Sick every morning

[Calgarian]

I am a physically fit 57 year old male who takes no prescription or other drugs. Every night when I go to sleep I feel fine, but every morning I wake up sick, feeling somewhat nauseas as if I'm toxic or have a hangover. It takes from 1-3 hours before the sickness dissipates and I feel good enough to go to work.

If I get up with less than 5 hours of sleep then I'm okay (just tired). If I sleep for a total of 6 hours or more I get sick, even if I get up for an hour and then go back to sleep. My only other symptom is vivid nightmares.

This has been going on for over a year. I have seen 4 physicians (general, GI, sleep and an anesthetist) without a successful prognosis. They all agree it might be a neurological or endocrine disorder, perhaps circadian. None has ever heard of someone who consistently goes to sleep feeling fine but wakes up sick. Cortisol, testosterone, growth hormone, melatonin, and serotonin levels have all been hypothesized as possible problem issues but only in a cursory sense.

I have no problems with insomnia, falling or staying asleep, and do not have apnea. I have had a complete metabolic workup and everything is good including diagnostics on my gastrointestinal system and no sign of GERD. I work from home in an uncontaminated environment, my weight and diet are good, I have no food or environmental allergies and do not suffer from depression or anxiety. There is no tingling or dizziness either and it makes no make a difference what or when I eat before sleeping. I just am sick every morning when I wake up.

What internal issues might be happening to me, especially during the last 2-3 hours of sleep, that makes me sick every single morning?

[Christopher R Newey, DO]

Thanks for using the forum. I am happy to address your questions, and my answer will be based on the information you provided here. Please make sure you recognize that this forum is for educational purposes only, and it does not substitute for a formal office visit with a doctor.

Without the ability to examine and obtain a history, I can not tell you what the exact cause of the symptoms is. However I will try to provide you with some useful information.

From a neurological perspective, there are neurogenic causes of abdominal pain and nausea in otherwise healthy individuals. These include abdominal migraine (usually seen  in children much more commonly than in adults and may or may not have associated headache) and abdominal epilepsy (which is quite rare).

The vivid dreams/nightmares are an interesting symptom. If you were to wake up before the nightmares, would you have nausea? Have you had an overnight sleep study? If not, you may wish to obtain one.

In addition to the GI workup, I agree that you should have a complete metabolic/endocrine workup to aid in the diagnosis of your nausea and vomiting. I would also recommend that you have a thorough endocrine workup and you may actually benefit from an endocrine consult.

Thank you for this opportunity to answer your questions, I hope you find the information I have provided useful, good luck.

[Calgarian]

The professional insight is very helpful. My nausea is throughout my upper GI, but not so strong that I have to throw up. Similar to the crappy way you feel with food poisoning. There is no fever, headache or pain, thank goodness. If I get up before the nightmares then I do not get the nausea, which makes me think it an endochrine problem that occurs during my REM sleep.