Is something going on in my sleep? Possible tests...

[InitialConditions]

Hi folks,

Over the past year I've become somewhat convinced that perhaps I am not sleeping soundly throughout the night, as I assumed I was. I'd really like to investigate this now, and figure out if anything is going on.

A little background. I have mild-moderate ME but sleep reasonably well. It takes me longer than the average person to fall asleep - particularly so when I'm feeling unwell and have that tired-but-wired feeling with the associated insomnia - but I often sleep roughly 9 hours without waking. I am on no medication but supplement with Cod Liver Oil, Ubiquinol, Vit D, and a B complex most mornings.

I generally feel lousy in the morning, and I know this is common. I feel best in the evenings and often this is the most productive part of my day for me. For example, some vision problems, which I've had since the start of the year, seem to improve later in the day.

So, here's a list of things that have started up over the past year, related to sleeping. Perhaps they are possible clues.

- The first thing is that i have discomfort on my right side - chest / shoulder area - which is worse in the morning and gets better as they day goes on. It sort of feels muscular, but at the same time not. It's really hard to explain. I have a feeling it could be due to soft tissue / rib problems. It is not extremely painful - I describe it as discomfort/soreness, but I wish it would go away.

- I've always considered myself a quiet/light sleeper. I don't think I snore, and I'm otherwise healthy (*lol*) and average weight for my height. However, a couple of times over the past six months or so I have had the feeling of my throat closing just as I'm getting to sleep, or perhaps I was asleep. It was like one snort that woke me up each time. This has made me consider the possibility of sleep apnea.

- I wake up with a dry mouth and sore throat most mornings. This started around the time I started to feel more ill, and has been pretty constant. Some mornings are worse than others. Like other symptoms, these don't generally bother me later in the day, but i do generally have a tight-throat sort of feeling (again hard to describe) which has been the case for years now.

- A visit to the dentist a few months back revealed that i have some tooth erosion (not expected at my age), despite otherwise good dental hygeine. This was a bit of a shock, but I had started to notice whitening of front upper teeth and that these same teeth were becoming very sharp at the bottom. This is all due to enamel being worn away. I spoke to the dentist and we came to the conclusion this was either grinding or acid erosion caused by acidic drinks/foods or GERD.

- I have mild IBS but heartburn / acid reflux has never really been an issue for me. However, over the past year or so I have had some instances of what I assume is acid reflux - particularly so the morning after drinking alcohol (though I drink it very rarely).

So, any thoughts? What do you think is most probable? Would a sleep study be a good thing to ask for? I'm even thinking of trying to film myself at home :thumbdown: though I don't know if this would be good enough to prove or discount anything.

This was longer than expected, so thanks in advance!

 

[Wonkmonk]

I have done a lot of things with respect to sleep before I knew I had CFS. I suspected I just had a sleep disorder, and therefore checked a lot of things out, so maybe I can point you to some things you might want to look into.

First it would be interesting to know your age and whether you are male/female.

Especially if you are female, it could be a hormonal problem. There may be natural remedies, e.g. monch's pepper tree seed extracts often help with hormonal imbalances and there is some evidence it might help correct the circadian rhythm.

You've probably done a thyroid panel already. What were the results? All problems you describe can come from an underactive thyroid, but I suppose you already ruled that out?

Falling asleep can be aided by red spectrum light, e.g. by turning your tablet, smartphone, laptop etc. into night mode. Modern TVs might have that mode as well, if your TV doesn't you might want to stop watching TV several hours before going to sleep because it emits blue light, which hinders ability to fall asleep.

Regarding snoring, sleep apnea and restless legs syndrome, all of these can be easily checked by a doctor (in my country it's done by a neurologist or a ear nose and throat doctor). They give you a small device that can check your heartbeat, blood oxygen and breathing while you sleep at home one night. That can tell you if you have sleep apnea or another problem.

If they suspect a different problem, you can go to a sleep clinic where you sleep for one night and you have more better monitoring of body functions than with the small device at home, and they are also videotaping you while asleep to see what is going on, but this is usually only done in case of severe sleep disturbance, which doesn't seem to be you problem.

Finally, you could also look into melatonin supplementation:

https://www.webmd.com/sleep-disorders/what-is-melatonin

 

[InitialConditions]

I am male, and have not had a fulll thyroid screen - just tsh which was normal level.

