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FYI.... I too disagree with someone's comment that N24 is "just when DSPS gets too bad". For some people with N24 it's not only that the time they fall asleep is constantly moving forward, but also that the length of their sleep cycle varies from day to day. For example the 2 loved ones of mine...

The rare autoimmune disease doctors suspect I may have (relapsing polychondritis aka: RP) and that I am currently being evaluated for has no biomarker. In RP patients with severe inflammation and ongoing cartilage destruction, inflammatory markers are often completely within normal range.

your patterns don't sound as severe as the sleep disorder "N24" (non 24) but it might be worth reading about it just in case you see a worsening in your sleep patterns you described. I have a friend and a cousin who suffer from N24.

I could be remembering wrong, but I recall @Jonathan Edwards making a comment on PR a while back about how some with an autoimmune disease (i forget which specific disease he was refering to) seem to describe symptoms that sounded very much like PEM. I may be remembering wrong though.

There are a few other conditions that are known to cause PEM. I believe Primary Biliary Cirrhosis is one them. I 100% have PEM and meet all the "respected" criteria for ME/CFS and was diagnosed by Dr. Chheda earlier this year. However doctors now suspect I could have a rare autoimmune disease...