You go to bed, rise early, and yet you feel exhausted all the time. Why? You could be suffering from Obstructive Sleep Apnea (OSA). It is most common among middle-aged men. It occurs when breathing is blocked by the closure of the throat tissues — you actually stop breathing for 20 to 40 seconds at a stretch you are asleep.

When this happens, you are forced to wake up to breathe again, though the next day you do not remember the interruptions in your sleep. The awakening is brief, but it can happen hundreds of times a night, thus you lose substantial sleep. Because deep sleep is disturbed, you miss out on the most important sleep, the restorative time, thus allowing unrelenting fatigue to set in.

But fatigue is not the only problem OSA can create. It can kill a person in sleep. In fact, thousands die of it every year in India. If you are suffering from OSA, you must consult a doctor. But lifestyle changes may also help you reduce or eliminate it. Two most effective steps are:cutting the consumption of fat and giving up alcoholic drinks. Studies show that a weight loss of 10 to 25 percent induced by decreasing fat consumption can eliminate OSA. Skipping alcohol can also lessen the severity of OSA.

If you are over 50, you may be making periodic leg movements during the night. It can mean anything from a toe-flex to a full-fledged kick that is sure to catch a partner's attention.

Sleep-disorder experts are not exactly sure what causes these involuntary movements, technically called nocturnal myoclonus. Some suspect lower back injuries to be the cause, while others suspect cental nervous system problems. What they do know is that these movements can cause fatigue. This happens because they can occur hundreds of times a night. They might disappear for an hour, then return to occur every 20 or 30 seconds, and since they can interrupt your sleep in the process, the result could be fatigue.

Periodic leg movements probably cannot be eliminated completely, but medication can help reduce their frequency. That could reduce your fatigue.

Are you breathing in a wrong manner? If so, it can be the cause of your fatigue. This breathing wrongly is called chronic hyperventilation syndrome (HVS) and it effects 25 to 40 percent of the people. These people breathe slowly and rapidly, leading to hyperventilation — the excessive loss of carbon dioxide. This loss affects blood’s haemoglobin, making it less able to carry oxygen throughout the body. So even though you are breathing quickly, you are getting less air.

However, most HVS sufferers think they just cannot catch their breath and assume they have a breathing problem — but rarely recognise it as hyperventilation.

HVS can be caused by many medical disorders — among them heart and kidney diseases, anaemia, diabetes and hypertension. Stress is a major cause of HVS because it causes you to tense your muscles — not only the ones in your neck but also those in your diaphragm. The gesult is that your diaphragm cannot move freely, and you compensate by breathing more quickly.

If you think you are a candidate for HVS, see a doctor who can literally teach you to breath again. Most people can relearn breathing techniques but some have trouble. For them the simplest treatment for HVS is to just keep their mouth closed. If you breath through you nose, you cannot hyperventilate — the nasal passages are too narrow. By doing so, you could do more than breathe a little easier; you just might get your energy back in the long run.

If you are suffering from loss of interest or pleasure in all or almost all activities, poor appetite, a feeling of worthlessness and fatigue for over two weeks at a stretch, then you are really suffering from depression.

In some persons, depression causes insomnia, others may sleep all the time. All this causes fatigue.

While a visit to a doctor is a must for those suffering from severe depression, excercise could also help to reduce fatigue. Do you know that a lack of stress can also contribute to fatigue? There is a delicate balance between boredom and burnout. Each person has an Optimal Point of Stress (OPS). So,if you are stressed past your OPS, your performance dips. On the other hand, if you do not have enough stress, you are not motivated to perform at all.

So, if you find yourself in this state, re-stress yourself. You will have to find out what works for you. Since a lack of creative engagement is tiring, you should try to get involved in more things — like learing a new skill, or becoming part of a group of active and committed people.

Are you taking in enough calories to sustain your body’s normal functions? If not, that may be causing fatigue.

In normal weight loss, you expend more calories than you take in. So your body turns to its reserves and burns its stored calories — your fat deposits. When your calorie intake is restricted too much, your body starts to live off itself. This whole process is abnormal and very stressful to the body and one of the many symptoms of this type of stress is fatigue.

Diets that bar you from eating a variety of foods may be as bad as those that drastically restrict your calorie intake. They may put you at risk of below-normal nutrient intake or even nutrient deficiency.

In order to lose weight without losing energy, cut the consumption of fat on the one hand and lose weight in moderation on the other. In the place of fatty foods take high-carbohydrate foods like fruits, vegetables, grains etc. If you are trying to lose weight, let your weight loss be no more than half to one kilogram per week. Diets that lead to drastic weight loss can cause fatigue. They may even cause heart problems and lead to the formation of gall stones.

Finally, if your exhaustion seems never ending, your mind as well as body needs to be treated. Recognise it and get medical help. But do not take recourse to self-medication under any circumstances. Avoid dependency on alcohol, cigarettes or any person. Try to enjoy whatever you do.

Live at a reasonable pace of life and find time for pleasurable activities. Cultivate hobbies, and indulge in activities that relax you, like music, outings etc. And soon you will be brimming with energy.