I think I need to have some sort of sleep test. I can also look into melatonin. Thanks for the reply!

 

[Wonkmonk]

What exactly was the TSH?

The TSH generally captures most of what might be wrong with the thyroid, but to get a more complete picture, fT3, fT4 and thyroid autoantibodies (Graves' disease, Hashimoto's) should also be tested.

 

[InitialConditions]

What was the reading? It was 3.0 mu/L .

 

[Wishful]

The TSH generally captures most of what might be wrong with the thyroid, ...

...but leads to invalid interpretations when the problem lies elsewhere, such as microglia producing extra picolinic acid, but the doctors insist that 'elevated TSH = hypothyroidism'. A more complete testing is definitely needed, especially when the symptoms and responses don't quite fit typical hypothyrodism.

 

[RuralRick]

- I've always considered myself a quiet/light sleeper. I don't think I snore, and I'm otherwise healthy (*lol*) and average weight for my height. However, a couple of times over the past six months or so I have had the feeling of my throat closing just as I'm getting to sleep, or perhaps I was asleep. It was like one snort that woke me up each time. This has made me consider the possibility of sleep apnea.

- I wake up with a dry mouth and sore throat most mornings. This started around the time I started to feel more ill, and has been pretty constant. Some mornings are worse than others. Like other symptoms, these don't generally bother me later in the day, but i do generally have a tight-throat sort of feeling (again hard to describe) which has been the case for years now.

- A visit to the dentist a few months back revealed that i have some tooth erosion (not expected at my age), despite otherwise good dental hygeine. This was a bit of a shock, but I had started to notice whitening of front upper teeth and that these same teeth were becoming very sharp at the bottom. This is all due to enamel being worn away. I spoke to the dentist and we came to the conclusion this was either grinding or acid erosion caused by acidic drinks/foods or GERD.

- I have mild IBS but heartburn / acid reflux has never really been an issue for me. However, over the past year or so I have had some instances of what I assume is acid reflux - particularly so the morning after drinking alcohol (though I drink it very rarely).

Don't know about the first one, but....

Throat closing = Acid Reflux
Dry Mouth/Sore Throat = Acid Reflux
Tooth Erosions = Acid Reflux
Heartburn = Acid Reflux

See the trend? Everything is connected to your reflux. Your symptoms are usually occurring after you lay down at night, which is when the acid has an easier time to make its way up to your throat, since its not fighting gravity.

Try an experiment: Start on Zantac 300mg at bedtime or Prilosec 40mg a day and see if your symptoms go away. Its the cheapest way to figure it out. Good luck!

 

[Wonkmonk]

What was the reading? It was 3.0 mu/L .

Then your problems are probably not thyroid-related, but it would be good to check it out thoroghly with an endocrinologist, just to be safe.

Apart from what has already been mentioned: Did you look into the common possible causes for CFS, esp. herpes viruses and autoantibodies?

If herpes virus is suspected, there are treatment options that can bring at least some improvement. Maybe for autoimmunity, too, but I can't personally speak to that topic.

 

[MarthaStett]

However, a couple of times over the past six months or so I have had the feeling of my throat closing just as I'm getting to sleep, or perhaps I was asleep. It was like one snort that woke me up each time. This has made me consider the possibility of sleep apnea.

I first suspected sleep apnea about 7 years ago, before my ME/CFS started this year after I developed Chronic Inflammatory Response Syndrome from exposure to mold and other toxins in our water-damaged home. One of the first things that alerted me to the possibility of apnea was how I felt like my throat was closing when I was lying down and close to sleep.

I first noticed this when I was doing a meditation class and practicing a lying-down body scan meditation at home. I would be close to sleep and feel my throat close up. I had been sleeping 9-10 hours a night but often waking with a headache and felt exhausted all day. I did snore at times, especially on my back.

A sleep study showed obstructive sleep apnea happening about 30 times an hour. A CPAP and then BiPap helped enormously.

Now, with the ME/CFS, I have developed central sleep apnea as well, and am waiting to be tested for an ASV machine that will breathe for me when the central sleep apnea occurs.

I am also waking repeatedly at night when on the edge of sleep with some sort of 1-second spasm in my central lower chest, near by diaphragm. Getting my heart tested as we speak, but I suspect a nerve issue or something else due to inflammation and dysautonomia.

I hope you got some answers about your suspected apnea.