[Poll] How does exertion affect sleep? (Read instructions in first post)

Discussion in 'Sleep Disturbance' started by forestglip, Jan 24, 2025.

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How does your sleep change on the first night after enough exertion to cause a PEM crash?

  1. Exertion does not cause my normal sleep pattern to change (select even if "normal" sleep is bad)

    0 vote(s)
    0.0%
  2. I fall asleep earlier

    4 vote(s)
    8.7%
  3. I wake up later

    5 vote(s)
    10.9%
  4. My total sleep time is increased

    7 vote(s)
    15.2%
  5. I fall asleep later

    25 vote(s)
    54.3%
  6. I wake up earlier

    11 vote(s)
    23.9%
  7. My total sleep time is decreased

    27 vote(s)
    58.7%
  8. I cannot sleep at all

    9 vote(s)
    19.6%
  9. Change in temperature regulation (e.g. night sweats, feeling hot, feeling cold)

    21 vote(s)
    45.7%
  10. Increased "wired but tired" feeling before bed (resembles the effect of a stimulant like caffeine)

    36 vote(s)
    78.3%
  11. Shaking/convulsions while asleep

    6 vote(s)
    13.0%
  12. Increased restless leg syndrome

    12 vote(s)
    26.1%
  13. Change in dreams (e.g. more/less vivid)

    9 vote(s)
    19.6%
  14. Takes longer to shift out of "groggy" to more alert after waking

    15 vote(s)
    32.6%
  15. Other changes in sleep

    9 vote(s)
    19.6%
Multiple votes are allowed.
  1. forestglip

    forestglip Senior Member (Voting Rights)

    Messages:
    2,036
    Edit: The poll is now up.

    Please read these details before answering:

    Only answer if you experience PEM. Consider what would happen if you were to do enough physical or cognitive exertion to trigger PEM or worsen ongoing PEM. How would your sleep that same night compare to the previous night(s). Choose options which follow such exertion at least half the time.

    If you select "I cannot sleep at all":
    • Also select "My total sleep time is decreased"
    • Do not select "I fall asleep later"
    If exertion causes a change which is not listed, select the "Other changes" option. If exertion does not change sleep compared to days without exertion, select the "Exertion does not cause my normal ..." option.

    -----------------------------
    No need to read the rest, it was from planning the poll.
    -----------------------------

    I'm hoping to add a poll to this thread to see how many people with PEM notice an effect on their sleep the night after significant exertion. It'll be a poll where you can select multiple options. Hoping to get feedback on wording and options before I make it live. If there are other sleep changes you think should be added as options, let me know.

    Here's the draft:

    For people who experience post-exertional malaise, what effects does significant physical or cognitive exertion have on your sleep that night, at least sometimes?
    • Exertion does not cause my normal sleep pattern to change (select even if "normal" sleep is low quality)
    • I fall asleep significantly later
    • I wake up significantly earlier
    • I wake up during the night more frequently
    • I have more night sweats
    • I notice other changes in my sleep

    ----

    Edit: Should probably include falling asleep earlier and waking up later too.
     
    Last edited: Jan 26, 2025
  2. Kitty

    Kitty Senior Member (Voting Rights)

    Messages:
    7,909
    Location:
    UK
    Good questions! Maybe add:

    • I cannot sleep at all

    Usually true for me after a significant exertion.
     
  3. Andy

    Andy Retired committee member

    Messages:
    23,709
    Location:
    Hampshire, UK
  4. EndME

    EndME Senior Member (Voting Rights)

    Messages:
    1,531
  5. forestglip

    forestglip Senior Member (Voting Rights)

    Messages:
    2,036
  6. forestglip

    forestglip Senior Member (Voting Rights)

    Messages:
    2,036
    Maybe options for more or less dreaming as well.
     
  7. Trish

    Trish Moderator Staff Member

    Messages:
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    Location:
    UK
    I think it's worth adding tired but wired as an option. It's not just about not being able to sleep it's mental and physical restlessness a bit like having too much caffeine.

    Also I think it would be worth asking if it happens specifically at the beginning if a crash.
     
  8. forestglip

    forestglip Senior Member (Voting Rights)

    Messages:
    2,036
    How would you recommend incorporating this?
     
  9. Mij

    Mij Senior Member (Voting Rights)

    Messages:
    10,191
    Cognitive overexertion negatively affects my sleep but this also affects healthy people.

    Physical overexertion does not negatively affect my sleep. I can have a great nights sleep but that won't prevent delayed PEM if I went over my boundaries.
     
  10. forestglip

    forestglip Senior Member (Voting Rights)

    Messages:
    2,036
    An option like this?

