What does "tired but wired" mean to you, when does it happen and what do you do to feel better?

Hey!
I'm interested in hearing your experiences with "tired but wired". I'm wondering if everybody is talking about the same (or similar) experience.

How does it feel to you?
When does it happen?
Is there anything you can do/take to help in your situation?
Do we know the pathophysiology behind this symptom?


For me it feels like I'm super tired in/behind the eyes (if that makes any sense?) but my body and mind is very awake but in somewhat of a trance state. It almost feels as if my eyes were too dry and strained. Brain fog is very strong during those moments.
I've read about it often in connection to insomnia, however I don't feel this at night. It definitely might cause insomnia when wanting to take a nap during daytime.
I pretty much have it constantly.

[tangent] It does not feel like what I would call an adrenaline surge. In my definition of such a surge, I get hot and cold instantly and my heart rate goes up - say when I'm on a train and I forgot to sign in with my ticket and I see somebody going around and checking tickets. Or I'm about to do a bungee jump.
I don't think I've felt this feeling "out of nowhere" from ME or any other illness. Hence, I'm not sure if this is what people call adrenaline surges. (I'm also not native English.) [/tangent]

The only thing that's every helped me with tired-wired was propranolol. Unfortunately, it's messed with my COVID induced asthmatic lungs, so I had to stop taking it. Nebivolol (also crosses BBB) does not affect it, which makes me think it's something related to the beta 2 receptors?
Nothing else, be it behavioral or pharmaceutical has helped me.

Interested in your anecdotes.

 

The simultaneous experience of exhaustion and difficulty entering into a restful relaxed state. I suspect the wired state is sympathetic arousal that occurs when we try to push past healthy and sustainable limits, and allows us to keep going when necessary.

Working on a better balance between rest and activity, and managing orthostatic intolerance seems to be helpful.

The body needs to experience both activity and rest during the day, and be good at shifting between these states.

 

Physically and mentally exhausted. But my body and mind are somehow not restful (I’m cautious to say not relaxed but that could describe it too, or maybe alert, primed) while awake or asleep, with sleep being difficult or broken/lower quality.

Exhausted and restless may be another useful phrase pairing.

There may be tension in the body, some things which could be described as pain, usually heaviness and weakness, but exhaustion is the big thing.

I may not be buzzing with thought, it’s not like when I’ve had depression/anxiety and had things running through my head (although this can happen if stressed, it’s not an essential component of this phenomena for me), but my mind can be sort of mindlessly drifting, and quite calm, just not going properly off to sleep. Or if awake tracking thoughts can be difficult.

 

For me, it's when I'm utterly exhausted but my body and mind are buzzing, tingling, restless, can't settle. It's not necessarily just about when am trying to sleep, just any time I need to rest and my body has other ideas. I've heard some describe it like being in a car with your foot on the accelerator but not in gear, just revving the nuts off the thing.

 

For me it’s a part of PEM.

After I overexert, it feels like my body sends some signals (perhaps adrenaline or something) to compensate. I feel jittery, energetic, wide awake, my symptoms also flare. Trying to sleep without benzos is a nightmare. My sleep time is way lower. My heart rate spikes. I often get diarrhoea. I feel like I’m overheating.

This feeling can last a long time, but it will go away if I force myself to stop doing activities. This feeling can last months or years on end if you’re in a state of constant overexertion. Once it finally subsides, it is followed by a decline in function, which is what I see as the main part of a crash.

I just call it “wired”. I guess I’m “tired” too, but that’s not what defines and differenciates the feeling, and it’s quite minor compared to the adrenaliney feeling, the “tired” (or more accurately bricks dragging down on my body) comes more strongly after the wired feeling subsides.

At the beginning of my illness I often mistaked it for anxiety attacks or panic attacks. I know a lot of people who mistaked it for that too.

 

I'm very tired, I know I've overdone it, but I can't stop.

My brain won't stop, but my body won't either. I know I need to rest, but I keep seeing small jobs that are high on my priority list and doing them. They're not high priority—it'll be things like getting up from the sofa to put a sweatshirt I abandoned on the back of a chair two months ago into the wash basket—but this bizarrely persistent mindset is a key part of the "wired but tired" thing.

I get into bed exhausted, barely able to keep my eyes open and having had little cognitive function for hours. But the moment I'm horizontal (the shift's always positional) my brain explodes into life.

There's no question of sleep, but no question of stillness either. I toss, turn and fidget, and often have to get up again in the hope that engaging my brain in something that will calm it down. if I've breached my PEM threshold by a long way, it won't.

The strangest thing is how little impact the absence of sleep has the next day. My cognitive function is better than usual, and physically I don't feel nearly as bad as I ought to. I assume it's because whatever process kept me up all night is still running.

When I was still working, there were a handful of occasions where I had no sleep for four consecutive nights due to this. It followed a long accumulation of low-level PEM, which suddenly fractured the dam. The first couple of days I'd be really on the ball and you'd never suspect I hadn't slept. By the fourth day I'd be getting cognitive blanks where it felt like the videotape had skipped.


ETA: @Yann04's post has reminded me that when I'm awake overnight, I cycle rapidly between too hot and so cold I'm shivering. Another one of the treats!

 

Exactly the same as others here, my brain fires up. Suddenly I’m reliving conversations and jumping to memories from childhood and then thinking about computer programming and some weird book I read a while ago. I want to sleep but my brain just won’t quiet down and before I know it, hours have passed and I’m still lying awake.

I also was only able to get relief from propranolol or Xanax back when I still had a prescription.

I suspect it has to do with sympathetic nervous system activation, but not an immediate “adrenaline” response for me, since my body doesn’t necessarily feel in danger and I don’t have any physiological signs besides a higher than normal heart rate sometimes. My ME is mild these days on a stimulant, so that probably makes a difference.

it’s most often due to PEM, though I have also triggered it sometimes by doing something really stimulating right before bed (playing a fun video game, trying to solve a difficult coding problem).

 

To me it feels like something is missing and another system has had to step in and take over but that system can’t let you relax in any way. Cruelly it gets worse the more over tired I get and I feel there’s something instrnsically different in people who have this presentation vs the people who doze as a response to tiredness. I read that the body needs energy to go into a state of relaxation and my experience is the sicker I’ve become and the less energy I have, the more on edge and the less relaxation is actually possible which could be part of the vicious cycle of m.e . on many days my oura ring will show me as having 0 restorative time during the day even if I've just been laying there having television on even if I've had my eye shut et cetera. When I raised this with my GP he brought up the fact that there was no evidence based medicine around this . They don't see this as anything they have anything to do with and yet your body is stuck in this dysfunctional state. Zopiclone helps me.

 

I feel like my original explanation downplayed it or only explained the ‘lighter’ forms of it. Because reading others descriptions I also agree with a lot said.

Zopiclone, there’s an interesting one that I’d had when younger and suffering from mental health issues and staying awake for days and it worked brilliantly. Better than diazepam, temazepam or anything. No side effects. Tried it a couple of years ago for my first covid vaccine triggered crash and it was a disaster, it would get me off briefly but would wear off very quickly and I’d have a massive sort of rebound effect so I’d wake up worse, more wired and I got stuck in a bit of a cycle with it and poor advice from a Doctor…

 

Tired but wired for me means feeling like you've not slept in a day or longer but not feeling sleepy. When I'm tired my Autistic sensory symptoms are worse than usual. You need sleep but can't get any.