Lethargy

You mentioned the late term miscarriage you're not over. I'd go to your GP and get a referral to someone to talk to about that. Perhaps some antidepressants. No shame in asking for help with emotional issues. I would think once you get that dealt with your energy will rebound. Emotions are so hard are draining

Ddsb11 wrote: »

To double down on some of the questions, I haven’t had any recent blood work done, and perhaps it’s time I do. I wanted to try some at home things before taking up the doctors time, but the iron and vitamin D deficiency comment sounds exactly like how I feel.

It seems any amount of movement depletes me. I can barely keep my eyes open around 3pm, which is why I skip lunch often. Typically I’m in excellent health, and still might be, so I don’t really know what’s going on. I thought maybe it was all mental and I needed to just force myself into a new routine or something, but how can I when the energy isn’t there? It’s a catch 22. Am I being lazy, unmotivated, or is it something else?

Thank you for pointing out a few things that weren’t previously on my radar. It has certainly given me some food for thought.

It could be depression. It could be stress. Our on-going pandemic lends itself to both. It could be physical. Could be both—untreated hypothyroidism can come with a side of depression. 🙋🏻‍♀️

I would advise against supplementation without a medical reason for doing so as both vitamin D and iron can have negative effects at too high a dose. B vitamin deficiency can also lead to fatigue. Sounds like getting a range of blood work would be a good idea for a baseline of where you are in relation to normal levels.

Quality of sleep can definitely lead to feeling tired. Do you have a fitness tracker to help you assess?

Sleep tracking can mislead. If you have a partner or housemate/roommate, asking whether you snore may provide some information, but not total. If your sleep tracking results are mediocre, my guess is that it's more likely that sleep truly isn't great; for sure, I wouldn't trust a tracker saying that sleep is fine (though it could be true, of course . . . but if feeling foggy and depleted, it may not be true even if the tracker claims it's great).

Some people think sleep apnea is the only kind of non-insomnia sleep disorder, or that only obese people can have sleep apnea. Neither is true.

I have sleep apnea. It was diagnosed when I was still obese, but (per follow-up sleep study) I still have sleep apnea at BMI 20. I also have sleep interruption insomnia, completely separate issue. Treating the sleep apnea made me sleep more soundly between the sleep-interruption insomnia wake-ups, but didn't help lots with brain fog, fatigue, and other symptoms of inadequate sleep. Pure hours of sleep are not the only issue, the type of sleep (deep, REM, etc.) and the patterns of types can also matter.

My good brand/model tracker - one that I've had way more than long enough for it to "learn me" - does not accurately catch my sleep interruptions, because I don't move around when I wake, and I go back to sleep very quickly rather than tossing and turning. It sometimes doesn't even see actual fully-awake but lying in bed for long time periods - it thinks I'm asleep.

The last overnight hospital sleep-center study I had (March 2020), I was wearing my tracker. I always have extra trouble sleeping during studies. In this case, I was lying in bed awake but absolutely still for several hours near the end of the study period. The sleep tech and I discussed this long awake interval, in the post-study conversation. I showed her what my tracker's app said - that I was asleep most of the night. We both laughed and laughed.

I'd suggest that you follow up, as you're planning, with the doctor visit and blood tests. Nutritional issues can compromise sleep quality. After that's all tuned up, and has been for a while, if you feel like you're still not getting restful sleep, follow up with your doctor about sleep studies specifically, *especially* if you perceive that you're sleeping through the night, but not feeling rested. (If you know you have some form of insomnia, and it involves conscious awake periods, there are other non-medical, non-nutritional interventions that can help, with the choice of intervention depending on how you perceive the conscious awake periods, and how long they are.)

Ddsb11 wrote: »

AnnPT77 wrote: »

Sleep tracking can mislead. If you have a partner or housemate/roommate, asking whether you snore may provide some information, but not total. If your sleep tracking results are mediocre, my guess is that it's more likely that sleep truly isn't great; for sure, I wouldn't trust a tracker saying that sleep is fine (though it could be true, of course . . . but if feeling foggy and depleted, it may not be true even if the tracker claims it's great).

Some people think sleep apnea is the only kind of non-insomnia sleep disorder, or that only obese people can have sleep apnea. Neither is true.

I have sleep apnea. It was diagnosed when I was still obese, but (per follow-up sleep study) I still have sleep apnea at BMI 20. I also have sleep interruption insomnia, completely separate issue. Treating the sleep apnea made me sleep more soundly between the sleep-interruption insomnia wake-ups, but didn't help lots with brain fog, fatigue, and other symptoms of inadequate sleep. Pure hours of sleep are not the only issue, the type of sleep (deep, REM, etc.) and the patterns of types can also matter.

