Top 10 reasons a child or teen is tired

I see many kids each month who complain of being too tired. Parents often fear the worse, such as low iron or even cancer. There are many things to consider, but there are a few very common reasons that could explain why a child or teen is tired. I’m also including some less common things that make kids feel tired, but are common worries of parents. Always remember that common is common. Serious causes of being tired will not happen with fatigue as the only complaint.

Here are 10 reasons a child or teen is tired:

1. Not enough exercise

top 10 reasons a child is always tiredStrenuous aerobic exercise helps our bodies get healthy, quality sleep. Better quality sleep improves our performance, both physical and mental.

If you lay around, you tend to feel more relaxed, lazy and tired. Getting up and moving can help.

Many kids sit all day at school, then come home to sit more doing homework, watching tv, or playing video games.

Limit time on screens, especially before bedtime. We need to encourage kids to get up and move, ideally outside.

Make it fun!

  • Take a walk to a park, then play
  • Play catch
  • Go on a bike ride
  • Swim
  • Join a sports team
  • Play frisbee
  • Golf
  • Go bowling
  • Dance
  • Try yoga — there are many online videos to get you started

Several of these ideas you can do with your kids. Make it a family goal to be active together! It models the healthy habits you want your kids to live.

2. Celiac disease

Celiac disease is an autoimmune disease in which people can’t eat gluten (a protein found in wheat, barley and rye) because it will damage their small intestine. This can lead to malnutrition and anemia (low red blood cell counts). Symptoms vary, but often include abdominal pain, diarrhea, constipation, fatigue and bloating. In kids it can affect puberty and growth. Celiac disease can run in families.

There are a lot of people who say they feel healthier when they avoid gluten for non-celiac gluten sensitivity. These people have symptoms that are found in celiac disease, such as abdominal pain, bloating, diarrhea, constipation, headaches, bone or joint pain, and chronic fatigue when they have gluten in their diet, but do not test positive for celiac disease. It is not clear what the etiology of this is, but removing gluten seems to improve symptoms.

It’s uncommon for kids to have fatigue as the only symptom of celiac disease, but if you are worried about their symptoms, schedule a visit with their physician to discuss it as a possibility.

A quick warning…

Do not remove gluten from their diet without talking to your doctor. Gluten in the diet is needed for testing, which is needed to confirm celiac disease.

Celiac disease is important to diagnose and treat due to chronic issues that can occur from long-term damage to the intestines. If a child doesn’t have a true diagnosis, it is more likely they will not remain compliant with the diet changes that are required.

3. Depression

We often think we would recognize a depressed child or teen. We picture them crying often or appearing sad, but this is not necessarily how they appear. Yes, they can cry and appear sad, but sometimes they don’t.

Depression doesn’t always look like you’d think.

Sometimes parents think their child is angry. Or parents are mad because a teen stops trying at school. The child might get into fights.

Common symptoms of depression:

  1. Sadness, crying and tears
  2. Losing interest in things they usually enjoy
  3. Appearing angry or irritable
  4. Boredom and apathy
  5. Isolation from friends and family
  6. Extreme sensitivity
  7. Headaches, stomach aches, and other ill type symptoms
  8. Low self-esteem or guilt
  9. Poor concentration
  10. Change in eating patterns – either more or less
  11. Low energy
  12. Falling grades
  13. Change in sleeping patterns – either more or less
  14. Self harm (cutting or other behaviors)
  15. Talks of suicidal thoughts or intent

If you think your child is depressed, please get professional help. Sadly, depression is a fairly common underlying reason for kids to be tired.

4. Thyroid problems

Thyroid problems are relatively common and can be present at birth or develop later in life.

Hypothyroidism occurs when the thyroid gland does not make enough thyroid hormone. About 5% of people over 12 years of age has hypothyroidism.

People with hypothyroidism might feel depressed, be tired, have poor focus, and become forgetful. They might gain weight or have slowed growth. They might feel colder than others or have constipation. Sometimes they’ll develop a swelling in their neck called a goiter.

Most of these are very common symptoms that are not specific to thyroid problems. Having some of them does not necessarily mean that there is a problem with the thyroid. If there are several of these symptoms, it’s relatively easy to screen for thyroid problems with a blood test.

Schedule an appointment to talk to your pediatrician if you’re concerned about a thyroid problem.

5. Too much sugar

Although the body needs sugar for energy, eating too much refined sugar can cause weight gain, chronic disease and sugar crashes. Excess weight can make it harder to exercise and sleep, both of which help us not feel tired.

Encourage kids to eat a healthy balance of fruits, vegetables, proteins, and complex carbohydrates.

Limit the juices, candies, and other high-sugar / low nutrition foods. I know this is easier said than done when kids beg and cry for candy. It’s even harder to limit when kids grab their own snacks.

Keep easy to eat healthy snacks available as much as possible. Don’t buy the junk. Kids will get plenty of it outside the home. If it’s not at home, they won’t grab it.

