Sleep Problems, Lethargy and Tiredness

History...

I have an underactive thyroid which I've had for 10 years. Im convinced this is all thyroid relates. All started off with problems with a dry throat, congested sinuses, tired eyes and just not having the same energy levels.

I've been for tests after tests after being told my thyroid levels are normal (TSH and FT4 only). A recent FT3 test shows everything is normal, but perhaps lower half of normal quadrant. Additionally, I was on 175 mcg, lost three stone went down to 150mcg, put on that three stone, and I don't need more thyroxine because my levels are still normal.

Two times I've managed to sleep properly was when I took an overdose of thyroxine, a massive dose, and pseudoephedrine.

OK, now that's out of the way...

The issues...

My sleep is very broken to say the least, I know of at least 4 times on average I wake up during the night, and what I would describe as generally a very restless sleep. I wake up not feeling refreshed and feeling like I could do with more sleep.

I seem to be able to accomplish my tasks during the day, I have the energy. But in some respects, it's almost like Im generating the energy from somewhere, like Im sucking it in from around me, rather than using my own reserves. I don't feel like I have a lot of energy in me to be honest.

Although Im not sleepy during the day, I don't fall asleep with a book for example, Im mindful of constantly tired eyes and a general sort of lethargy, lack of motivation. I feel very tired and don;t feel I have the same energy levels as I used to.

I score very minimal on a depression test, a sleep study suggests I don't have sleep apnea, although I have a few apneas a night (two or three) apparently the sleep clinic says that's normal, oxygen levels are pretty standard on the trace, but the thing that they couldn't explain, was the heart trace which shows lots of fluctuations and they reckon explains my sleep issues.

But the thought I don't really have a problem with sleep disorders due to the fact I don't fall asleep during the day, seems a little odd. Just because I don't sleep, doesn't mean Im not tired. Just because I don't sleep doesn't mean I can't sleep. And what if the Caffeine is stopping the sleep during the day?

I wouldn't say Im incapable of falling asleep, but I do take an enormous amount of caffeine and keep myself awake through sheer will. But if I gave in to my body, I'd probably sleep a lot more.

Has anyone got any thoughts?

Im being forwarded to a polysomnogram, so that might shed more light.

As I said, assuming it's not sleep apnea, or depression... stress? thyroid? something else? can sleep apnea coexist with say insomnia?


Thanks
SImon

[Jerry_NJ]

You didn't mention dreaming, or did I simply get confused?  In either case, when you wake up try to remember if you were dreaming, and if you can remember anything about it write it down, in short form - e.g., I dreamed about a lot of confusion related to travel arrangements and business meetings.  This the the kind of trouble mares I have.  But I remember them, but tend to forget details as the day takes my mind on to life issues.

I don't have a "fix" but I'm working on it.  I will spare you any further exploration of my problem unless you tell me more to which I can relate.

[sjdean]

You see I seem to suffer from a load of things which are real to me, but score low on classic tests.

So to me, when I feel depressed and suicidal, the doc says it's situational, and tests give me a low score. Anxiety? OCD issues. Slight. But again borderline scores.

Sleep, I feel shattered, exhausted, I could sleep, but I have too much to do. So I don't fall asleep during the day. When I manage to get a holiday, then I can sleep. But I essentially just spend most of time running on fumes. At least that's what I think. As I say, I do wonder if the caffeine and adrenaline keep me going.

Sleep is very much a voluntary action, even though I would say I walk around with a general malaise feeling, tired, little energy, I keep myself going.

I fight the urge to sleep sometimes like at the wheel, as a passenger, or elsewhere, and apparently this is normal, and not indicative of sleep apnea or other sleep disorders.

In terms of dreaming, yes, I mentioned to the doc, I rarely dream, but the times I do, it's usually because I've slept on my front. I do sleep better then.

I wondered if I had some brain disorder and that blood was pooling into my frontal lobes allowing me to dream

I also have a crichopharyngeal spasm.

But doctors don't think enough of it to do anything about it.

