Modern life can be made up of hectic routines that invariably leave people lacking in one thing or another. Proper rest is one of those things. Insufficient sleep can often lead to general conditions like insomnia or fatigue. Such problems often come with sleepless nights and numerous symptoms for both adults and children alike.
General practitioner, Dr Paul Ang, is a Family Physician with a special interest in mental health. He is the founder of the Zenith Medical Clinic at Punggol West and focuses on bringing quality healthcare to Singaporeans who need it. He responded to several DoctorxDentist posts related to fatigue and how to deal with the issue. Here's what he had to say.
What is fatigue?
The term fatigue is used widely as a blanket description of overall tiredness or lack of energy. Patients often experience drowsiness or sleepiness, having no motivation or energy to perform everyday tasks.
Fatigue isn't exactly the same as being sleepy but sleepiness can be a symptom of fatigue. 
Causes of fatigue can be difficult to identify
Fatigue is one of the most common conditions seen by GPs, yet it can be quite difficult to establish a cause for the condition. There are various reasons for this challenge as the cause of fatigue can be traced to the following factors: 
- Lifestyle Factors: where fatigue is a result of one’s lifestyle habits and choices.
- Physical Health Conditions: where fatigue is a symptom of an underlying condition that would require medical attention.
- Mental Health Issues: where fatigue is a common symptom of several mental health conditions.
From Dr Paul's experience, most patients suffering from fatigue don't have physical ailments. Many suffer from a dysregulation of lifestyles consisting of poor eating habits, excessive caffeine intake, a lack of exercise and insufficient sleep.
Help for tackling fatigue can come in many forms
Aside from talking to his or her GP about symptoms, a patient can also approach nurse counselors or psychologists who can help identify the root cause and offer solutions.
Patients with fatigue due to lifestyle induced reasons should correct bad lifestyle habits like excessive caffeine intake, by limiting to a cup a day. Similarly, a personal trainer can also help manage patients' physical wellness which in turn resolves fatigue. 
Mild mental health issues might also cause fatigue
Other than poorly-managed lifestyles, patients may suffer from mild mental health issues like depression, family problems or anxiety. These issues can all easily lead to general fatigue and eventually physical deterioration. Doing relaxation exercises can be a good step towards managing fatigue. 
Sometimes viral infections can play a role!
Viruses like influenza and adenovirus can impact energy levels in a big way and be followed by fevers, coughs and other symptoms. Once the body recovers, the tiredness and feeling of being drained can linger. Exercise and sunlight are paramount for a successful recovery. 
A combination of disorders can also be at play!
A mixed bag of disorders including hormonal problems, thyroid issues, low blood counts, underlying diseases and sleep disorders like obstructive sleep apnea can all contribute to the development of severe fatigue. This is why a patient should start by approaching his or her GP in order to get a proper evaluation of the condition. 
Fatigue in children might indicate ADHD
Children who experience sleepless nights may suffer from ailments that are quite different from adults. This is because their sleep patterns are not the same as a healthy adult's. In some children, poor sleeping habits at night could be signs of ADHD (especially if they have had the problem since birth).
Chemicals can also affect children quite extensively
Children are very sensitive to chemicals. Medication can affect their sleep. Doctors may have to stop prescribing certain courses if this is the case. Allergies can also have a role in sleeplessness and cause loud snoring.
Salt, snacks, chocolates, as well as food with colouring, can also affect a child's sleep. A GP can determine whether treatment involves surgery or other forms of medication. 
Children below 2 years old should get zero screen time
Screen time is a major problem at the moment, with people using their phones right before and up till the moment they sleep. As light-emitting devices have an effect on the sleep hormones in children as well as their development and attention, it is recommended to avoid the use of such devices 1 hour before sleep or it will affect the melatonin production and affect sleep quality. 
Accordingly, it is strongly encouraged for kids below 2 to have ZERO screen time. For kids above 2 years, the American Academy of Paediatrics has listed the following recommendations: 
- For children aged between 2 and 5 years, it is recommended to limit the usage of light-emitting devices to 1 hour a day.
- As for children age 6 and above, consistent limits should be placed on the screen times to ensure that screen activity does not compromise adequate sleep, physical activity and other behaviors that are crucial in a child's development.
Identifying fatigue can be complex and challenging. A patient should get properly evaluated by his or her GP. There are many causes of fatigue but there are also various solutions that can make a difference.
Dr. Paul Ang founded the Zenith Medical Clinic at Punggol West in 2014. With a keen interest to improve the delivery of General Practitioner (GP) services, Dr. Ang aims to bring great, quality, affordable healthcare to the residents in Punggol, Singapore. In his free time, he enjoys cycling around Punggol and Sengkang with his family to maintain a healthy and well-balanced lifestyle.
Would you like to ask any related health questions?
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