Why don’t you feel energized after sleep when you have chronic fatigue?

There are a lot of disheartening and frustrating things about existing in a perpetually fatigued state. The first is the state itself. All of the symptoms that come along for the ride. The brain fog, the digestive issues, the mood crappiness.

Seeing what you used to be like compared to how you feel and function now and how nothing that you do seems to work can lead to profound dispair.

But the second aspect, which often adds insult to injury, is just how counter-intuitively bad the advice is for what to do about it.

Getting more sleep and rest is pretty standard. As if you hadn’t already thought of that and tried it.

At the other end, you might be told you just need to exercise more. Which is fairly cruel if you have post-exertional malaise, pain and worsened fatigue when you move.

But here’s a more basic question and one I had for many years as I navigated the escape room that is profound brain fog and fatigue: why doesn’t sleep help? The answer to this is pretty fascinating.

The first thing we need to realize is that lying down for 8 hours a night and going unconscious to the world is not something we evolved. Sleeping was actually the default. We evolved the trait of wakefulness and consciousness.

You can see a mini-version of this if you have the privilege of spending time with a new baby, who spends most of their time asleep.

So when we’re functioning well, we open our eyes and go out into the world. We eat, we poop, we work, we have fun. And then we go back to sleep where we can run programs for repair, memory consolidation, and emotional sense making.

But sleep has a cousin that looks very similar on the surface but is actually quite different. Think about hibernation. That’s actually not really sleep. Yes, the bear is lying down with its eyes closed, oblivious to the world, resting.

Under the hood, though, a different program is running. The program is: minimize metabolic output, power down as many non-vital functions as possible so that we can reduce energy output and damage until such a time as conditions change, more food is available, the weather turns warmer.

Of course, hibernation is normal and expected for many animals. When we’re looking at chronic fatigue, something called “dauer” is more analagous. Dauer is a state that some animals go into when conditions are harsh and food is scarce. It’s powering down suspended animation state and it’s risky. If you’re unconscious you’re much more vulnerable to getting eaten or consumed by the elements.

But when conditions and stressors are bad enough for long enough, it’s actually a decent strategy for survival.

What tends to be called “chronic fatigue syndrome” is actually a human version of dauer. We’re running a program that’s designed to conserve energy while we lay down and don’t move.

This is why sleep isn’t restorative. Because it’s not actually sleep. It’s a survival program of suspended animation. Sleep is something that ideally gets cycled every 24 hours.

Dauer is something that we can only come out of once our nervous system has determined that the threat is truly past.

Because we’re modern humans, it’s usually more than one threat that’s led to this state and at the very least it’s caused by different things. In other words, what people with this condition have in common is that they are stuck in a state of dauer, suspended animation. But how they got there is as individual as their finger print.

And it’s these causes that need to be addressed, not the state itself. That’s why it’s so poorly treated and lasts so long. I was reading one study where the average duration of the condition is the sample was 20 years. That made me feel better about coming out of my fatigue after only a mere 9 years. And with what I’ve learned, people in my membership can often recover even more quickly since they don't have to figure all of this out themselves.

A mentor of mine recently taught me that a paradox is an opportunity to examine our assumptions. The reason why it’s paradoxical that people with Chronic Fatigue don’t feel restored after sleep is because we’re incorrectly assuming that what they are doing is actually sleep just because it looks so similar when in fact it’s an evolutionarily conserved survival mode designed to make us lay down and stay there until we sense that safer conditions have arrived.