In general, you notice sleepiness is in your head or mind; whereas, fatigue or tiredness are something you notice more in your body.  When you are sleepy, it is difficult to hold up your head; it may literally bob up and down as you try to stay awake.  Your eyelids become heavy, it is difficult to keep them open.  Your mind drifts and loses focus, seeking the natural and presumably healthy escape of sleep, given the right circumstances.  Sleepy feelings should be pleasant, especially if circumstances permit sleep, but they can generate frustration or anxiety, even pain if driving a car or meeting a deadline. 

Fatigue or tiredness is felt more in the body than in the head or mind.  Your muscles might be sore or achy.  Your body doesn’t have the energy to do anything in particular, almost as if the energy had been snatched or stolen from you.  If you force yourself to do something while tired, it may generate painful or frustrating feelings in your body.  Feeling tired after a hard day of work can feel satisfying, though, whereas, fatigue (chronic tiredness) is usually more annoying or demoralzing.

Many sleep patients blur these distinctions, which is especially problematic for someone with insomnia, because the insomniac will try to fall asleep when tired but not sleepy. Worse, some insomniacs are confused by the last sentence, asking “Is there really such a precise difference between feeling sleepy or tired?”  

In our treatment approach, you will learn that if you do not sense the experience of sleepiness primarily in your mind and fatigue or tiredness primarily in your body, then we actually spend considerable time working on this particular problem first, because it is such a large barrier.  Removing this barrier opens up many more treatment options as well as speeding up treatment success.

Can you detect the difference between sleepiness and fatigue?   Can you rate your sleepiness versus your fatigue or tiredness currently experienced in daily life?  Can you see how you would be tempted to use sleeping pills if you did not feel sleepy at bedtime or during the night?