Tiredness/fatigue/aches

[Vync]

After being asked for the 50th time why I am always tired and achy, I thought about it and decided to ask what you guys what you think about what it could be.

Partial list of symptoms

- Rarely awake feeling rested

- Frequently sleep through my alarm clock

- By lunchtime, I am exhausted and ready to go home

- Frequently take lunchtime naps at work, sometimes not by choice

- Awaken at night to go to the bathroom, often have trouble going back to sleep

- Frequent pain in joints or muscle spasms

- After work, want to just eat and gostay in bed instead of doing other activities

- After dinner, often go to bed, watch some tv and I am out.

- Had this problem on and off during and since active duty, have service and VA treatment records

- VAMC prescribed sleep meds like ambien or trazodone

- SC for allergies/rhinitis/sinusitis, GERD, TMJ (wear bite guard for bruxism). Regarding sinus, can't really breath through nose much at all, snore, awaken with dry mouth, etc...

Partial results from sleep study

- Insignificant OSA, no CPAP required

- Dysfunctions of sleep stages

- Multiple arousals from sleep

- Spontaneous arousal index of 8 per hour

- History of sleep related bruxism

I checked the sleep apnea ratings and it has a rating for persistent daytime hypersomnolence. What exactly does this mean and could it be related?

I checked the chronic fatigue syndrome and its ratings are similar to:

"Which are nearly constant and restrict routine daily activities by less than 25 percent of the pre-illness level, or; which wax and wane, resulting in periods of incapacitation of at least two but less than four weeks total duration per year"

Could someone please explain the both parts of this, especially the latter?

What do they mean by incapacitation? Is it like when someone's back is shot and the doctor puts them on bedrest for x number of days, i.e. incapacitated for x days?

Do they mean the periods must last two to four weeks consecutively or merely total that amount over a year?

Could it be something else?

Any ideas, recommendations, advice?

Thanks

[Chuck75]

I'd think that the first thing to do would be to try to identify any possible factors that might come into play.

Military service - -Where, when nature, etc. and indemic problems in the areas of service.

Others as a start.

Media records - - review for any significant information.

Quality of life - - Stress, happy/unhappy, etc.

[carlie]

Any guess on these issues would just be non medical speculation.

Talk with your doctor/s.

[Guest]

I agree with Carlie, you need to get checked out by your doctors. It could be CFS (Chronic Fatigue Syndrome),FM (Fibromyalgia), GERD (Gastro esophageal reflux disease), or OSA (Sleep Apnea).

I checked the sleep apnea ratings and it has a rating for persistent daytime hypersomnolence. What exactly does this mean and could it be related? Hypersomnolence is extreme sleepiness that occurs for no apparent reason and is constant. A person may fall asleep unintentionally at any given time, it could be related.

I checked the chronic fatigue syndrome and its ratings are similar to:

"Which are nearly constant and restrict routine daily activities by less than 25 percent of the pre-illness level, or; which wax and wane, resulting in (periods of incapacitation of at least two but less than four weeks total duration per year)" Only VA can decide if the periods of incapacitation should be two to four weeks consecutive or a few days totaling two to four weeks per year.

To make things even worst it could be a combination of the GERD (Acid Reflux) aggravating your sleep apnea but of course this is all speculation and you really need to see a doctor. I am not sure what type of sleep study you did but you may want to try an in-home study that records your sleep for several days instead of a one night stay at the sleep clinic.

Edited May 25, 2011 by pete992

[Vync]

Thank you for the good advice. An assessment by a doctor would be a good idea, but I also need to identify any additional factors to help answer the doc's questions.

Which route would you recommend? Primary care doctor, a specialist, or both?

[Guest]

You may need a referral from your PCP to get to a sleep specialist or a GI specialist.

[Vync]

Hello everyone,

There have been some new developments. I am considering filing a claim for sleep apnea and I wanted to get some opinions.

My rheumatologist suspects fibromyalgia and referred me for a sleep study. The sleep study showed significant OSA and also alpha wave intrusions, so I was just put on a BIPAP machine. The doc said many people with FM also have OSA and/or alpha intrusions, but their symptoms may improve after being put on a CPAP/BIPAP machine to facilitate restorative sleep.

I reviewed my Army treatment records from '90-'95 and found multiple visits for recurrent tiredness, fatigue, falling asleep during the middle of the day, insomnia, and midnight ER visits for asthma. I am still digging, but so far there is no mention of sleep apnea while on active duty. The Army provided asthma treatment and also meds to help me sleep (benadryl) or stay awake (fiornal).

However, less than a year after leaving active duty, I found several mentions of sleep apnea in my VA treatment records. Since then, the VAMC noted dozens of instances of me being sleepy, fatigued, and occasional notes about sleep apnea.

What is the likelihood that I could get SC for sleep apnea?

Aside from getting a Sleep Apnea DBQ to my doc, does anyone have any other recommendations?

Thanks