Why is my teen always tired?

If it feels like your teenager is perpetually exhausted, you are not imagining it. But, you may not know why – or when to be concerned.

Erin Wallace, M.D., Pediatrician at Children's Health℠ Primary Care Mansfield, breaks down the science of teen fatigue and what parents can do about it.

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In this episode of Children’s Health Checkup, Dr. Wallace shares what parents need to know about teenage fatigue.

Is fatigue normal in teens?

Some tiredness in teenagers is completely expected. Yet, there is an important distinction to make.

Normal fatigue typically improves with a day or two of rest. If your teen is getting adequate sleep and still tired then that could be a sign that it may be something more.

What can cause teen fatigue?

The most common reason teens feel tired is simple: They’re not getting enough sleep.

Part of the reason is biological. During adolescence, the brain naturally releases melatonin – the hormone that helps the body wind down – later in the evening than it does in children or adults. As a result, many teens don't feel sleepy until late at night. When you pair that with early school start times, many teens are running on a chronic sleep deficit.

Other common causes of teen fatigue include:

• Poor nutrition or nutrient deficiencies

• Mental health conditions, such as anxiety or depression

• Overscheduled days and burnout

Chronic fatigue in teens

Chronic fatigue syndrome, or Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS), is a serious neurological condition that causes extreme exhaustion that lasts three months or more. It is extremely rare in teens.

No amount of sleep helps and it is often accompanied by brain fog, sudden crashes, hypersensivity and headaches.

If you suspect your child’s fatigue is not normal, contact your pediatrician.

How much sleep do teens need?

Teens typically need eight to 10 hours of sleep, but there are many factors and daily habits that can affect a teen’s sleep quality.

Sleep hygiene for teens

Good sleep starts with healthy daily habits. Encourage your teen to:

• Limit screentime before bed. Keep phones, tablets and other screens out of the bedroom. Charge family devices in a central location. Stop all screen time one hour before bed to give the brain time to wind down.

• Stick to a consistent sleep schedule. Going to bed and waking up at the same time each day can improve sleep quality and support mental health.

• Cut back on caffeine. Encourage your teen to avoid energy drinks and limit caffeinated beverages, especially in the afternoon and evening.

• Stay physically active. Regular exercise – even a daily walk – can improve sleep and burn off restless energy.

• Eat a balanced diet. Nutritious meals help support growing bodies and brains. Some teens, including those who follow vegetarian or vegan diets and girls who have heavy menstrual periods, may need additional iron. Talk with your pediatrician before starting a supplement.

“Sleep is not downtime for our teenagers,” Dr. Wallace says. “It really is when their brains are learning and growing and recovering and regulating their emotions.”

When to seek help

Fatigue that lasts more than a month or two deserves medical attention. Other red flags include:

• Significant weight changes

• Frequent headaches or stomach pain

• Dizziness or fainting

• Heavy periods

• Failing grades

• Signs of depression and anxiety

“Persistent fatigue where you're sleeping eight to 10 hours but still coming home and taking two- or three-hour naps is also worth discussing with a doctor,” Dr. Wallace advises.

Find the right care for your teen

Occasional tiredness is normal, but ongoing fatigue isn't something to ignore. If your teen is always tired despite getting enough sleep, talk with your pediatrician. They can help identify the cause and recommend the right treatment or refer your teen to a specialist if needed.

Children's Health Primary Care provides comprehensive care for children and teens, helping families navigate concerns about sleep, nutrition, mental health and overall wellness. Learn more and find a pediatrician.