tremors during sleep

[bobito]

I'm a 60 year old men, in excellent health, except for experiencing tremors during sleep that wake me up and have difficulty going  back to sleep.  As I start to fall sleep again, I feel these "rumbleling" (tremors) around my upper body.  I immediately wake up again.  These tremors last for about 10-15 seconds after I wake up.  The first time I experienced this condition was exactly two years ago.  It lasted for about four days and it simply went away.  Except for minor incidents (by "minor" I mean I experience the tremors for about two nights and go away) with no major disruptions in my sleep patters.  Last week, however, I experienced another episode which does not seem to be going away.  The first two nights I simply could not go back to sleep at all.  My body wanted to go back to sleep, but, as I mentioned above, everytime I fell sleep the tremors woke me up.  I'm on my  9th day and there seems to be no sign of letting up. I went to see my doctor on the fourth day--He prescribed Zolpidem, which I have been taken since.  Interestingly enough, even under the influence of the sleeping pill, the tremor wake me up, but they are short-lived since I go back to sleep almost immediately.  My doctor said to take the medicine for about two weeks and essencially placed me on a "wait-and-see" mode.  My concern at this point is "how long can I possobly survived on this medicine.  Does any body "out there" know anything about this condition?  As you can immagine, it is extremely debilitating.  I'm, for my age, a very atheletic man who is the right things, no vices and bikes to work every day--About
twenty miles a day.  Married with two grown children.  My job is very stress-free and very enjoyable.  Any ideas?  Thank you very much.

[bl218]

I got one of those biostrap things which also measures oxygen saturation.  Not quite as accurate as a real pulse oximeter and it only samples every 10 minutes.  However, I was able to see that my average O2 is in the mid to high 90s as it should be.  However, it drops to around 90 every now and then.  Based on some data I had collected from my CPAP machine a while back, I think this might be because my breathing becomes shallow periodically during sleep.  I don't know whether any of these events correlate with the vibrations though.  Right now, I can usually get a solid 6 hours of sleep before I wake up with vibrations.  This is probably due to the combination of supplements I'm taking.

My anxiety during the day has been at an all-time high which is really upsetting.

Did I ever mention that this whole thing feels like some sort of diaphragmatic paralysis?

[toby1101]

So just a quick update.  

I had been doing well for quite some time without vibration.  Falling off the wagon with the Ketogenic diet, I put back on a few pounds and started experiencing issues again.  I have started on low sugar again and the issues are going away.

Down deep it feels like my problem is breething.  During a lung test it was identified that there may have been an issue that was never ran to ground because it seemed like a rat hole that was not related.  I monitored my O2 with a pulse ox recorder and noticed my O2 dropped off several times during deep sleep stages.  By loosing weight it helps removing the labor to breath.  

At this point I am not really sure about anything.  I am still going forward with no supplements without sugars.  

Oh,  I tried the 1.8HZ tone and immediately felt vibrations in my hands and back of neck.  Just sitting on couch with headphones.  Really do not know what that means.  

Toby

[bl218]

That 1.8 Hz tone thing is really interesting.  I tried a bunch of different 1.8 Hz tones, but they didn't produce any vibrations.  Although, I do think it made me feel slightly uneasy... Definitely something to the ketogenic diet though.

[bl218]

Status report.  This unfortunately may not apply to you depending on where you live.  I recently obtained my medical marijuana card (I live in Massachusetts) and have been trying out some things.  It's still early days, but I've been taking a CBD tincture before bed which has a 2:1 ratio of CBD to THC.  I am not getting 7-8 hours of sleep and wake up with only minor vibrations. I'm planning to try some tinctures with even higher CBD/THC ratios to see what happens.  I had tried a pure CBD oil from hemp previously which didn't do anything for me.  So I'm guessing that at least some amount of THC is needed.

[bl218]

Quick update.  I saw a gastroenterologist today about my possible GERD issues (which I think may be related to the vibrations). I mentioned the vibration symptom to him and held my breath waiting for usual eye-roll or blank stare.  Instead he said, "Oh, yeah I've seen a lot of that particular symptom."  I almost cried. He was actually surprised when I told him that most doctors I've seen have never heard of this symptom and that I was told it was "just anxiety." He believes this can be caused by a hypersensitivity to the acid reflux or just the hiatal hernia causing some kind of autonomic nervous system effect. This is similar to one of my theories. In any case, I have to do an annoying pH study where they put a sensor into your esophagus for 24 hours to measure how much acid is hitting the esophagus. If his theory is correct, then the standard treatment is either PPIs (which I've already told him I don't want to take since I believe I've had adverse reactions) or a "neuro-modulator" such as low doses of Gabapentin. I'm not thrilled with the Gabapentin idea either, but the nurse assured me that they've prescribed that a lot and she's never had a patient react badly to it or have difficulty tapering off when the time comes.

[ricepeg]

Great! I found PharmaGABA (which also allegedly goes to the brain) very effective in the early days when I was having daytime adrenaline surges. Been meaning to try it again, but have gone with Taurine for now, which I think still helps somewhat.

