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Archive for April, 2008

HPA Axis and Sleep Schedules

Tuesday, April 22nd, 2008

Recently ive seen a doctor who has recovered from Chronic Fatigue Syndrome.

It turned out that he had an Epstein Barr infection and once he was treated antiviral drugs, he felt somewhat better, but was still sick.

The thing that he told me helped him to fully recover was keeping a strict sleep schedule. Waking up early and going to sleep at the same time every night. He said that this was one of the most important things in his recovery.

If it worked for him, i thought it might work for me. I didnt think it would help, because all CFS patients seem to be really different. But i gave it a shot.

I started waking up at 8:00am and going to sleep at midnight every night. Making sure to get as close to 8 hours sleep a night as possible (no more, no less).
My goal with this new schedule was to normalize my sleep patterns, and hopefully my circadian rhythms and hpa axis.

Since ive been on the yasko protocol supplements (and klonopin & benadryl), ive been able to get a full nights sleep. But i have a tendency to oversleep, and have a really hard time waking up. My schedule was horrible, i would go to sleep anywhere between 1:00am-3:00am and sleep till 10:30 oo 11:30.

But, after a couple weeks of sticking to this schedule (and staying on the Yasko supplements), my sleep is much improved. My concentration also started to improve. I get weird bursts of energy, where my body feels warm, my muscles relax (my muscles are always really tense), and my concentration improves. I feel almost well sometimes, but it doesnt last.

I think it has to be some kind of improvement in hormonal function, because i cant think of anything else that would come in bursts like that. I know that the HPA axis, insomnia, and CFS are all related, so it makes sense to me that maybe my HPA axis might becoming more normalized.

So whatever those energy bursts are, i need more of them. Im hoping for slow steady progress. The yasko protocol combined with this sleep schedule seems to be leading on the right path. So far ive been on the schedule for 1 1/2 months and i hoping with more time, ill have more improvement.

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Immune Dysfunction and Chronic Fatigue

Thursday, April 10th, 2008

A recent study corollated certain immune system markers to the severity of fatigue in chronic fatigue syndrome patients. It showed that those who had increased RNase L activity, RNase L cleavage, and Elastase activity had greater fatigue. CFS researchers found patients to have an abnormality in an antiviral pathway. This led them to have abnormal size molecules of an enzyme called RNase L. This causes the enzyme to not be an effective antiviral.

These RNase L molecules can be cleaved to 1/2 their normal size (80 kDa protein into the putative 37 kDa fragment) by an enzyme called elastase. Elastase is an enzyme which is created during the inflammatory response (interleukin-6 and interleukin-8 release elastase).

So, certain inflamatory cytokines (interleukin-6 and interleukin-8) lead to the creation of more elastase, which cleaves the RNase L molecule and makes it ineffective as an anti-viral.

Some doctors believe that the drug Ampligen works on CFS patients by correcting the abnormal RNase L enzyme. It is still up in the air as to how effective this drug is and if it will even be approved. It is in the final stage of approval and may come out sometime this year.

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Insomnia and the HPA Axis

Tuesday, April 1st, 2008

Insomnia is a major problem for many CFS and FMS patients.

It can be difficult for CFSers to keep a normal sleep schedule. They tend to have shifted sleep patterns which lead them to fall asleep and wake up much later than healthy people.

This may be because of HPA axis dysfunction.

The HPA axis is a system of glands which regulate many body systems including the sleep/wake cycle.

A dysfunctional HPA axis could cause the body to release decreased levels of cortisol or release it at inappropriate times through out the day (like bedtime).

In normal people, levels of cortisol (released by the adrenals) rise upon wakening and reach their peak levels with 30 minutes. They lower gradually though the day and the increase again in the late afternoon.

Here – Chronic Fatigue like symptoms (including fatigue, cognitive complaints, pain, sleep disturbance) were induced in hepatitis patients when they were treated with a drug called Interferon-Alpha. Its is believed to be due to the drugs affect on the HPA axis.

If you have CFS, here are some things that may help stablize your sleep/wake cycle (and maybe the HPA stress response).

- The first thing is to wake up and go to sleep at the same time every day. (This has worked wonders for me, ive been sleeping the best that i have in years.)

- Exercise if you can. This is not an option for all people with chronic fatigue, but if you can exercise without negative effects, it can help.

- Also make sure and get light exposure everyday, via the sun or a light box.

- Dont watch t.v. in bed. Studies have shown that people who watch television or use the computer before bedtime, get less sleep. Using electronics that emit light can affect your sleep patterns when you use them before bedtime. Reading a book is a better option if you have insomnia.

Sometimes the above techniques arent enough. You might have to move on to supplements or prescription sleep aids, if you still arent able to get a decent nights sleep.

**Here are sleep aids that have been effective for me:

Benadryl: Benadryl blocks histamine at the H1 receptor. Histamine induces wakefulness and blocking it with benadryl is a safe and non-addictive way of dealing with insomnia.

Valerian: Valerian is an herbal supplement which causes sleepiness. It is believed to increase levels of an inhibitory neurotransmitter called GABA. It has a similar mechanism of action as benzodiazapenes like xanax and klonopin.

GABA: Supplements of the inhibitory neurotransmitter GABA are available in pill form at health food stores.

Melatonin: Melatonin is a naturally occuring hormone made by the pineal gland.

Klonopin: A perscription drug that is very effective for sleep among CFS patients. Is recommended by CFS doctors like Charles Lapp.

Doxepin: A tricyclic antidepressant, that is also one of the stongest antihistamines available. Chronic Fatigue patients can take it at a low dose, where it is only really effective as a sleep agent, not an antidepressant.

** If you decide you want to try these supplements, discuss them with you doctor first. Mixing sleep aids can be especially dangerous.

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