Why do we feel better at night?

[bombsh3ll]

I'm certain blood volume has a lot to do with it. I have POTS and after all day reclining and chugging buckets of salt and water, I can get up and do a few things like light housework in the evening. I have wondered about doing 24hr salivary cortisol levels too.

 

[Prefect]

I have wondered about doing 24hr salivary cortisol levels too.

But wouldn't cortisol be highest in the morning and reduce as night approaches? That would be the opposite of us feeling better as night approaches, wouldn't it?

 

[bombsh3ll]

But wouldn't cortisol be highest in the morning and reduce as night approaches? That would be the opposite of us feeling better as night approaches, wouldn't it?

In a healthy person yes, but circadian hormone secretion can be deranged in ME so it may be peaking at the wrong time of day and low when you really need it.

I have had 2 random blood cortisol levels taken both of which were normal but this doesn't reveal anything about the daily pattern of secretion.

 

[ukxmrv]

But wouldn't cortisol be highest in the morning and reduce as night approaches? That would be the opposite of us feeling better as night approaches, wouldn't it?

24 hour saliva cortisol shows exactly that for me. The opposite from a "normal" pattern with my cortisol higher at night and lowest in the morning.

I've only ever day morning blood cortisol tests - which were also low.

This is the pattern PWME and CFS have been reporting on these patient forums for many years

 

[andyguitar]

When I am severely ill and bedbound, I suddenly feel better in the evening. When I look at the clock, it always says 7 pm. It is as though a switch has been suddenly thrown.

I feel significantly better about 7pm

There must be something happening at 7pm.

Body temperature starts to drop at 7pm. Maybe it's that.

 

[uglevod]

Probably due to melatonin release. Immune system needs to rest too.

 

[andyguitar]

But would'nt melatonin release make people feel less active?

 

[Prefect]

The melatonin angle intrigues me as well. I specifically feel better after dark, which is known to trigger melatonin secretion. I may feel less active, true, but a lot of my neurosensory and cognitive issues improve, I'm more relaxed, and able to concentrate more.

As for cortisol, I've had my day time levels checked, and they're within normal range.

But I'm an odd case; I have no body fatigue, do not get PEM, but have all the brain symptoms of CFS. To this day I'm not quite sure what I have to be honest. The only two things that improve my symptoms are alcohol and night time.

 

[gbells]

I see so many people on this board, including myself, experience this. I almost feel normal at night.

Surely, if the reason for this phenomenon was investigated maybe we could come closer to finding an answer to this syndrome?

When I think of all the times I had an infectious disease, I in fact feel the worst at night time, even with the common cold, I dread the way I begin to feel when night time hits.

But this disease; it's almost the opposite. Makes me wonder if an infection is really behind it at all.

I've also spoken to many people with mood disorders as well who've said they feel better at night. The conditions must share something in common in terms of the pathological process.

Cortisol is lower in the evening so the body is better able to mount antiviral immune responses then. Perhaps this inhibits the viruses somewhat and that is helpful in the early stages of the disease until the infections become more entrenched and completely overwhelm the defense system.

 

[stefanosstef]

I've thought that it may have to do with immune system's circadian rhythm.In the same way that when you have a flu you get fever at night.

For me personally, everything is much better at night.I am a different person.Energy, mental clarity, mood, everything.

 

[manasi12]

In my case , it is low blood volume and tachycardia in the morning. With salt and water loading and atenolol, I start feeling better in afternoon.

 

[andyguitar]

The melatonin angle intrigues me as well. I specifically feel better after dark, which is known to trigger melatonin secretion

There could be a very simple way to find out if it is melatonin that's helping. Take a supplement of it during the day. I dont think melatonin is whats making people feel better in the early evening as levels dont rise much until about 9-10pm.

 

[andyguitar]

This shows Melatonin levels.

 

[Howard]

Better Evenings

This may only apply to me, but I believe a fair percentage of my evening improvement comes from the diminished overall brightness. As the sun is setting there are fewer and fewer things to visually process, or to keep track of within my immediate surroundings (for the most part, we only utilize natural lighting). So, as darkness settles the environment becomes less taxing.

As suggested by others, there are likely other factors.

 

[flitza]

Better Evenings

This may only apply to me, but I believe a fair percentage of my evening improvement comes from the diminished overall brightness. As the sun is setting there are fewer and fewer things to visually process, or to keep track of within my immediate surroundings (for the most part, we only utilize natural lighting). So, as darkness settles the environment becomes less taxing.

As suggested by others, there are likely other factors.

You may be right. I have found that rigorous limiting of bright light has helped my condition. Specifically, I have all my screens dimmed, night shift on at all times and the brightness at about 1/4-1/3 on my iphone and I start wearing my blue-blocker glasses at about 6:30 PM. When I look at my phone at night ( which I try to do as little as possible), the brightness is set at minimum and I put the blue- blockers on first. I believe all this has helped more than just my sleep.

 

[Dufresne]

When I think of all the times I had an infectious disease, I in fact feel the worst at night time, even with the common cold, I dread the way I begin to feel when night time hits.

But this disease; it's almost the opposite. Makes me wonder if an infection is really behind it at all.

