Sleep Disorder

I'm a 30-yr old male  5'10"  250 pounds,   I was sent to a sleep doctor with mild polycythemia, and my sypmtoms of heart palpitations,  tightness in my chest,  and the feeling the something is "pulling" at my heart making me feel very weak and faint all the time.
I have good days and bad days...I just came off a 2 week very good feeling stretch, but I woke up in the middle of the night with a racing pulse and shortness of breath,  then for several days I feel very bad again with the pulling at my heart, weakness, severe lightheadeness, and I sweat much too easily.'
The sleep doctor also said that I "walk the clock"  in that i have to stay up later and later each day to straiten my sleep out...and I have been in this cycle for years, since I'm self employed and have no set hours,    I'll stay up an hour or 2 extra each day until I skip a 24 hour cycle.

About my symtpoms, I had a thorough cardiac workup with echo, Thallium stress, and cardiac CTA...I also was tested Liver, Thyroid, CBC, CMP, BNP...and only the mild polycythemia showed.

So to review my symptoms :  Feels like something is pulling at my heart making me feel very weak and lightheaded, and sweaty.   Waking up at night SOB or SOB w/ racing pulse.  Heart palpitations,  mental coudiness.    And, all of these symptoms started maybe 8 months ago after I gained 25 pounds for no reason.

Could all this really be sleep apnea?    Or is there something more going on that should be investigated?
You thoughts are appreciated/

[National Jewish Health]

Much, if not all, you describe, could be on the basis of sleep apnea, resulting in chronic sleep deprivation.  It is possible that you could have some type of recurrent abnormal heart rhythm as a primary event but the palpitation could just as easily be due to sleep apnea.  Such sleep disturbances can also have a significant effect on one's emotional state, leading to anxiety, panic attacks, depression, confusion and even hallucinations.

The initial approach then should be a serious attempt to lose weight and the initiation of effective therapy, the use of a continuous positive airway pressure (CPAP) device, for the presumed sleep apnea.  Be aware that a fair number of individuals have difficulty adjusting to the use of the CPAP apparatus.  If that proves to be the case for you, do not abandon the CPAP, but work with the sleep doctor and his/her team to make whatever adjustments may be necessary to make you comfortable with the device.  This may take considerable time and effort on your part, but it will be worth it.  It is not an exaggeration to say that the effective treatment of obstructive sleep has the potential to change your life.

Good luck.