Sleep studies negative but having chronic fatigue

[weiss27md]

I started getting fatigue around 2014. I had a in lab sleep study in 2016 and it was normal. My fatigue continued to get worse. I also developed tired heavy eyes. I have been to many doctors. Only things abnormal are my upper GI which I have GERD and Barrett's Esophagus, I also have elevated cortisol. I've been tested for everything in blood, thyroid, testosterone and autoimmune. Had nasal surgery January 2020 (balloon, etc) and August 2021(FESS, etc). Before the fatigue started I had a history of reflux, headaches and anxiety. Surgery helped with sinusitis, still recovering after the latest surgery, 2 different doctors. I've tried many things: supplements, new mattress, reducing blue light, air purifiers, different diets, etc. Any ideas as to what I could have?

[weiss27md]

Here is my older sleep study.

[Julie]

Would love to give you an 'Aha' answer, but we're not doctors (by a mile), so if all the doctors say you don't have apnea, I'd keep looking for another answer. Have you been tested for Lyme Disease? Chronic Fatigue? Depression?

[weiss27md]

I was tested for lyme and it was negative. I did try SSRIs for a month or two but they had too many side effects. I don't have the main symptom of chronic fatigue syndrome which is Post-exertional malaise.

[zonker]

Any ideas as to what I could have?

i really don't want to be "that guy" and i have sympathy, i really do.

that said, this is cpaptalk.com. i don't think you are going to find your answer here, as much as you'd like to.

best of luck to you!

[Miss Emerita]

As Zonker says, lots of sympathy for the predicament, but unable to help outside the apnea sphere.

With very general symptoms like fatigue, having a doctor who is really persistent and imaginative as a diagnostician is one key; being a calm, clear communicator as a patient is another. I've sometimes seen doctors work harder on a difficult diagnosis when someone else comes to an appointment to attest to the change the patient has undergone. E.g., "My husband used to have several projects going at any one time, and he loved going out in the evening, but since this hit, he just seems to drag himself through the day. I'm worried about him; clearly something is wrong."

Very best of luck to you.

[Kargurin]

Vitamins B and D are things to check. B12 shots are often given to people experiencing fatigue. But I'm just spitballing here. Good luck finding an answer.

[weiss27md]

I guess it isn't sleep apnea. It's just when I wake up in the morning that's when I feel the worst. My eyes are very tired and heavy. I have those eye lines coming down at an angle. My cheeks feel heavy so I thought sinusitis was the culprit but after 2 nasal surgeries my sinuses feel better but I still have fatigue plus tired eyes. The ENT that did my FESS said I might still have apnea but need to get a different kind of sleep study. Or I could just have depression, I didn't think I did though. I know I have anxiety but didn't think I have depression. Sucks all SSRIs have all those side effects. I've done 4 sessions of ketamine therapy with no improvement but think I might try again. Even with being halfway under I still had anxiety. I think when I can let go of that anxiety that's when I could see improvements. Vitamin D and B12 have been tested and are good.

[openmind]

Recommend you look into Adrenal fatigue.

[weiss27md]

I noticed I have no N3 sleep which is deep sleep so no wonder why I feel so tired. Been working on this for 7 years. Going to be trying to get a PES sleep study since I still think I do have sleep apnea, maybe UARS. I thought maybe anxiety or bad sleep hygiene was causing a lack off deep sleep but I've tried many thing to help with sleep. I've tried: magnesium, night time glasses, melatonin, tryptophan, 5-htp, phosphatidylserine, omega 3, CBD, new mattress, etc... Fatigue is already bad but getting much worse. Woke up with a headache the past 2 nights. I have an evaluation appointment to get the PES sleep study on Monday. I'm also going to see an orthodontist about orthotropics to see if my jaw, bite, sinuses are abnormal. I know I have TMD, bruxism, overbite and swollen sinuses even after nasal sugery.

[ElusiveSleep]

Psychiatric medications affect sleep stages. This a handy chart of what the most widely used drugs do:

http://a360-wp-uploads.s3.amazonaws.com ... -Sleep.pdf

Also, opiate drugs reduce N3 duration.

[sleepcrapnea]

I think we are twins. We are around the same age and mostly have all the same issues.

I am a little bit similar to you in that I am having trouble working out what is causing my problems. Except I have not been as far down the diagnosis track.

I tested for sleep apnea three times and it was negative each time. It was at home sleep studies though so I am skeptical of their effectiveness. I need to have an in-lab sleep study which looks like you had.

Like you, I have had nasal surgeries. I thought my nose was the main problem. But I think it was just part of the problem. I am generally better now but its still bad. I had FESS, deviated septum fixed and turbinate reduction. In May 2021. Yours was very recent, you would not be recovered yet I would not think.

Like you, I also get bad dry mouth. Most of the night I seem to mouth breath so my mouth and throat get very dry and sore. I wake up 2 or 3 times in the middle of the night and eventually cant get back to sleep.

As for fatigue during the day I dont think I get that in the same way as you. My fatigue is directly related to my awareness of asleep vs awake time. If I know I have had awakenings and inability to get back to sleep again and have had like less than 6 hours sleep I feel like shit. It feels like a hangover without having drunk any alcohol. But, if my sleep has been better I feel ok. So, its directly related to my awareness of how much asleep time I have had. I never feel fatigued if I know I have had 7 plus hours of asleep time.

I very much wonder if I have UARS or RERA

Have you had tests for glandular fever and chronic fatigue syndrome? I think those things can happen independently of sleep apnea or UARS.

[vilnius]

Just a heads up that you forgot to redact your name on the second page of your results