My good brand/model tracker - one that I've had way more than long enough for it to "learn me" - does not accurately catch my sleep interruptions, because I don't move around when I wake, and I go back to sleep very quickly rather than tossing and turning. It sometimes doesn't even see actual fully-awake but lying in bed for long time periods - it thinks I'm asleep.

The last overnight hospital sleep-center study I had (March 2020), I was wearing my tracker. I always have extra trouble sleeping during studies. In this case, I was lying in bed awake but absolutely still for several hours near the end of the study period. The sleep tech and I discussed this long awake interval, in the post-study conversation. I showed her what my tracker's app said - that I was asleep most of the night. We both laughed and laughed.

I'd suggest that you follow up, as you're planning, with the doctor visit and blood tests. Nutritional issues can compromise sleep quality. After that's all tuned up, and has been for a while, if you feel like you're still not getting restful sleep, follow up with your doctor about sleep studies specifically, *especially* if you perceive that you're sleeping through the night, but not feeling rested. (If you know you have some form of insomnia, and it involves conscious awake periods, there are other non-medical, non-nutritional interventions that can help, with the choice of intervention depending on how you perceive the conscious awake periods, and how long they are.)

I don’t trust my tracker at all, for sleep patterns, exercise burn, anything like that. I quit wearing it when I deeply felt that way. But before when I wore it, knowing it wasn’t accurate, it still helped me mentally push to reach goals, and for that alone I think they’re great tools.

For my poor sleep, my husband bought me a weighted blanket and I’m surprised to say it has helped. I have less of the fidgety restless legs that I used to have, and for some reason I have fewer nightmares. Maybe it’s cause I feel like I’m being hugged or protected, it’s nice.

I used to listen to meditation videos on YouTube that were helpful but for some reason that has subsided with my move. I need to build up those good habits again, but without energy it’s like my brain can’t focus enough to build positive habits. Ugh.

Did you discover any tips or tricks to prevent poor sleep? How are your energy levels? If they’re good, what do you attribute to that most?

I always cringe a little when I say this (because people think it's woo), but the thing that helped the most was a course of hypnotherapy by a licensed, hypnotherapy-credentialed psychologist.

It wasn't a complete solution, but it was a *major* help. I went from waking up every 90 minutes (at longest) most nights, to getting 3-5 hours sleep before the first wake-up (then the 90-minute-ish pattern). That may not sound like much, but it made a huge difference functionally in how I felt and performed.

I was very skeptical about hypnosis, and wasn't sure how hypnotize-able I'd be (personality thing), but I was *desperate*. I'd tried everything from folk remedies to the medical sleep studies, multiple kinds of sleep meds (woke up just as often, just groggier!), varying exercise/eating patterns, and more. I was ready to try *anything*, after a couple of years of this. (For me, it came on after chemotherapy.)

IIRC, it was 6 one-hour-ish sessions, I believe each 2 weeks apart. The first was an interview, to help her plan the hypnosis sessions. At each of the other sessions, she would have me lie on a couch, while she talked to me. I never heard the full session, just the beginning and maybe some snippets. She'd record each session, turning off the recording before bringing me out. She gave me the recording. I was to listen to the recording at bedtime, in bed, nightly until the next session. After the final session, she told me I could repeat that cycle anytime I wished, but should use the sessions in the original order, and use each session for the same number of days (any number of days I chose).

One of my friends had a similar-but-worse experience after chemotherapy: She couldn't sleep at all, she said. She would do full-night meditation practice instead, and found that a significant improvement. (I don't know how she's doing now; haven't seen her in a while.) Just in case there are other readers: Severe insomnia is not a common after-effect of the kind of chemotherapy we both had. I know many, many people who had the same chemo, didn't have these sleep issues. It's rare.

These days, my energy levels are OK, and to the extent they aren't, I think it's mostly my fault (I don't maintain as consistent a sleep schedule as I know is best for me). A lot has changed in my life since then, including weight loss from obese to healthy weight, better dialed in nutrition (though it wasn't terrible then), a more established athleticism, retirement, and overall lower life stress. I think my sleep quality is better, though still not perfect; and my current lifestyle gives me more options for sleeping extra hours (to improve quantity vs. quality) than when I was working full time at a demanding job. I also don't *need* as much energy now, so it's hard to compare.

Since you have nightmares, I'm wondering whether some kind of psychotherapy intervention might be helpful. I know that CBT helps with the "can't sleep/can't get back to sleep because mind is racing" type of insomnia. Hypnotherapy obviously helped me. I don't know what therapeutic modality could help with nightmares, but I'm wondering if there might be one. I still think your medical avenues may help (even potentially with nightmares), but perhaps some psychological-side intervention could be productive, too.

