Sleeping Troubles

[ShinyJabberwocky]

I'm 29 years old and for as long as I can remember, I've been waking up during sleep. When I was younger, I would sleepwalk around the house, flicking on lights and falling asleep somewhere else other than my bed. I eventually grew out of the sleepwalking but now...well, let me explain. One night I awoke, thinking there was some sort of crustecean crawling across the ceiling. I shot out of the bed and went running to the stairs, but by the time I reached the stairs, I realized what I was doing, calmed down, and went back to bed. Another time I shielded my wife with heavy covers because I thought a crow was trying to peck our eyes out. Again, I came to my senses within 10-15 seconds and I was okay.

My problem is while I wake up and think I am seeing things, I wake up constantly. I don't always see things, but my mindset is stuck in the dream for a moment, to which I eventually reset and realize what is going on. I can fall asleep quickly because I'm usually always tired but every other night I have issues actually staying asleep. When I wake up, my mindset isn't always urgent; sometimes I just wake up and happen to see something that was in my dream, while other times my mindset is more fight or flight and I react like a crazy person.

Since November 2008 I've been suddenly feeling sick with high blood pressure, low body temperature, and all sorts of fatigue. My muscles don't seem to recover as quickly as they used to (had to stop bowling because my chest, arms and legs were hurting) and if I just gently bend my wrist a certain way, my entire hand shakes. Its like I'm tired and I can sleep for 6,7,8,9,10, or even 11 hours and I never feel 100%.

I've had sleep studies done and due to my weight, the doctors found that I have very slight sleep apnea (I think the one stat was anything over 5 was abnormal and mine was 5.6) but a CPAP didn't seem to work and I never showed any sort of crazy reactions while in the sleep study. My ENT does think that there is something wrong with my thyroid as the removal of a cyst found some papillary tissue, which could have a possible link to thyroid cancer.

Could my craziness of waking up in the middle of the night be the cause of my symptoms? Would anxiety meds at night possibly calm me down or quell my waking up? Or maybe something wrong with my thyroid could be causing this? I'm not a stressful person either; anyone who knows me knows that I am very chill and hardly ever let anything get to me so I doubt that stress is causing my lack of sleep. The pulmonologist who did my sleep studies (3 to be exact) could not find anything really wrong that would cause the symptoms that I am having.

[ShinyJabberwocky]

Thanks for the response, KatEyes!

I'll have to get my reports from the pulmonologist, and I think two of them were normal but the third, they tried the CPAP on me just to see how I would react to it. Ironically, I developed complex sleep apnea when the CPAP machine went above 4 or 5 (whatever the measurement of the air pressure was). I think the limit for sleep apnea was at a 5 on some rating, and I had a 5.4, which the doctor partially attributed to being overweight. Even the representative of the company I went to for the CPAP fitting didn't know how much the CPAP would actually help.

The problem with using the CPAP at home was that I couldn't sleep very much at all. The first night that I used it, that next day, I felt like complete crap and my blood pressure went from a normal 140/90 sitting up to 180/120. I felt so horrible that I didn't use the CPAP for about two weeks because I didn't know if I could take another day of that. Gradaually I started using the CPAP again, but every now and then, in the middle of the night, I would wake up and take it off my face without even realizing what I was doing. In the morning, the mask would be hanging on the side of the bed and I would be confused as to how it got there.

I did use the mask for a few weeks, and it was tracking my AHI for the time that I was using it, and my AHI was never higher than 4.5 and was never lowering than 3. I'm assuming the machine would have shown a higher number if something was wrong, right? Or maybe that is a false assumption. Either way, my sleep efficiency (I recently purchased a device that checks this) hardly ever drops under 90%, and when it does, I can always attribute that to drinking too much caffeine or being restless and unable to fall asleep.

And the thing is, I feel tired most of the time, but not tired enough to sleep. My wife naps on the weekends, but I can't nap for some reason;  when it is time to sleep, I pass out in moment, but otherwise have issues falling asleep. Maybe there is some sort of sleep apnea or some idiopathic hypersomnia thing going on. I guess if my thyroid gets fixed and nothing changes, I will have to check out my sleep patterns again.

[KatEyes]

I can't begin to know all the influences in your symptoms, but I can say that disturbing dreams, climbing blood pressure, poor quality and non restorative sleep, excessive need for sleep, and increased sensitivity to pain are all things commonly reported with sleep apnea. About your sleep studies, even mild sleep apnea merits treatment. There's much more to this than a count of events. Just for example, if a person had only 5 events each hour, that's 40 events in an 8 hours night. Usually a number of them will cause arousals, or disturb sleep stages. Mild does NOT mean insignificant. Also, duration of each event and oxygen desaturations factor in when assessing the significance of those 5 events per hour. I'd rather have 10 an hour that lasted 12 seconds and the oxygen didn't drop much, rather than have five an hour that lasted a minute each and caused dangerously low desats. I have 2 friends whose doctors told them the scary things they wake up and see are due to low oxygen when being awakened by an apnea event. May be other potential causes, just saying, this can be one. If I were you, I'd get copies of all the sleep study reports (not just the summary page) and look them over for clues. For one thing, did you get much sleep, and did they capture some time in REM while supine? If not, what they were able to record may not be your worst case scenario. Some of my studies were termed "technically suboptimal" for that reason. Another thing to consider - did any of the reports mention limb movements? A study with lots of limb movements might prevent the sleeper from fully exhibiting their OSA due to being unable to sleep well due to the movements. My limb movements caused me lots of pain during the daytime because of failure to get restorative sleep. As far as CPAP didn't seem to work, one has to use it consistently - sometimes for weeks or months - before they begin to see any difference in how they feel. Not sure how much time you gave to it, but maybe you could revisit this.