Acute and chronic infections: apples and oranges.

For many years I had an aversion to bright lights. This would keep me from going outside during the day much of the time. It basically went away after treating for parasites. I don't think I was able to eradicate all parasites, but I think I got rid of one species and the symptoms associated with it.

Parasites are thought to do some pretty manipulative stuff to ensure their survival. Yes they're very common and don't necessarily cause disease, but in my experience they do play a part in the disease of someone who's become highly sensitized to things (mold illness, MCAS, etc). Maybe it behooves the bugs to keep us from fresh air and sunlight.

When I'm camping in fresh air I fairly happily wake up in the morning, and this occurs even when I use my computer at nighttime. When I'm back in the apartment for the winter I become a total night owl.

 

[Pyrrhus]

Great thread. I like all the different ideas raised.

For what it's worth, I would point out that there are a number of threads that discuss this same issue:
https://forums.phoenixrising.me/threads/feeling-better-at-night.30750/
https://forums.phoenixrising.me/thr...ning-cortisol-pain-and-insomnia-issues.45483/
https://forums.phoenixrising.me/threads/anyone-feel-a-little-better-at-night.54349/
https://forums.phoenixrising.me/threads/feeling-worse-after-waking-up.40353/

3/ I know one of the hormone how it cycles (I forget now which) can be also the cause of someone feeling better at night.

My daily rhythm is to feel better as the day goes on. Assumed cortisol as it corresponds with the saliva test I had plus the bloods / short synacten.

I assumed it was due to hormone swings, such as cortisol. For quite a long time, I'd feel abruptly worse at around 2:30 PM, and that time didn't seem to vary with when I ate, slept, etc. I just assumed it was somehow linked to the circadian rhythm.

Someone else on here stated they had cortisol testing and it showed cortisol increased as the day progressed, which might explain the unrefreshed sleep.
It is the opposite in healthy individuals

Yes. It's the cortisol, I reckon.

But wouldn't cortisol be highest in the morning and reduce as night approaches? That would be the opposite of us feeling better as night approaches, wouldn't it?

In a healthy person yes, but circadian hormone secretion can be deranged in ME so it may be peaking at the wrong time of day and low when you really need it.

24 hour saliva cortisol shows exactly that for me. The opposite from a "normal" pattern with my cortisol higher at night and lowest in the morning.

I've thought that it may have to do with immune system's circadian rhythm.

I see that cortisol levels and the circadian rhythm are mentioned a lot. For anyone interested, the circadian rhythm in the human body is controlled by the suprachiasmatic nucleus, located in the hypothalamus. The hypothalamus then releases cortisol according to the circadian rhythm, and other cells in the body synchronize their internal clocks based on the cortisol output. In a healthy person, cortisol rises just before waking up and then slowly decreases as the day goes on.

Many abnormalities have been noted in ME patients, with regard to their 24-hour cortisol levels. But these abnormalities are not consistent, and some patients show a 24-hour cortisol profile that is close to that of a healthy person.

Hope this helps.

 

[wastwater]

Elevated ammonia causes sleep inversion
https://en.m.wikipedia.org/wiki/Sleep_inversion

Sleep inversion may be a symptom of elevated blood ammonia levels[2] and is often an early symptom of hepatic encephalopathy.[3] Sleep inversion is a feature of African trypanosomiasis after which the disease takes its common name "African sleeping sickness";[4] sleep-wake cycle disturbances are the most common indication that the disease has reached the stage where infection spreads into the central nervous system.[5]

If I manage to get up at a reasonable hour I spend all day wrecked and then cannot shut down at night

 

[stefanosstef]

Acute and chronic infections: apples and oranges.

For many years I had an aversion to bright lights. This would keep me from going outside during the day much of the time. It basically went away after treating for parasites. I don't think I was able to eradicate all parasites, but I think I got rid of one species and the symptoms associated with it.

Parasites are thought to do some pretty manipulative stuff to ensure their survival. Yes they're very common and don't necessarily cause disease, but in my experience they do play a part in the disease of someone who's become highly sensitized to things (mold illness, MCAS, etc). Maybe it behooves the bugs to keep us from fresh air and sunlight.

When I'm camping in fresh air I fairly happily wake up in the morning, and this occurs even when I use my computer at nighttime. When I'm back in the apartment for the winter I become a total night owl.

What was the parasite, how was it diagnosed and what treatment did you take exactly?Thanks

 

[Dufresne]

What was the parasite, how was it diagnosed and what treatment did you take exactly?Thanks

The only parasitic diagnosis I ever received was "parasite present, taxonomy unknown" as part of a CDSA, and that was after I rid myself of whatever it was I refer to in my post. This is something I had for decades and was a MAJOR source of brain fog. I always thought it was candida but I haven't had any recurrence of its die off symptoms, and you don't ever actually rid yourself of candida. Therefore I'm assuming this was a parasite. And the die off symptoms match those that I've read are associated with parasites: I'd wake up drooling, not knowing where I was. The only thing I needed to eradicate this thing was a carb-free diet and a whole lot of garlic. If only they could all be that easy.