    "I get a "tired but wired" feeling the same day of the exertion before bed that feels like having taken a stimulant like caffeine."
     
  11. Trish

    Trish Moderator Staff Member

    Messages:
    58,823
    Location:
    UK
    Your question says 'that night'. Do you mean the first night after the excess exertion and before or at the start of the crash?

    My sleep changes over the nights for as long as the crash lasts. I think I remember correctly that tired but wired often happens on that first night and is the first sign to me that I'm about to crash.
     
  12. forestglip

    forestglip Senior Member (Voting Rights)

    Messages:
    2,036
    Yes, I'm curious about the first night. No doubt sleep is affected for multiple days, but I think it's interesting to focus in on the first sleep, because this is before a crash has started for many people.
     
  13. Trish

    Trish Moderator Staff Member

    Messages:
    58,823
    Location:
    UK
    Tou may need to shorten the question to fit it into the poll.
    Maybe something like
    Which option best describes your sleep at the beginning of a crash?
     
  14. forestglip

    forestglip Senior Member (Voting Rights)

    Messages:
    2,036
    I'd like "first night" to be included so that people don't answer about subsequent nights so the poll is more focused on a single thing.

    What about: How is your sleep the first night after enough exertion to cause a PEM crash?

    Edit: I forgot it should include how it changes compared to other nights. This still fits the length maximum: "How does your sleep change on the first night after enough exertion to cause a PEM crash?"
     
    Last edited: Jan 24, 2025
  15. Mij

    Mij Senior Member (Voting Rights)

    Messages:
    10,191
    Ok, I just looked at the 'poll'. My poor nights sleep from cognitive overexertion is a wired/tired brain that won't shut off that results in insomnia. This is the first symptom I experienced within 3 weeks from returning to work after 'recovering' from PVFS in 1992. After resigning from work, my sleep returned back to normal 2 weeks later.
     
  16. Yann04

    Yann04 Senior Member (Voting Rights)

    Messages:
    1,989
    Location:
    Romandie (Switzerland)
    Is there a reason you don’t include
    “My overall sleep duration is longer”
    “My overall sleep duration is shorter”
    “My overall sleep duration is unchanged”

    Also I would be very confused on how to answer this. In the initial stages of PEM I’m all wired (and this coincides with allergic reactions for some reason that prevent me from sleeping), so I get way less sleep than usual, while in late stages of PEM I have hypersomnia and sleep most of the day and night. If PEM is the entire crash period, then my sleep looks wildly different in different parts.
     
  17. forestglip

    forestglip Senior Member (Voting Rights)

    Messages:
    2,036
    I could include the first two. Is the third needed if there is this: "Exertion does not cause my normal sleep pattern to change (select even if "normal" sleep is low quality)"

    If someone has issues with other aspects of sleep but not duration, that will show up as the percentage of people who did not vote for longer or shorter.

    Basically trying to ask how sleep directly after exertion compares to the previous night(s). So it should be only about the beginning of PEM (or beginning of a new level of PEM if exerting during another crash).
     
  18. hotblack

    hotblack Senior Member (Voting Rights)

    Messages:
    559
    Location:
    UK
    I’d have difficulty answering a ‘first night’ question. I can’t be that fine grained really. I would say that I have a mixture of all of these after exertion, but it varies presumably depending upon many variables which tbh I cannot be sure of:
    • Difficulty getting to sleep
    • Less restful sleep
    • Wake more often
    • Wake earlier
    • Sleep less overall
    • Don’t sleep at all

    Then associated I can have all sorts of things, some more night specific some less so including
    • Feeling tired but wired
    • Shakes/convulsions
    • Pain and Difficulty getting comfortable
    • Restless less
    • Temperature regulation problems/fluctuations (feeling hot)
    • Cardiovascular symptoms

    Or just peacefully lying there drifting in and out of something and not really sleeping but not being too bad either!

    Not sure if this helps but there may be some useful words for you here.
     
  19. Yann04

    Yann04 Senior Member (Voting Rights)

    Messages:
    1,989
    Location:
    Romandie (Switzerland)
    That is pretty much exactly what I experience @hotblack Just that since I became very severe, it now seems to always coincide with allergic reactions causing all sorts of bodily symptoms. Diagnosed as MCAS, but I’m not sure that really means anything.
     
  20. forestglip

    forestglip Senior Member (Voting Rights)

    Messages:
    2,036
    Since this allows multiple selections, maybe answer any that happen at least sometimes. I know for me, even though insomnia is common the night after exertion, there are days after intense exertion where inexplicably I fall asleep just fine.

    Thanks, I'll try to include these as options.
     

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