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Any chance you have ADHD? I learned (far later in life than I would have liked) that I have ADHD and that it is one of the biggest reasons I'm almost always tired or even exhausted. Brain's just thinking too hard/inefficiently. (I have other contributing factors, but this one is significant and fairly obvious). Still can't get treatment, but the awareness has helped me work around it somewhat, by removing stressors and taking time to relax and/or hyperfocus.

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Seconding for for ADHD and narcolepsy. I had a sleep study done a few years back that came up borderline positive. Doctor had me try a few meds out but the one that really stuck was Vyvanse (basically a slow release pro-drug of Adderall). Suddenly I’m not having sleep attacks every time I sit down, or even feeling like my head is made of bricks.

I grew up in a family that didn’t believe in ADHD so I would cope with excessive amounts of caffeine. It’s definitely worth looking into if you have the slightest suspicion.

Also don’t get too caught up in passing the MSLT. Personally, I think it’s barely medical science, but it’s a part of getting a diagnosis and some insights into how your brain is (or isn’t) sleeping.

Have both ADHD and Sleep Apnea, both are treated (CPAP and Addral)

Wait that's not just me? Holy crap.

Same for me. Chronically tired all the time since I can remember. Tried everything. Exercise, diet, probiotics, meditation, sleep training. Got diagnosed for depression ten years ago. No medication helped. Finally got prescribed “off label” treatment for narcolepsy and ADHD called Modafinil.

Completely changed my life!

Turns out there is some connection to narcolepsy and ADHD (Huberman talks about this on his podcast), and it makes sense.

Anecdotally, other people I know who’ve been diagnosed with CFS or ME tend to exhibit similar ADHD-like patterns. Maybe there’s something to that. Certainly worth exploring further.

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