6. Caffeine

Most adults have grabbed a caffeinated beverage to help ward off fatigue, but caffeine can lead to poor sleep and more tiredness. It can become part of an unhealthy cycle.

Kids don’t need caffeine. If they do have it, it should be before noon. Caffeine can stay in your body for about 8 hours and keep you from sleeping.

Children under 10 years of age should not have caffeine due to jitteriness, irritability, and other side effects. It’s recommend that kids who are 10 – 12 should get no more than 85 mg per day. Teens should have 100 mg or less. Up to 400 mg of caffeine a day appears to be safe for most healthy adults.

Mixing caffeine with certain medicines or alcohol can increase its problems.

7. Anemia

Anemia is a low red blood cell count.

Our red blood cells bring oxygen to the cells of our body, and when the levels are low we can feel tired. Other symptoms are irritability and pale skin coloring. Often there are no symptoms with mild anemia.

There are many causes of anemia. Blood work can help to identify anemia and its causes. Treatment depends on the cause.

If you’re worried about anemia, schedule an appointment with your pediatrician. A history and exam will be needed to determine if labs are indicated.

8. Insomnia

It makes sense that if you don’t sleep enough, you’ll be tired. When people have insomnia, they do not sleep enough hours.

There are many causes of insomnia, but all can lead to insufficient sleep. Addressing the underlying cause is important.

  1. Anxiety and depression (see above)
  2. Screens (see below)
  3. Circadian rhythm changes
  4. Allergies or other causes of nasal congestion
  5. Pain
  6. Gastroesophageal reflux
  7. Restless leg syndrome
  8. Some medications and caffeine
  9. Exercise too late in the evening
  10. Nicotine (growing in popularity among kids due to vaping)

If your child is struggling to sleep, schedule an appointment to discuss potential reasons and treatments.

9. Sleep apnea

Sleep apnea happens when a person stops breathing during sleep. It’s usually caused by something blocking the upper airway. You might hear snoring followed by pauses in the breathing pattern, gasps, or choking sounds.

Because the airway is obstructed, oxygenation levels can fall briefly. This triggers the brain to wake up to open the airway. When this happens repeatedly throughout the night, sleep quality is affected. A person wakes feeling tired.

Enlarged tonsils or adenoids and obesity are common causes of sleep apnea. If you think your child has sleep apnea, talk to your child’s pediatrician.

10. Screen time

The light emitted from televisions, computers, tablets, and smart phones trick our brains into staying awake.

When kids are on a screen up until bedtime, their brain is not yet ready to go to sleep. This leads them to stay up too late, which makes them too tired the following day.

Dr. Craig Canapari discusses the problems with screens and sleep in Prevent Sleep Problems in Kids: Keep Technology Out of The Bedroom.

Not enough sleep is the common thread to many of these.

Not enough sleep is the #1 reason I find for kids being tired. They need more sleep.

Studies show that many of us just don’t sleep enough. It’s important for kids to get adequate amounts of sleep. If your child is tired and is not able to sleep sufficiently, talk to your pediatrician about ways to improve sleep and decrease fatigue.

 

Sleep Tricks

I preach about sleep to kids all the time, both at the office and at home. It’s one of my three most important things for overall health along with eating nutritious foods and daily exercise. Most of us don’t get enough sleep. Here are some tricks to get in a few extra minutes each day… they all add up!

Most of these tips are appropriate not only for kids and teens, but also for their parents! In November I wrote about the problems I often see with teen sleep deprivation specifically.

Know how much sleep is typical for every age group.

A great infographic of this is found at the Sleep Foundation.

Warning: It shows generalizations. For example, when tweens and teens go through a growth spurt many need 10-11 hours of sleep per night, which is more than the graph shows.

Just remember that individuals are just that: individual.

Think of sleep as a currency.

We can go into sleep debt when we don’t get enough. If it’s just a little loss of sleep, it’s easy to catch up and pay back the debt. The further into debt you go, the harder it is to get out of debt.

Don’t let the bank come after you in terms of health problems!


Listen to your body and teach kids to listen to their needs.

If you’re tired, you need more sleep. It’s sometimes easy to recognize but not always. Some kids are notoriously not able to do this well.

The longer you stay up, the harder it will be to fall asleep. It’s ironic, but sleep deprivation leads to insomnia. If you suffer, try to allow extra zzz’s on a weekend to fill the deficit. But don’t let the sleep deprived person sleep in so late that he can’t go to bed on time that night.

Many parents have realized that the later the kids stay up, the earlier they wake. Despite waking early, they didn’t get enough sleep. Behavior shows that they’re tired when they don’t sleep enough – you might see whining, tears, frustration, and irritability when this happens.

Many kids get hyper when they’re tired, so don’t be fooled if they have lots of energy in the evening. If they don’t wake easily in the morning or are whiney during the day, they are tired!

Routines.

Go to bed and get up at the same times every night and morning. If you let your kids stay up later on a weekend, be sure it isn’t more than 2 hours past their ideal bedtime.

