Dragging yourself out of bed no matter how many Zzz’s you caught last night? Or feel like you completely lack concentration and energy?

Something might be up with your personal Rest-O-Meter beyond just lack of sleep.

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Health and sleepiness go hand in hand. Certain health conditions can make you feel like you have no energy or need to sleep. Others can cause extreme tiredness or lack of concentration.

Sometimes it just feels like no matter how much you sleep, you’ll never catch up on Zzz’s. If you’re extremely tired after no sleep — or after tons of sleep — one of these health conditions might be to blame.

1. Chronic fatigue syndrome

Chronic fatigue syndrome (CFS) affects about 1 million people in the United States. Women are more likely to receive a diagnosis of CFS. Symptoms include extreme fatigue, weakness, trouble sleeping, and the lack of a refreshed feeling after sleep.

You may also have other symptoms such as:

  • trouble concentrating, paying attention, or remembering things
  • dizziness
  • muscle aches
  • joint pain
  • headaches that are out of the ordinary for you
  • tender lymph nodes
  • sore throat

Some people who have CFS experience post-exertional malaise, a temporary period of extreme fatigue after minor physical or mental activity.

2. Thyroid condition

Thyroid conditions like hypothyroidism (when your thyroid doesn’t make enough thyroid hormones), Hashimoto’s thyroiditis, and Graves’ disease can cause fatigue. Even hyperthyroidism (when your thyroid makes excessive thyroid hormones) can make it hard to sleep, adding to your fatigue.

Thyroid hormones are a major player in metabolism and circadian rhythms that help you sleep, so when they’re out of balance, you can slow waaaay down.

Symptoms of hypothyroidism include:

Thyroid disease is also associated with period problems, infertility, and pregnancy complications.

3. Anemia

Anemia basically means you don’t have enough healthy red blood cells. Because iron is necessary for red blood cells, iron deficiency is the most common cause of anemia.

Research suggests that sleep quality is worse in people who have iron deficiency anemia.

Anemia doesn’t always cause symptoms, but some people experience:

  • fatigue
  • shortness of breath
  • pale skin
  • irregular heart rate

4. Fibromyalgia

About 4 million U.S. adults have fibromyalgia, a condition that causes widespread pain, sleep disturbance, and fatigue.

You may also have these symptoms with fibromyalgia:

Reducing pain is an important part of improving sleep in people with fibromyalgia. Studies have found that people with fibromyalgia pain have decreased sleep quality and duration and greater sleep disturbance.

5. Seasonal allergies

Allergies are virtually always in season — from pollen in the spring and summer to moldy autumn leaves.

Common symptoms of seasonal allergies (aka hay fever or allergic rhinitis) are:

  • sneezing
  • coughing
  • congestion
  • runny nose
  • itchy eyes, nose, mouth, or throat

But did you know seasonal allergies are also associated with fatigue, sleep problems, and difficulty thinking? A 2018 study found that during pollen season, folks with allergies had more fatigue and sleepiness and longer periods of deep sleep.

Battling seasonal allergies with antihistamines may also be the source of your sleepiness. Antihistamines are notorious for causing drowsiness. Try taking them at bedtime or look for “nondrowsy” formulas.

6. Illness

Flu, cold, random virus — it’s normal to need more sleep when you’re sick. It’s a two-way street: Your immune system affects your sleep patterns, and sleep quality affects your immune system.

So, your body’s inflammatory response to an infection may cause you to sleep more, or it may disrupt your sleep.

7. Sleep disorders

Sleep disorders can really wreck your rest. Here are just a few of the more than 80 known sleep disorders:

  • Insomnia. This is the most common sleep disorder. It means you’re unable to fall asleep or stay asleep.
  • Sleep apnea. This condition causes you to stop breathing during sleep.
  • Restless legs syndrome. This condition makes your legs feel tingly and like they need to move, which messes with your ability to fall asleep.
  • Hypersomnia. With this condition, you fall asleep during the day.
  • Circadian rhythm disorders. These conditions disrupt the patterns in your body that help you sleep and wake up at appropriate times.
  • Parasomnia. With this condition, you engage in unusual behavior during sleep, like sleepwalking.

Common symptoms of various sleep disorders include:

  • feeling sleepy during the day or napping often
  • taking 30 minutes or longer to fall asleep
  • waking during the night or too early in the morning
  • snoring, gasping, or not breathing during sleep
  • feeling unusual sensations in your legs when you try to sleep

8. Autoimmune disorders

If you have an autoimmune disorder, your immune system attacks healthy parts of your body, causing inflammation. Multiple sclerosis, lupus, celiac disease, and rheumatoid arthritis are a few examples.

Inflammation contributes to sleepiness, so extreme fatigue is a common symptom of autoimmune conditions. The other symptoms vary, depending on the condition.

9. Diabetes

Diabetes and sleep problems are kind of a “chicken or the egg” situation. There seems to be some link between them, since people with diabetes often have trouble sleeping. Research has found that more than 90 percent of folks with type 2 diabetes report sleep problems.

Diabetes might disrupt sleep by causing:

  • frequent urination (more late night trips to the bathroom)
  • restless legs syndrome
  • neuropathy (a complication of diabetes that causes pain)

10. Heart disease

Fatigue is a common symptom of heart disease, which might seem like a long shot if you’re in good health. Sorry to be a downer, but heart disease is the most common cause of death in the United States.