Best wishes: I do understand that this is tough, and in your case the fatigue could be multi-factor.

Ddsb11 wrote: »

I love that you brought up hypnotherapy because it’s been something I’ve long considered, due to the subconscious nature of nightmares. Another thing that has been brought to my attention is acupuncture. I never would have considered that before, and turns out it is used for practically everything imaginable. I prefer seeking these options before drugs any day. Glad you found success with hypnotherapy!

Funny side note-

My aunt was obese and even though she was nearly 50 and I was 24 she was my best friend. She didn’t want to go to a hypnotist alone for weight loss and asked me to go to an event with her where the hypnotist would hypnotize the audience. I said sure, and didn’t think it would have impacted me at all. I attribute never binging again to that 3 hour session, which I typically did at least once a week prior. It could just be a bazaar coincidence but the only thing I did differently was getting hypnotized.

I'm going to come across as more alt-health here than I actually really am (I think), but I've had acupuncture, too - for knee problems, not insomnia. It's another thing that I didn't expect to work, frankly, but was willing to try.

The opportunity in that case was not via desperation, though. My late husband was a teacher of Chinese martial arts (though not Chinese), and I studied fairly diligently myself for around 8 years. Our lineage's teacher was an older Taiwanese-American guy with great martial arts lineage, who would come here to teach workshops in a couple of nearby places. When he taught in our city, he'd stay with us. He was also licensed in his home state to practice acupuncture (it often used to be practiced and taught alongside martial arts in his youth in Taiwan). I was having regular, pretty significant knee pain, and he was traveling with plenty of sterile acupuncture needles, so he offered to treat me with acupuncture and moxibustion (it's a "heat the needles" thing) at our house. He said he would do some unusual things because it could only be one treatment.

I didn't expect much, but knew he wouldn't injure me, and it seemed gracious to accept (I thought) so I did. The results were amazing. I went from routinely being in discomfort, often pain to the point of limping during my normal office workdays, to no pain; and was able to do the weekend's workshops without aggravating pain, besides. It was effective for a very long time (years), but I had some further joint degradation and soft-tissue injury, and gradually got worse again. Another opportunity hasn't presented itself, and weight loss went a huge way toward eliminating my pain anyway. It's minor, these days, at most.

I don't know about acupuncture for nightmares, but IMO it's worth a try for pain, if a good practitioner is available.

I'm thinking about brain fog again. I've been doing some volunteer text banking. We have multiple canned responses and different actions to do depending on what the response is. When I was text banking in the fall and again in December and January, I caught myself making a lot of mistakes. (Ex: Archive instead of Opt Out, vice versa, etc.) This time I've noticed I haven't made a single mistake, which is amazing! I changed up my iron regimen mid-December. Getting blood work again next week and will be interested to review the numbers.

Ddsb11 wrote: »

kshama2001 wrote: »

I'm thinking about brain fog again. I've been doing some volunteer text banking. We have multiple canned responses and different actions to do depending on what the response is. When I was text banking in the fall and again in December and January, I caught myself making a lot of mistakes. (Ex: Archive instead of Opt Out, vice versa, etc.) This time I've noticed I haven't made a single mistake, which is amazing! I changed up my iron regimen mid-December. Getting blood work again next week and will be interested to review the numbers.

I’d love to try Acupuncture for all the things I don’t know is wrong with me. Not sure if people ever just go in and say that, but sometimes we get so used to feeling bad that that becomes our normal. So it would be nice to just say, I feel lethargic, foggy, low mood... what’s wrong with me? And them say, oh wow your intestines are inflamed... or whatever. Just would love that aha! moment.

Sounds like low iron is a big culprit for many people here. I have my appointment on Thursday so we’ll see if that’s the case for me as well. Until then, I’ve been trying to be mindful about getting outside for some fresh air and sunshine, taking more brief walks, seeing if that changes anything at all. I just want to be actively trying to improve my situation and not just complaining to myself about it. I’m kind of tired of my negative self talk at this point lol.

Let us know how your appointment goes!

Depending on the particular acupuncture practitioner, they may be more willing to look at a condition as a wholistic general malaise, rather than diagnosing down to a specific body part or acute health condition. The traditional Chinese medicine perspective is a whole different paradigm from standard Western medicine; now they collaborate and interplay, both in the field as a whole and even in individual practitioners.

I don't have an opinion on how good a thing that "different paradigm" is, but it's definitely not just like Western scientific medicine's, so I wouldn't assume that you need a very specific symptom set in order to consult an acupuncture practitioner.

drink water and get hydrated... eat more... move more..