Remember that going to bed just 15 minutes late each weeknight gives over an hour less sleep during the week – it all adds up!

Resetting the internal clock.

If someone has a hard time getting up, have them get natural sunlight as soon as possible in the morning. It helps set the circadian rhythm. If you can’t get natural sunlight, turn on lights in your home.

Conversely, start turning down lights a few hours before bedtime. Avoid screens (tv, computers, smart phones). Lights keep you from feeling tired. Don’t let them keep you up!

Use a night mode on a screen if you must work online prior to bed – a common problem for teens who have homework these days. I have used a free app called f.lux with great success. I can tell the difference in tiredness and ability to fall asleep when I have this active on my computer.

Winding down.

There are many ways to wind down before climbing into bed.

  • Journal before bed if thoughts keep you awake. People who spend bedtime thinking about everything can’t sleep. Jot a few things down to give yourself permission to not think anymore. Sounds weird, but this “worry list” works for many people!
  • Coloring is another way to relax. It’s not just for kids anymore!
  • Learn meditation. There are many apps available for smartphones and tablets, just do a search in your store. I refer kids to Stop, Think, & Breathe often. There’s also an adult version. I have many of these apps (mostly free) on my Mindfulness Pinterest Page.
  • Belly Breathing is very effective and can be taught to kids. Some kids will put a stuffed animal on their tummy and try to raise the animal with a slow, deep breath.
  • Set the mood in the room: darken the room, get the temperature “just right”, and find the number of blankets that helps you sleep. Setting up a fan or other white noise maker helps many people sleep. For more tips on setting up the perfect room for sleeping, see Bedroom.
  • Weighted blankets have been shown to help many people, especially those with anxiety fall asleep faster but there is a concern about safety when used by kids.
  • Listen to Weightless – music that’s been shown to help initiate sleep.
  • Reading at bedtime can be a great relaxing thing, but if you have a page turner, be careful to not get caught up in the book for hours. I find that stopping at a lull mid-chapter is better than waiting until the end of a chapter. A good author leaves you hanging at the end of a chapter and begging for more! Set a time limit and stop reading when time’s up! That’s what bookmarks are for.
  • Take a warm bath. This can help relax you for a good night’s rest.
  • Ask a family member to give you a massage or back rub. Again, a great way to relax!
  • Warm milk or herbal teas might help some sleep.
Be active during the day.

Lounging around makes you feel more tired during the day, but it’s then harder to fall to sleep at night.

Experts recommend avoiding exercise for a few hours before bedtime, but I know that is really hard for kids in sports. I don’t have a great fix for that, unfortunately.

Skip the snooze.

Kids and their parents who hit snooze several times miss out on all that sleep that they are in a half awake zone. If you really don’t need to get up until the 3rd snooze time, set the alarm for that time. You will be more well rested so it will be easier to get up immediately. Train your body (or your kids) to get up at that time. After several days of an extra few minutes of sleep, you’ll notice the difference!

Kids sleep alone.

Keep kids out of the parent bed so everyone gets the best sleep. Snoring, different bedtime, and other body movements makes it hard to sleep together. No one sleeps well, which makes everyone grumpy the next day.

If kids are anxious about sleeping in their own room, see The Most Common Reasons Why Kids Are Afraid To Sleep.

Pets

Pets can either help an anxious child calm down and sleep or can keep kids awake. Know the situation and act accordingly.

If pets make noise or try to wake their person, they should not be in the bedroom at night.

If the pet is quiet and lets kids sleep, they can provide reassurance to a child who doesn’t like being alone. But be sure they don’t wake the child!

Melatonin

Melatonin is a hormone that’s made in our body and helps us feel tired. It’s also available as a supplement. I think that if other sleep techniques fail it can be a great sleep aid, but I also think that if you’re going to give it to your child you should talk to his physician first.

Dr. Craig Canapari is a pediatric sleep expert who has written a great deal on how melatonin works, when it would be appropriate to try it, what concerns there are regarding melatonin, and more. Check out his Melatonin Guide for Parents.

Avoid Caffeine

Most of us know that caffeine will help wake us up, but many think they can drink it later in the day and it doesn’t affect their sleep. Dr. Melissa Welby has a great blog on how caffeine works and what it does to our sleep cycle.

Don’t be fooled with hidden sources of caffeine. I have occasionally gotten ice cream with coffee for a family bedtime treat, only to find out upon tasting it that it had coffee. Caffeine is often added to drinks, so read labels. But be careful! It might not say caffeine directly. Some are labeled as “guarana” — a plant with caffeine. Pretty much anything that is labeled as an energy drink (or food) is a likely culprit. Even decaf coffee has a small amount. Chocolate naturally has caffeine… the darker the chocolate the higher the caffeine content. Some pain relievers and other medicines have caffeine.

Especially for those not accustomed to caffeine, it will disrupt sleep even if taken several hours before bedtime.


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