In a study of 102 people with heart disease, 40 percent reported fatigue more than 3 days a week for more than half the day. Women in the study felt more fatigued, and tiredness interfered more with their activity.

Symptoms can vary depending on the type of heart disease, but any chest pain or shortness of breath warrants a visit to the doctor.

11. Pregnancy

It makes sense that growing a human would make you tired, but pregnancy can be downright exhausting. Like, “taking a nap in the bathroom at work” tired.

Some reasons you may feel zapped for energy during pregnancy:

If you’ve got preggo fatigue, there’s probably not much you can do about it besides sleep. But talking with your doctor can help rule out any issues that might need treatment, like anemia.

12. PMS

Almost 50 percent of people who have periods experience premenstrual syndrome (aka PMS), which can make you super tired. Other possible symptoms include:

A drop in estrogen before your period may also lead to decreases in acetylcholine, dopamine, and serotonin, which can contribute to fatigue and insomnia.

13. Diet and vitamin deficiencies

What you eat can really impact your energy levels. Similar to an iron deficiency, a vitamin B12 deficiency can also cause anemia and fatigue. Vegans and vegetarians are especially prone to B12 deficiencies since animal products are a main source of B12.

The following nutrients also play a role in physical and mental energy:

Eating a varied diet with plenty of minerals and vitamins should help, but your doctor or a registered dietitian can help you choose supplements to fill in any gaps.

14. Dehydration

Fatigue is a symptom of dehydration, so if you’ve been slacking on your H2O, it’s time to drink up.

Other symptoms of dehydration:

  • extreme thirst
  • decrease in urination or sweating
  • dark urine
  • dry skin
  • dizziness

You’re more at risk for dehydration if you’ve been sick with vomiting or diarrhea.

15. Stress

Stress can mess with your body in a number of ways, including by making you tired AF.

Here are some of the reasons stress can tire you out:

  • Muscle tension uses up energy.
  • Shortness of breath means you’re not getting enough oxygen.
  • Chronic stress causes inflammation, which your body spends energy trying to calm down.
  • Stomach upset may decrease your appetite, causing you to have less energy.
  • Stress may suppress nutrient absorption in your intestines.
  • Chronic activation of your nervous system can lead to wear and tear on other body systems.

16. Depression

It’s not uncommon for people dealing with depression to sleep all day or be unable to get themselves out of bed.

Sleep issues are actually a super common symptom of depression. Insomnia can also lead to depression.

Other symptoms of depression:

  • persistent sad, anxious, or empty mood
  • hopelessness
  • irritability
  • feelings of worthlessness or helplessness
  • loss of interest in hobbies and activities
  • slowed movement or speech
  • thoughts of self-harm or suicide

17. Anxiety

The restlessness and uncontrollable worry that come with anxiety can make it really difficult to sleep. Insomnia can also lead to anxiety.

Other symptoms of anxiety:

18. Bipolar disorder

Bipolar disorder is a mental health condition that causes extreme mood changes, like a sudden elevated mood (aka mania) or deep depression.

There are a few different types of bipolar disorder, but episodes of both mania and depression can impact your ability sleep or make you super tired.

An episode of mania may cause:

  • decreased sleep
  • high, elated, or jumpy feelings
  • wired feeling or irritability
  • loss of appetite
  • fast speech
  • racing thoughts
  • behaviors that may have harmful effects, like drug use, excessive spending, or sex without a barrier

An episode of depression may cause:

  • excessive sleep or loss of sleep
  • feelings of sadness, worry, or hopelessness
  • slowed speech
  • increased appetite
  • trouble concentrating
  • thoughts of suicide

19. ADHD

Attention deficit hyperactivity disorder (ADHD) can make it hard to sit still, focus on tasks, and pay attention (among other symptoms). These effects can get in the way of everyday life.

An estimated 2.5 percent of adults and 8.4 percent of children in the United States have an ADHD diagnosis.

If you have ADHD, you might also experience chronic exhaustion and sleep issues.

Whether a health condition or a behavior (like “revenge bedtime procrastination”) is affecting your sleep, here are some things you can do right now to feel more rested and energetic:

  • Cut down on the java. Drink caffeine early in the day and avoid a midafternoon latte.
  • Stick to a sleep schedule. Go to bed at the same time every day and aim for 7 hours of sleep.
  • Let the sun shine in. Get some sunlight in the daytime, but avoid blue light a few hours before bedtime.
  • Move your body. Get regular exercise, but don’t schedule intense sweat seshes right before bed.
  • De-stress. Chill out with techniques like yoga, breathing exercises, and meditation.
  • Create a sleep den. Make your sleep environment dark, cool, and comfy for optimal Zzz’s.

If you think a health condition is zapping your energy, the best way to reach your #SleepGoals is to see a doctor. They can help you identify the underlying cause of this constant need to sleep and find treatment options.

Make an appointment with a doctor and discuss any symptoms you’re experiencing along with your lack of sleep and tiredness. The doc may then order tests or refer you to specialists.

Depending on your diagnosis, there are medications, equipment, habits, and therapies that can help you sleep better or treat the health condition that’s causing your sleep probs.

A simple blood test can also help you figure out if you have anemia or certain vitamin deficiencies that can be treated with diet and supplements.

If stress or a mental health condition is to blame for your lack of energy or need to sleep, therapy for stress or cognitive behavioral therapy could also be a helpful tool.