve covered more advice on catching up on sleep here.

Get in Sync With Your Circadian Rhythm 

Sync up with your circadian rhythm to boost your energy levels and have an easier time getting enough sleep, which will (you guessed it) also boost your energy levels. 

You can sync up by: 

  • Keeping a regular sleep schedule, even on weekends: We found RISE users with consistent sleep times have lower sleep debt than those with inconsistent sleep times.
  • Eating meals at roughly the same times: And avoid eating within two to three hours of bed
  • Heading to bed during your Melatonin Window: This is what we call the roughly one-hour window of time when your body’s rate of melatonin production (the sleep hormone) is at its highest. You should find it easier to fall asleep during this time. 

Check RISE for a daily prediction of your circadian rhythm. You can see when your body wants to wake up, wind down for bed, and go to sleep. Do your best to sync up with these times. 

RISE app screenshot displaying your melatonin window reminder
The RISE app can tell you the best time to go to bed.

Expert tip: Being more aware of your circadian rhythm can help you make the most of the energy you do have, even when you’re always tired. RISE predicts when your energy levels will fluctuate across the day as part of your circadian rhythm. Schedule your most important daily tasks — think presentations, writing, and decision-making — for energy peaks, and easier tasks — think admin, emails, or taking a nap — for energy dips. 

Lower your sleep debt to make these peaks higher and dips more manageable, and keep a regular sleep schedule to keep them at predictable times.  

RISE users on iOS 1.202 and above can see their circadian rhythm on the Energy screen here

Improve Your Sleep Hygiene

Sleep hygiene are the daily behaviors that affect your sleep. By improving your sleep hygiene, you should have an easier time falling and staying asleep — which will help you keep sleep debt low and stay in sync with your circadian rhythm. And many of these behaviors will help you feel less tired during the day independent of sleep debt and your circadian rhythm.

Here’s what to do: 

  • Get bright light first thing in the morning and plenty of daylight through the day 
  • Avoid bright light about 90 minutes before bed 
  • Avoid caffeine, vigorous exercise, large meals, and alcohol too close to bedtime
  • Do a relaxing bedtime routine — this is especially important if stress and burnout are contributing to your fatigue  
  • Make your bedroom dark, cool, and quiet 

You might not even realize how much these habits can cause poor sleep and therefore low energy levels.

To stay on top of it all, RISE sends you reminders to do 20+ sleep hygiene habits at the ideal times for your circadian rhythm each day. This makes the habits even more effective. 

We’ve covered more advice on how to stop feeling tired here.

RISE app screenshot showing sleep hygiene reminders
The RISE app tells you when to do 20+ sleep hygiene behaviors.

RISE users on iOS 1.202 and above can set up their 20+ in-app habit notifications here

Heads-up: If you’re experiencing extreme fatigue, speak to a healthcare provider about sleep disorders and physical and mental health conditions that could be to blame. They can recommend treatments, supplements, and medications to help. 

Stop Feeling Tired All the Time Once and For All 

Sleep debt and being out of sync with your circadian rhythm are the two biggest factors influencing your energy, and they could be the reason you’re feeling tired all the time. They can often coincide with and exacerbate other causes of feeling TATT and, because they’re linked, lowering your sleep debt and getting in sync with your circadian rhythm can help you manage other causes of tiredness.

Tired of feeling tired? RISE can help. RISE helps you lower your sleep debt and sync up with your circadian rhythm with personalized predictions and 20+ sleep hygiene reminders. 

Users say RISE has helped them overcome their lack of energy: 

“You need RISE if you’re always tired…I never realized how deprived of sleep and unregulated my sleeping pattern was and to my surprise, once it was fixed, I didn’t need coffee or a nap or anything else to have energy for the day.” Read the review.

And it doesn’t take long — 80% of RISE users feel more energy within five days.

FAQs

About Our Editorial Team

Written by
Jeff Kahn, M.S., Rise Science Co-Founder
Reviewed by
Chester Wu, MD, Rise Science Medical Reviewer
Our Editorial Standards
We bring sleep research out of the lab and into your life. Every post begins with peer-reviewed studies — not third-party sources — to make sure we only share advice that can be defended to a room full of sleep scientists.
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Updated Regularly
We regularly update our articles to explain the latest research and shifts in scientific consensus in a simple and actionable way.

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