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Sleep Disorders

Tired,headaches,andupset stomach

08/03/2004

Question:

I have been really tired and whenever i wake up i have this really bad headache and my stomach ache like i have to throw up, but i dont. what should i do and what do you think it might be?

Answer:

Fatigue, headaches and nausea would be enough to make anyone feel poorly and seek help, as you are doing. With these type of symptoms, the main issue to sort out is whether they are due to a primary sleep disorder or related to a problem that is not a sleep disorder, but may be effecting your sleep. Fatigue or tiredness can be the result of a number of sleep related disorders, but may also be due to other illnesses or conditions.

Primary sleep-related problems that may contribute to this symptom may include anything that fragments or disrupts your sleep (such as breathing disorders in sleep or sleep apnea, leg jerks in sleep or periodic limb movement disorder, or a loud or noisy sleep environment), not getting enough sleep (insufficient sleep disorder), or sleeping at odd or unusual hours (circadian rhythm disorders). Of course, a number of other conditions that may or may not affect your sleep can also result in chronic tiredness and fatigue. Some of these problems might include chronic pain conditions (such as arthritis), thyroid disorders, depression, and chronic infections, to name a few.

Morning headaches can be a sign of poor or fragmented sleep and is often mentioned as a potential sign of breathing problems in sleep. Other signs or symptoms of sleep apnea include loud snoring during sleep, witnessed breathing disturbances during sleep (usually a bed partner may comment that a person "stops breathing when they sleep"), waking up with a choking or gasping sensation, feeling unrefreshed upon awakening in the morning, and excessive daytime sleepiness. Morning headaches may also result from a number of problems, including chronic headache condition (such as migraines), depression, caffeine withdraw, or substance abuse or withdraw.

Awakening with a sensation of nausea is not typical of a primary sleep disorder and usually represents another problem - the causes of which could be numerous (for example gastrointestinal illness, pregnancy, medication effects, substance abuse or withdraw, etc.). To determine how best to help you, further information is required in order to make a diagnosis. I recommend you discuss your symptoms with your primary care physician. He or she will ask for additional history from you as well as review your medications and medical history and perform an examination. With this additional information, you physician can then determine if further testing, referral to a sleep specialist or perhaps initiating some form of therapy would be appropriate at this time.

If you would like additional information regarding sleep and sleep disorders, you can obtain it on the American Academy of Sleep Medicine website at www.aasmnet.org. This website also contains a list of Sleep Centers across the country so you can locate one near you if need to.

Good luck and here's to better sleep!

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Response by:

Dennis   Auckley, MD Dennis Auckley, MD
Associate Professor of Medicine
School of Medicine
Case Western Reserve University