Are You "Too Tired"? Causes And Solutions For Tiredness And Chronic Fatigue

Feeling tired for a few days or weeks is something we have all experienced. However, when does being tired become a problem? The answer may be found in the world’s most tired countries.

According to research by a manufacturing firm, Sleepseeker, Singapore is the ‘most fatigued nation in the world,’¹ while Mexico, Brazil, and the US complete the top four.

It is unsurprising that these fatigued countries also tend to have the most overworked people with the least amount of sleep. As individuals, this can teach us a lot about burnout.

What is fatigue?

Fatigue is a broad term that refers to feeling tired, exhausted, or lacking in energy. It can be both physical and mental. In most cases, fatigue will disappear once a person rests and recharges, but longer-term fatigue can be a sign of a serious illness such as heart disease or another chronic condition.

The most fatigued countries in the world can help us understand the causes of tiredness.

To discover the countries in the world with the most fatigued people, researchers in the Sleepseeker study considered four variables:

  • Amount of sleep

  • Amount of screen time 

  • Number of work hours per year 

  • Search data from Google keywords 

Data from Statista,, Wikipedia, and Google Keyword Planner was used to discover fatigue rates. Once the data of the four variables had been studied, countries were given a score out of ten.

The researchers gave Singapore a fatigue score of 7.20, Mexico a score of 7.01, and Brazil a score of 6.28. The next three most fatigued countries were the US with 5.57, Japan with 5.32, and the United Kingdom with 4.82.

Singaporeans work 2,238 annual hours

It probably comes as no surprise that the most fatigued countries were also those that recorded the longest working hours. Within the top group, Mexico was found to have an annual average of 2,255 working hours. Singapore followed closely with 2,238, while China came in third place with 2,174 annual hours.

The Sleepseeker researchers claimed that the considerable dedication to working life in Singapore can eventually take a toll, leading to tiredness and burnout. “This small island nation in Southeast Asia is a bustling tech hub that has experienced rapid and widespread urbanization. The busy lives of Singaporeans reflect this, leading to high levels of fatigue,” they noted.

Working longer hours can naturally lead to fatigue. The researchers wrote that “[b]y working longer or more unsociable hours, we give our bodies and minds less time to rest and recover. Repeatedly over-working can lead to serious levels of fatigue.”

A meta-analysis² of 243 paper records also found that long working hours can adversely affect the occupational health of workers, including raising the risk of serious illness. Correlations between long working hours include an increased risk of:

  • Cardiovascular disease

  • Hypertension

  • Stress

  • Anxiety

  • Depression

Longer working hours also resulted in fatigue due to less sleep and reduced quality of sleep, though the authors did note that the results were not conclusive.

Common causes of fatigue

Feeling tired for a few days or weeks isn’t normally problematic. If that tiredness or fatigued feeling lasts longer though, it might be a sign of a medical issue.

There are many reasons for feeling tired. Nutritional deficiencies, sleep issues, mental health challenges, stress, infections, and various illnesses can all play a role. Interestingly, women are at a higher risk of experiencing chronic fatigue issues than men.³

Lifestyle factors can also play a role, including: 


One factor is the “couch potato syndrome,” a nickname often used for a sedentary lifestyle. Too much sitting and inactivity can contribute to a host of health issues as well as fatigue.

Some findings show that nearly half of Americans sit for too many hours per day without getting any exercise at all. A survey⁴ of 5,923 adults found that 25% sat for more than 8 hours per day while 44.6% did no exercise.


While many of us rely on our morning coffee to wake up, if you drink too much caffeine, it can lead to sleep loss and tiredness. A 2016 study⁵, for example, found that a higher caffeine intake was associated with a greater chance of depression and insomnia.


Alcohol is another well-known reason for tiredness. There’s plenty of research⁶ showing that alcohol consumption⁷ is associated with a range of health issues, including cancer, heart disease, memory impairment, immune system issues, and mental health problems. Alcohol also affects sleep, resulting in lower sleep quality and feelings of tiredness.


Certain medications can also induce feelings of fatigue and drowsiness. If you think this is affecting you, it’s important to discuss it with your doctor before stopping any medication.

