Nearly three-quarters of adults in the United States report experiencing fatigue, according to a report from the Centers for Disease Control and Prevention’s National Center for Health Statistics (NCHS).

The findings highlight fatigue as a widespread public-health concern, particularly among women, younger adults and people living in rural areas.

“Overall, 71.5% of adults said they experienced fatigue on at least some days. Frequent fatigue, defined as symptoms occurring most days or every day, was reported by 16.6%. A further 10.7% said they felt fatigued on most days”

The analysis, published recently, used data from the US 2024 National Health Interview Survey. It included adults aged 18 and older and examined how often fatigue occurred, how long it lasted and whether it affected daily activities.

Overall, 71.5% of adults said they experienced fatigue on at least some days. Frequent fatigue, defined as symptoms occurring most days or every day, was reported by 16.6%. A further 10.7% said they felt fatigued on most days.

“About 20% of women said they experienced symptoms most days or every day. Younger adults also reported high levels, with frequent fatigue affecting 19.5% of people aged 18 to 34”

Fatigue is more than ordinary sleepiness after a busy day. It may involve a persistent lack of energy, reduced motivation and difficulty concentrating. Sleep may not provide complete relief. In more serious cases, fatigue can interfere with employment, relationships, household responsibilities and social activities.

The report did not identify the causes of fatigue. Possible contributors include inadequate sleep, chronic stress, depression, anxiety, anaemia, thyroid disorders, infections, chronic pain, medication side effects and other medical conditions. Several factors may be present at the same time.

Experts say prolonged stress is one possible explanation for the high levels reported in the survey. Work demands, financial pressure, caregiving responsibilities and uncertainty about the future can place sustained strain on the body and mind. Over time, chronic stress may disrupt sleep and contribute to emotional and physical exhaustion.

Women in the US reported frequent fatigue more often than men. About 20% of women said they experienced symptoms most days or every day. Younger adults also reported high levels, with frequent fatigue affecting 19.5% of people aged 18 to 34.

Experts suggest that women may face overlapping professional, domestic and caregiving responsibilities. Hormonal changes associated with menstruation, pregnancy and menopause may also affect energy and sleep. Younger adults may be coping with education, job insecurity, housing costs, debt, relationship pressures and other major life transitions.

“Compared with adults without frequent fatigue, those experiencing it were more than three times as likely to report depression symptoms. They were also twice as likely to report anxiety symptoms and cognitive difficulties”

However, the US figures should not automatically be treated as representative of every country. Health systems, working conditions, cultural expectations, economic pressures, sleep patterns and access to support differ widely between populations. The survey also relied on self-reported symptoms, which may be influenced by how people recognise or describe fatigue.

Still, the broader patterns may be relevant internationally. Fatigue is closely connected with sleep, stress and mental health, issues that affect populations across many countries.

Malaysia has credible evidence of widespread fatigue-related conditions, particularly insufficient sleep and mental-health problems, and Malaysian research suggests younger adults are more vulnerable to pandemic-related fatigue. However, a direct national comparison showing that Malaysian women and young adults experience fatigue more often is still lacking.

This distinction is important. Evidence from the US may raise useful questions for Malaysia, but it cannot establish the prevalence or distribution of fatigue among Malaysians. Local research is needed to determine whether similar patterns exist, which groups are most affected and what social or health factors may be involved.

The US report also found differences by race and ethnicity. Frequent fatigue was reported by 25.5% of American Indian and Alaska Native adults, 18% of white adults, 17.3% of Black adults and 12.9% of Hispanic adults. These results should be interpreted within the social and healthcare context of the US rather than applied directly to other populations.

People living in rural communities may face longer journeys to healthcare, fewer doctors, limited public transport and reduced access to mental-health services. Physically demanding employment and social isolation may also contribute to exhaustion or make it harder to seek help.

The strongest associations involved mental health and cognitive function. Among adults with frequent fatigue, 69.6% reported symptoms of anxiety, 46.1% reported cognitive difficulties and 45% reported symptoms of depression.

Compared with adults without frequent fatigue, those experiencing it were more than three times as likely to report depression symptoms. They were also twice as likely to report anxiety symptoms and cognitive difficulties.

The relationship is complex. Depression and anxiety can cause disturbed sleep, low motivation and exhaustion. Persistent fatigue may then worsen mood, concentration and social withdrawal. In some people, the symptoms may reinforce one another.

Frequent fatigue also affected employment. About 36% of people with frequent fatigue reported limitations in their work. Problems may include reduced stamina, difficulty concentrating, slower performance or an inability to complete usual duties.

Social participation was affected too. Around 16.2% reported some difficulty taking part in social activities, while 12.8% experienced a lot of difficulty or could not participate at all. These limitations may increase isolation, particularly for people already experiencing anxiety or depression.

The duration and intensity of symptoms varied. Among those with frequent fatigue, 45.3% said symptoms lasted some of the day, 34.5% said they lasted most of the day and 20.2% experienced them throughout the day.

Nearly half, 46.8%, described the severity as between “a little” and “a lot”. Another 38.8% said their fatigue was “a lot”, while 14.5% described it as “a little”.

Menopause can be another important factor. Hormonal and metabolic changes may affect sleep, mood and energy. Night sweats, hot flushes, anxiety and other symptoms can leave people exhausted during the day. One study found physical and mental exhaustion in 46.5% of perimenopausal women and 85.3% of postmenopausal women.

Fatigue can also indicate an underlying illness. Possible causes include iron-deficiency anaemia, thyroid disease, diabetes, sleep apnoea, long-term infections, heart or lung conditions and chronic pain. Some medicines, alcohol and other substances may also impair sleep or cause low energy.

People should consider speaking to a healthcare professional if fatigue lasts more than a couple of weeks, becomes severe or interferes with daily activities. Medical advice is especially important when fatigue occurs with unexplained weight loss, breathlessness, chest pain, fever, fainting, unusual bleeding or major changes in mood.

A clinician may ask when symptoms began, whether they are constant, how well the person sleeps and whether rest improves them. Questions about diet, medicines, mental health, menstrual or menopausal changes and daily stress may help identify possible causes. Blood tests or other investigations may be recommended.

Practical measures can help some people. Keeping regular sleep and waking times, limiting caffeine late in the day, reducing alcohol and maintaining a calm sleep environment may improve rest. Gentle activity, regular meals, adequate fluids and realistic planning may support energy. Severe exhaustion should not be ignored or treated simply by forcing greater effort.

The CDC findings show that frequent fatigue is common and closely associated with depression, anxiety, cognitive difficulties and reduced participation in work and social life. Although the US data cannot be assumed to represent Malaysia or the wider world, the general links between fatigue, poor sleep, stress and mental health are highly likely to be relevant across many populations.

Persistent fatigue is not a character flaw or a lack of discipline. It is a genuine symptom that deserves careful assessment. Local studies, including research in Malaysia, can help clarify who is most affected and which interventions are most effective.

For individuals, seeking professional advice remains the best starting point when tiredness is ongoing, disabling or accompanied by other concerning symptoms.