Why Do I Wake Up Exhausted?

November 29, 2014 / Charles W. Lapp, MD / Ask The Doctor

Q: I wake up each morning feeling tired, even though I have slept. Would a sleep study be useful?

A: There are at least four core symptoms in ME/CFS: pain, cognitive dysfunction, fatigue or post-exertional malaise, and non-restorative sleep. Thus, awakening unrefreshed is one of the cardinal symptoms of ME/CFS, and one of the last symptoms to resolve as one improves. You will probably wake up tired whether you sleep 4 hours or 14. Nevertheless, primary sleep disorders such as apnea and periodic leg movements occur in up to 60% of people with ME/CFS or FM, and can disrupt sleep. So, if such problems are suspected, then a sleep study would be in order.

Another characteristic of ME/CFS is “dysania,” or waking up stiff and sore or foggy-headed. Almost everyone awakens a little stiff and foggy-headed for the first few minutes, but PWCs really feel badly and this situation may last for 30 minutes to several hours – much longer than a normal healthy individual. One of my patients said, “I shuffle to the bathroom each morning like Tim Conway in his comedy show!” The treatment?: spend a few minutes in the bed loosening up, then try ‘waking up’ with a cup of coffee or a warm shower.

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Dr. Hillman was born and reared in Utica, New York. He attended college at Clarkson University where he earned a bachelor’s degree in engineering, and then spent two years toward a master’s degree in biochemistry/oncology at the University of Buffalo’s Roswell Park Division, where he did research in leukemia. Dr. Hillman attended St. George’s University School of Medicine, and completed his clinical years at the Maimonides Medical Center in Brooklyn, New York, graduating in 1996. During the Summer of 1994 he also did research at the University of Buffalo Dental School using PCR technology on RNA subtyping of gram negative oral bacteria. Following medical school, Hillman went on to a Family Practice Residency at North Shore / Long Island Jewish Hospital in Bay Shore, NY.

After his residency, Dr. Hillman worked for the US Army at the West Point Military Academy (Keller Army Hospital family practice unit), worked in the Emergency Room and hospital admitting areas, and ran a private practice as well. From 2005-2006 he also worked at the Winn Army Hospital at Fort Stewart, GA, before setting up a private Family Practice in Huntersville, NC in 2007. In addition to his private practice Dr. Hillman also has an interest in helping clients with disabilities. He has worked for ProMed Urgent Care in Occupational Medicine and performed over 13,000 examinations for Social Security Disability.

Dr. Hillman has a family member with Chronic Fatigue Syndrome, so he has a long standing interest and empathy with the disorder! He is married and has two sons and a daughter. The family lives in Huntersville.