Simple ways to avoid burnout

Many factors can contribute to the feeling of burnout, including:

  • Working long hours

  • Not getting enough sleep

  • Feeling stressed or overwhelmed

  • Drinking too much alcohol

There are many ways to avoid it.

Get enough rest

Sleep is one of our most critical bodily functions. Scientific research has found that sleep has an impact on almost every system in the body, including the brain, heart, lungs, metabolism, and immune function.

According to the Sleep Foundation⁸, adults should be aiming to get between seven and nine hours of sleep per night.

Yet, many people aren’t getting enough sleep. Nearly half of Americans surveyed⁹ say they feel tired during the day three to seven days per week, while 35% of adults in the US¹⁰ report sleeping less than seven hours per night on average.

Speak to someone you trust

While many people might feel embarrassed to admit that they’re feeling stressed, anxious, or depressed, expressing your feelings can be very helpful. It’s important to keep in mind that most people feel overwhelmed at some point in their lives.

Speaking to someone, whether a friend, a family member, a counselor, your doctor or a psychologist can be incredibly helpful. By expressing how you feel, you may gain a new perspective, adopt strategies to avoid feeling this way in the future and understand that you are not alone.

Limit working hours

Many of the most fatigued countries were also the most overworked. Longer working hours contribute to less rest and more stress overall.

Where possible:

  • Limit overtime at work

  • Ensure you take your allotted holidays

  • Sim to finish work on time each day

This will help you to feel rested and rejuvenated for the following day.

Adopt a healthier lifestyle

As we’ve seen, many lifestyle factors, including inactivity, alcohol, and caffeine, can all play a role in causing fatigue. Adopting a healthier lifestyle is one way to prevent and treat feelings of tiredness.

If you are inactive, introduce an exercise routine (with approval from your doctor) that can have positive benefits beyond improving fatigue. Limiting alcohol and caffeine can help improve sleep and gain energy. Eating a nutrient-dense diet with plenty of fruit and vegetables can be highly beneficial too.

Long-term tiredness might be chronic fatigue

If fatigue is impacting your life long-term, there may be a greater issue at play: chronic fatigue syndrome (CFS).

Chronic fatigue occurs when the symptoms of tiredness last for longer than six months. While the cause of the illness is unknown, many factors, including viral infections, immune system issues, hormonal imbalances, and trauma, may all play a role.

While the illness is relatively new, the Center for Disease Control and Prevention (CDC) has categorized chronic fatigue to ensure individuals can be diagnosed and treated.

In 1987, a working group defined the features of the illness and made “chronic fatigue syndrome” an inclusive term alongside “myalgic encephalomyelitis” (ME). The abbreviation ME/CFS is commonly used to refer to the illness.

How do I know if I have chronic fatigue?

Only a medical professional can diagnose ME/CFS –– though there are some common symptoms to look out for. According to the CDC¹¹, people experiencing ME/CFS tend to have three core symptoms:

  • Reduced ability to partake in typical activities for six months or more due to fatigue 

  • Worsening of symptoms –– which can include issues with sleep, headaches, a dizzy feeling, and severe tiredness –– after both physical and mental activity 

  • Issues with falling asleep and staying asleep

To be diagnosed with ME/CFS, in addition to the three core symptoms, a person must also be experiencing one of the following:

  • Challenges with memory and thinking 

  • A worsening of symptoms when mobile –– standing or sitting upright –– including feeling lightheaded, dizzy, or weak

If you are experiencing long-term tiredness, it is very important to speak to your doctor to see if your symptoms might be cause for concern. 

It’s important to note ME/CFS does not show up in blood tests or scans, so there are no standard lab tests to conclusively diagnose the illness. A doctor, however, will likely ask a range of questions, run tests to rule out other diseases, and consider the core areas of symptoms as set out by the CDC if other causes have been ruled out.

Once a doctor has given you a diagnosis, it is worth considering different treatment options.

Treatments for ME/CFS are not one-size-fits-all

ME/CFS can be challenging, though not impossible, to treat. Many of the symptoms are similar to other illnesses, but they differ from person to person, and they can also mimic the side effects of certain medicines.

While there isn’t a standard cure or FDA-approved treatment, there are certain treatments that can help manage the symptoms of the disease. Each person’s management plan will look different depending on their situation.

There is a range of treatment options available to address individual symptoms.

