Hard to get up and tired by afternoon. What can I do?

Waking up heavy and struggling to get out of bed usually comes down to too little or irregular sleep, plus the groggy spell after waking that normally lasts no more than 30 minutes. Afternoon tiredness mostly comes from a natural dip in alertness in the middle of the afternoon. Alternatives to coffee include a steady wake time, morning light, a 15-minute walk, a 15 to 20-minute nap, smaller meals spread through the day and enough to drink. If you have felt tired for a few weeks without knowing why, see a doctor.

Why do I wake up feeling heavy and unable to get out of bed?

The most common reasons are about sleep and what you do before bed. The UK's NHS lists not getting enough sleep, finding it hard to get to sleep, and lifestyle factors such as an unhealthy diet and not getting much exercise among the usual causes of tiredness. Feeling heavy right after waking is something that happens to everyone.

Too little sleep, or sleep at irregular times

The US CDC recommends 7 hours or more for adults aged 18 to 60, 7 to 9 hours for ages 61 to 64, and 7 to 8 hours for 65 and over. If you sleep 5 or 6 hours on work nights and then lie in for a long time at the weekend, your wake time keeps moving. That is why both the CDC and the NHS advise going to bed and getting up at the same time every day, not just getting enough hours.

The groggy spell after waking

Training material from NIOSH, the CDC's workplace safety institute, describes a temporary period of disorientation and lower performance or mood after waking: slower reactions, poorer short-term memory and slower thinking. It typically lasts 30 to 60 minutes and has been seen to last up to 2 hours. In people who are well rested it usually lasts no more than 30 minutes, but it can be longer if you are short of sleep. NIOSH also found it lasts longer when sleep has moved into its deeper stages before you wake.

So the first few minutes of feeling unable to move are not in themselves a sign that something is wrong. But if it happens every morning and lasts more than an hour, look first at how many hours you are really sleeping.

Caffeine and alcohol in the evening

The NHS says the effects of caffeine on the body can last up to 7 hours, so an iced coffee or tea at 3 p.m. can still be working at 10 p.m. Alcohol may help you fall asleep, but it makes sleep less deep, so you can wake up tired even after a full night.

Late meals and screens before bed

The NHS advises not eating, having caffeine or exercising in the couple of hours before sleep, and not using smartphones or screens in the hour before. Scrolling in bed late into the night quietly shortens the sleep you actually get.

I wake up feeling heavy every morning. What can I do?

Start with the night before, then look at the morning. Easier mornings usually begin with enough sleep and a steady wake time.

The night before

• Count back from the time you need to get up so you get 7 hours or more, and set your bedtime from there.
• Turn off electronic devices at least 30 minutes before bed, as the CDC advises; the NHS suggests no screens in the last hour.
• Avoid large meals, alcohol, and caffeine in the afternoon or evening.
• Keep your bedroom quiet and cool.

If a racing mind keeps you awake, see Can't sleep because your mind won't stop thinking?

In the morning

• Get up at the same time every day, even on days off, so your body gets used to its wake time.
• Open the curtains or step outside into bright light, and wash your face. CDC NIOSH material notes that after a nap, bright light and washing the face helped restore alertness more quickly; you can try the same in the morning.
• Leave around half an hour in the morning before tasks that need precision, such as driving or an important meeting.

Why do I get tired so easily in the afternoon?

This happens to most people, not only those who slept badly. CDC NIOSH material explains that in the middle of the afternoon the body clock signals that keep you awake dip, while the drive to sleep has built up since you woke, so the pressure to sleep takes over more easily.

A short night

The afternoon dip is felt much more strongly after a short night, so afternoon tiredness is often linked to heavy mornings. Looking after your night-time sleep is the starting point for both.

A big lunch, or skipped meals

When work is busy, many people skip breakfast and then eat a large lunch. The NHS suggests eating regular meals and healthy snacks every 3 to 4 hours rather than one large meal.

Not drinking enough

The NHS says even mild dehydration can make you feel tired. In an air-conditioned office you may not feel thirsty, so you can drink less than you think.

Sitting for long stretches

The NHS lists not getting much exercise among the common causes of tiredness. Hours at a screen without getting up can make the afternoon feel heavier still.

I get tired easily in the afternoon and don't want to rely on coffee. What are my options?

Several options work right at your desk: a short walk, a 15 to 20-minute nap, smaller meals through the day, enough to drink, and a break from the screen. Pick what fits your day.

A 15-minute walk

The NHS says even a single 15-minute walk can help you feel more energetic, and suggests building up to 2 hours 30 minutes of moderate-intensity activity a week. On work days, walk a bit further for lunch or take the stairs instead of the lift.

A 15 to 20-minute nap

CDC NIOSH material says studies have shown a 15 to 20-minute daytime nap can improve alertness, and that the brain benefits from actual sleep rather than just a quiet rest. But a nap is a temporary aid, not a replacement for enough sleep at night. If you find it hard to sleep at night, the NHS suggests avoiding daytime naps.

Smaller meals and water

Instead of skipping breakfast and having a large lunch, spread your eating across breakfast, lunch and an afternoon snack such as fruit, yoghurt or nuts. For fluids, the NHS suggests about 6 to 8 glasses a day, and says water, lower-fat milk and lower-sugar drinks, including tea and coffee, all count. A water bottle on your desk makes it easier to sip regularly.

If you still want coffee

You do not need to stop all at once. The NHS suggests cutting down gradually, because stopping suddenly can cause headaches and trouble sleeping. If you drink it, have it in the morning rather than the afternoon, since its effects can last up to 7 hours. The US FDA says that for most adults, 400 milligrams of caffeine a day, about two to three 12-fluid-ounce cups of coffee, is an amount not generally associated with negative effects, but how much is too much varies with body weight, medicines and sensitivity.

What should I watch out for when I'm groggy in the morning or sleepy in the afternoon?

While you are still groggy or very sleepy, your reactions and thinking are slower, so take care with tasks where mistakes matter.

Driving and precise work

CDC NIOSH material advises allowing time for grogginess after waking to pass before critical tasks. If you become very sleepy while driving, pull over and rest before going on.

Don't rely on weekend lie-ins

Long lie-ins at the weekend push your wake time later and make work-day mornings harder. Get back to your usual wake time as soon as you can.

Caffeine and alcohol limits

The NHS advises not regularly drinking more than 14 units of alcohol a week. During pregnancy, the NHS advises no more than 200 milligrams of caffeine a day.

When should I see a doctor about feeling tired?

Tiredness from short sleep or busy days is common, but if it continues without a clear reason, let a doctor help find the cause rather than guessing. The NHS advises seeing a doctor if:

• you have been feeling tired for a few weeks and are not sure why
• your tiredness affects your daily life, such as work or study
• you feel tired and have other symptoms

Also see a doctor if you still keep nodding off during the day after looking after your sleep as above. If you take regular medicines, talk to a doctor or pharmacist, as some medicines can affect sleepiness or tiredness, and do not start any medicine on your own.