Sleep Disorder or More?

[LostAndNeedMedicalHelp]

In the last 2 years I've been experiencing episodes of extreme anxiousness/irritability and breathing issues randomly to varying degrees.  The often came before I went to bed (or when I lie down often) and randomly before throughout the day.  I have done every test possible including tests for heart, lungs, thyroid, diabetes, glycemia, various cancers, brain (MRI), etc.  Everything basically.  And nothing has showed up except that I was low on vitamin D.  I have now discovered that I've developed a caffeine intolerance/allergy.  I used to drink lots of coffee, caffeinated pop and have now cut it out.  But when I sleep and sometimes lie down, the episodes sometimes come back.  I also now have really restless sleep (very broken) and I've started snoring lots. I've gained a fair amount of weigh in my abdominal from age but I'm not sure if that has any relation.  Does anyone have any advice or any further tests they would suggest?  I'm willing to do anything to figure this out.  Thanks.

[Paderla Anitha, DNB]

Hello and hope you are doing well.

Please stop worrying that would be the first step to help you fall asleep. Sleep is a natural process, so imbibe the rhythm. Do we stress ourselves about getting hungry?

You should not keep thinking about sleeplessness, as this in turn promotes insomnia and it becomes a vicious cycle.

You should stop becoming anxious and try to relax. Try to have a warm bath before sleeping. Have a glass of milk or read a book before trying to sleep. Don’t watch TV or do exercise before sleeping. Condition yourself that you can relax and that you can sleep well.

Try yoga and meditation they have calming effects. Go for long stress free walks. Also, do exercise in the daytime this promotes good sleep.

Hope this helped and do keep us posted.

[LostAndNeedMedicalHelp]

Dear Dr. Anitha,

Thank you for the response.  I was limited by the number of characters restriction so I did not get to include that I did also get a sleep apnea test done.  It was actually one of the first things I did.  Nothing showed up.  I also did a holter monitor as well as an event monitor and nothing showed up.  However, the restless sleep/broken sleep and snoring did not happen until about 6 months ago.  I did the sleep/holter/event monitor long before this.  My doctor has been involved from the start and put me through alot of tests and nothing is showing up.  Its been chalked up as stress but I don't feel stessed.  I've cut out caffeine entirely and its helped reduce the episodes during the day.  But at night, just before I go to sleep, I get this feeling of irritability, nervousness almost and it often sends me into tremors.  If I wake up, it goes away.  If I fall asleep it comes back.  Eventually I just fall asleep but its restless.  I worry that its the physical act of lying down that is causing something but I'm not sure.  I also get chest pain (varying on both sides of chest) here and there when I breath in deep.  I'm not sure if thats related.  I go many nights with what feels like little to no sleep and it affects my work greatly.  I'm not sure what else to do.  Any further input is greatly appreciated.

[Paderla Anitha, DNB]

Hello and hope you are doing well.

Shuddering or restless in sleep could be due a sleep disorder. These disorders can be like obstructive sleep apnea, wherein during sleep there is an obstruction to air flow due to laxity of the throat muscles during sleep and this could cause breathlessness. Hence for therapy CPAP (continuous positive airway pressure) is used to keep it patent. Another cause could be an entity called restless leg syndrome, where there is an odd sensation in the legs during sleep causing the individual to move, which relieves the sensation. These disorders can cause inadequate sleep leading to fatigue and daytime sleepiness.

So, I would advise you to consult your primary care physician for further evaluation. He may then ask for a sleep study called polysomnography for further evaluation.

Hope this helped and do keep us posted.