I must admit Ima bit peeved of our disjointed NHS so that every issue is taken in isolation and none of it together.

Thanks
Simon

[Jerry_NJ]

As you probably know the USA is moving toward a National Health System, and is already there for seniors - people 65 and older.   This is being driving full blast forward by our current administration, and I am not optimistic.  To day my experience with the USA health system is it is great.  Still it does not cure all it could, and there are many human health problems medicine has not yet produced a solution for.

I find your situation very confusing.. I understand each sentence, yet I am lost what to conclude other than you are tired/sleepy.  I don't get a direct connect with "sleep disorder".

I "hang out" here mostly looking for a solution my my trouble mares (not night mares) and I have given some attention to the art of Lucid Dreaming, see Stephen LaBerge Stanford University USA.  It has not produced anything more than hope, no reduction in dream problems... I think the dream problems are costing me rest time and increase depression and anxiety, which I don't consider myself to suffer from, at least not more than the most of us... and here I mean seniors, a depressing state in itself.

[sjdean]

Thanks again.

My problem is that I have very restless ineffective sleep.

You're right about being tired, I do feel tired. But the question is what is causing that tiredness. I do nowhere near as much as the average individual (at least I don't think so).

So I looked into sleep issues knowing that the few times I have slept soundly, it has been because of an overdose in thyroxine or phenylephrine which promotes the T4 to T3 conversion process which I know can have an impact on sleep.

But the sleep study detected only two or three apneas (periods of oxygen depravation/not breathing) which they told me was normal.

But they do say my heart is very active and on the go, and that could be causing my restlessness.

Now that could be stress, or something else.

So Im going to be getting a polysomnogram.

In many ways, a true NHS system though should work. Unfortunately there's too much private sector in our NHS and our NHS is an instituation that no one will let complain about, even though it may have several faults that could be rectified and allow it to run cheaper. Why should it run cheaper when soemone is willing to throw money at it? Trouble less money at it, and you're not going to get rid of the problems.

Overworked staff, admimnistrative **** ups, lack of modernisation, private finance initiatives (which is killing our NHS if you ask me - the thing where so the government gets the cost of building a new hospital off the books, they pass it to a third party to build but that third party charges on average 8 times as much over say a 50 year period than if the government were to foot the bill entirely.

[Jerry_NJ]

Exactly, well stated !  What you typed in much of what makes me believe in the private market and competition. Most of human (talking hear about societies of millions) efforts to sustain itself are too complex for central control (government).  I do support centralized government for things such as national defense and highway/infrastructure but only with strong citizen oversight... and our (USA) elected officials seldom do their first responsibility, manage government so that it serves the people, not itself.  So, nothing works out perfectly but I believe less government is the right direction/axiom.

Still, you have had many of the medical test I have not undergone, and I think I should seek a sleep study.  I purchased a real-time only Heart Rate Oximeter which reads out my HR and %Oxygen saturation.  It also has a pulse amplitude display which indicates over a very limited range (4 segments) how "strong" the individual pulses are.  For about 4 times the cost of the unit I paid I can purchase a recording unit, which if I could keep the detector on over night I could run my own Oxi-test.  This has the appeal of costing (it is paid for by taxes or insurance premiums if not directly) much less and being much more convent.  Of course the DIY approach doesn't have any medical expertise oversight/evaluatoin.

[sjdean]

Unfortunately you have to jump through so many hoops with the NHS for anything real to be done.

Thyroid tests only cover T4 and TSH. For a T3 test, I had to pay private. The doctor agrees with me that it's a very worthwhile test for someone in my circumstance who still faces much of the same issues he did (tiredness, lethargy etc), that he can't even flag up a request for T3 tests because the lab will overrule.

The "sleep study" was just a recording oximeter that I wore over night.

Fortunately I am being referred for a Polysomnogram due to the anomolous heart readings.

If it wasn't for that, I'd be back in the same situation, tired, lethargic, sleepy but not falling asleep, unrefreshing broken sleep.