My reflux symptoms are less lately. And I was getting relief from bicarbonate of soda. I also did a technique where you drink water and then jump in order to coax the hernia down with gravity (not sure if it helped).

And I'm on a ketosis diet which has done wonders for brain fog, fluctuating energy levels, and perhaps anxiety.

Oh, and I tried the Wim Hof breathing method (basically controlled hyperventilation), and after 15 or so breaths I had induced a tremor in my head and neck, which isn't supposed to happen, and is almost certainly set off by adrenaline. I am still convinced of a role for adrenaline during sleep in my case, likely set off by the apnea. I've been tracking my snoring and have had random successes where I can't figure out the reason (yet). Possibly sinus massage. I've noticed that my snoring patterns represent shallow but rapid breathing, and I figure that it's a form of hyperventilation that triggers adrenaline and tremor, as I feel with the Wim Hof thing. It's going to be noticeable in the chest by morning because that's where the muscular action is.

[bl218]

Unfortunately, none of the forms of GABA or taurine ever did anything for me.

[bl218]

FWIW, I just did some blood tests for B vitamins since they are involved in methylation, stress, anxiety, etc.  I was very surprised to find out that my serum B6 is 2x the upper limit. I had done some light supplementing with B6 prior to that, but very little.  One site I found indicated that high serum levels could actually result from a *deficiency*. B6 is known to be a stress mediator.  Both too little and too much B6 can cause significant problems. Also something that is not recognized by mainstream medicine. http://www.easy-immune-health.com/vitamin-b6-toxicity.html

[ricepeg]

Thank you. Very useful information, because counter-intuitive. According to the article, the fix is to take bioavailable B6 & B12 in particular; something I can try. I'm MTHFR compound heterozygous, normal B12 and unknown B6. Might put B6 testing down on the to do list.

[bl218]

Exactly, I started supplementing with B6 because I thought it might be exactly what I needed.  But I think it backfired on me because all of a sudden I started getting terrible anxiety.  I'm not 100% certain that it was due to B6 toxicity though.  In any case, I've stopped the B6 and I plan to measure my levels again in a few weeks. I was taking both the pyridoxine form and the P5P form and so I guess it's still possible that I have functional deficiency and maybe I need to take the P5P form only. I'm MTHFR heterozygous for c677t only and my homocysteine is at the very high end of the normal range according to conventional levels and definitely high according to functional medicine levels. I'm still holding off an continuing with B12/folate supplementation until I measure my B6 and B12 levels again. You might also want to Google "pyroluria" to see if you fit that description.  Yet another potential rathole to  go down...

[ricepeg]

You're right about yet another rathole, but I appreciate the reminder, as I meant to follow up on pyroluria again (first time dismissed as fringe, second time intrigued by the similarities... now I'm open to just about anything!)

From memory my homocysteine wasn't high comparable to yours. I am stopping my pyridoxine B6 and will order P5P next round and hopefully get a test for it.

[bl218]

Warning: supplementing with Zinc/B6 backfired on me big-time. It without a doubt caused significant anxiety/depression.  I don't know whether it was the Zinc or B6 or both. I've found some mention of this while researching pyroluria. One theory is that since Zinc is a Copper antagonist, it might cause copper to be "dumped" into  the blood stream resulting in some of these psych symptoms. My plan is to do the pyroluria urine test to see if I can confirm that I even have this condition.  Then I might try supplementing again at much lower dosages.  And yes, I realize this whole thing is diverging from the whole sleep vibrations issue, but who knows whether this could be a contributing factor?

[bl218]

ricepeg, I'm wondering if you've started on the beta blocker yet and whether that's helped at all.

[ricepeg]

I unfortunately failed an asthma test designed to qualify me for safely taking beta blockers, so I don't have them. I'm supposed to see a lung specialist to determine whether I still can.

I do really think that a beta blocker could help, as I'm leaning towards an adrenal malfunction. I do have the sensation on occasion of adrenaline/cortisol flooding my body. It makes sense that it is a cause of tremor. Those stress hormones cause the vagus to signal release of acetylcholine, which has been on your radar. Don't know. Would be nice to know.

[bl218]

Have you ever had your morning cortisol measured? Mine has always been on the high side not surprisingly. You can do a blood test for this.  You can also do the "diurnal cortisol test" which functional docs use to diagnose adrenal fatigue. You collect 4 saliva samples over the course of the day and send them into a lab. In the States at least, this can be ordered by the patient.  Don't know what the rules are in Australia.

[ricepeg]

Surely that morning feeling in the body—it's like a dull ache for me, and feels "yuck"—is either cortisol or adrenaline. Surely the condition is somehow related to otherwise normal sleep-induced changes/cycles, such as that of cortisol.

[bl218]

Yes, I suppose that's the way I would describe it.  That "dull ache" I associate with anxiety and/or depression the severity of which is proportional to how bad a night I've had. I'm trying my CPAP machine again to at least see if I can use it to record any breathing events that might occur just prior to my waking up with vibrations. I have an appointment with the last sleep neuro I saw  in a few weeks and I hope some of this data might be helpful. Still wondering whether this is due to untreated sleep disordered breathing in the past and/or insufficiently treated SDB now.