Pain management

People with CFS/ME often have headaches, pain in their muscles and joints, and soreness when their skin is touched.

A doctor may recommend a range of ways to treat pain depending on the severity and frequency. This might include over-the-counter pain medication such as aspirin or ibuprofen. In other situations, a pain specialist may be used to help patients manage and deal with long-term pain.

Alternative therapies that may provide relief include:

  • Counseling to deal with the psychological impact of pain

  • Movement therapy

  • Acupuncture

  • Gentle massage

These options should all be overseen by your doctor.

Cognitive behavior therapy (CBT)

CBT is a psychological treatment used to treat a range of mental and physical health conditions. The therapy is based on a few core concepts, including:

  • Issues are based on unhelpful ways of thinking

  • Issues exist due to learned patterns of unhelpful behavior

  • Individuals can learn to adopt better ways of coping to relieve symptoms

Research has found¹² that CBT is effective in reducing the symptoms of fatigue for those who experience chronic fatigue. It has been found to be more effective than other psychological therapies.

Why diagnosing chronic fatigue syndrome is challenging

For those who experience continuous tiredness, it can be a frustrating illness. As recently as the 1980s, some doctors considered chronic fatigue a psychological illness. Many people with the condition felt ignored by the medical institution and couldn’t get the help they needed.

This was partly because the disease is complex, and the symptoms are wide-ranging. They can also mimic symptoms of other diseases and disorders.

According to Jose G. Montoya¹³, MD, professor of medicine in the division of infectious diseases at the Stanford University Medical Center: "Not only does the face of the illness vary significantly from one patient to the next, but within the same patient symptoms change over time."

Although patients experience continuous tiredness, there is no specific blood test or scan for the disease, so making a diagnosis is challenging for doctors and patients. However, with a standardized method, both diagnosis and treatment are now possible.

The lowdown

Feeling tired occasionally is part of life. However, when that tiredness starts to interfere with normal living, it’s time to speak to your doctor. Many factors can contribute to fatigue.

The most fatigued countries in the world appear to be some of the most overworked and the most sleep-deprived.

Many things can contribute to a feeling of tiredness, including medications, caffeine, alcohol, lack of sleep, stress, and working long hours. Speak to a professional if you’re concerned, as fatigue can be an indication of a health condition.

If your tiredness lasts longer than six months, it could be down to CFS/ME. Only a doctor can diagnose the condition.CFS/ME can be challenging to diagnose, but for patients with long-term fatigue issues, there is hope. A range of treatments, both psychological and physical, can help treat the symptoms and may also address the cause.

Although chronic fatigue can be frustrating, health professionals can help sufferers to manage their condition.

  1. Fatigues cities | Sleep Seeker

  2. The effect of long working hours and overtime on occupational health: A meta-analysis of evidence from 1998 to 2018 (2019)

  3. QuickStats: Percentage of adults who often felt very tired or exhausted in the past 3 months,* by sex and age group - National Health Interview Survey, United States, 2010-2011 (2013)

  4. Joint prevalence of sitting time and leisure-time physical activity among US adults, 2015-2016 (2018)

  5. The relationship of caffeine Iintake with depression, anxiety, stress, and sleep in Korean adolescents (2016)

  6. Global status report on alcohol and health 2018 | World Health Organization

  7. The relation between different dimensions of alcohol consumption and burden of disease: an overview (2010)

  8. How much sleep do we really need? | Sleep Foundation

  9. Sleep hygiene | Sleep Foundation

  10. Data and statistics | Centers for Disease Control and Prevention

  11. Symptoms of ME/CFS | Centers for Disease Control and Prevention

  12. Cognitive behaviour therapy for chronic fatigue syndrome in adults (2008)

  13. The difference between chronic fatigue syndrome and just being really tired all the time | Self

Other sources:

Chloe Garnham is a writer exploring a broad range of topics, including healthcare, education, and technology.

Have you considered clinical trials for your medical condition?

We make it easy for you to participate in a clinical trial for your medical condition, and get access to the latest treatments not yet widely available - and be a part of finding a cure.

Discover which clinical trials you are eligible for

Do you want to know if there are any a medical condition clinical trials you might be eligible for?
Have you taken medication for a medical condition?
Have you been diagnosed with a medical condition?