What causes me to wake up feeling muscular pain all over my body?
March 1, 2015 2:25 PM   Subscribe

Hi! I really hope someone has had a similar condition and can help me. For about a year now, I wake up every morning with intense body pain and very low energy, as if my body had been tensed up all night long. I can sleep a solid 8, 9, 10 hours and still feel the same. I used to suffer from insomnia but not anymore. I can now fall asleep within minutes of reading. The muscle pain is similar to what you get when you have a flu. The situation does not improve during the day.

I can feel some relief IF I can fall asleep during a nap, but being that my body hurts so much, it's hard to fall asleep if I try to nap. I have noticed lately that I have stressful dreams (when I can remember them) but I wonder if stressful dreams are sufficient to cause the deep muscular pain.

I have taken the sleep apnea test and was diagnosed with very light apnea. I bought the CPAP mask and tried it during a month but it didn't improve my situation.

My physician had told me to try taking promethazine (her psychiatrist had told her to use it to treat her insomnia) and I've been taking it on and off for a while now, a maximum of 2 pills per night. Promethazine is an antihistamine which is a strong sedative. It sometimes helps me to wake up feeling normal but super groggy for the first hours of the day. I used to take many painkillers too, mainly to help me to fall back to sleep for a little bit in the morning and wake up feeling ok. I've tried to stay away from the painkillers for the past month and a half.

The weird thing is that when I am able to fall back to real sleep in the morning or in the afternoon, even for 15 minutes, my pain and weird low energy goes away or diminishes considerably.

I've started seeing a therapist last week, and we will be working on analyzing my dreams. I'm hoping this may help. I'm an anxious person. If the problem is 100% psychological and subconscious, I hope I will win this battle.

Thanks in advance!
posted by alexalexalex to Health & Fitness (22 answers total) 12 users marked this as a favorite
Is it the same on every bed? Is it possible your mattress is a contributing factor? Do you stretch before sleep? Upon waking? Are you sedentary?
posted by taff at 2:34 PM on March 1, 2015 [1 favorite]

This may be a long shot, but it's based on something that happens to me. I have chronic pain (abdominal) and if I take my Tramadol for it too late at night, I find I don't move at all when I sleep. I tense up and wake up in the morning in exactly the position I went to sleep in. A cat and a boyfriend with me on our queen-sized bed further restrict me sometimes. When I've slept like that, it takes about an hour before the muscular pain I'm feeling all over dissipates.

I wonder if your sedative is putting you in such a deep sleep that you're basically in the same predicament?
posted by xingcat at 2:34 PM on March 1, 2015 [7 favorites]

My body feels like that if I'm dehydrated - I almost always notice it after I fly, for example, and it also happened after a bout of nausea last week that kept me from drinking almost anything all day long. That seems a little simplistic but I thought I would mention it on the off chance it might help.
posted by something something at 2:36 PM on March 1, 2015 [1 favorite]

Dehydration perhaps? Try drinking a huge glass or two of electrolyte water as soon as you wake up.
posted by joan_holloway at 2:45 PM on March 1, 2015

I read recently that people who wake up stiff and sore (I am often one) are doing so because they aren't moving around enough when they sleep. I find that nights when my sleep is broken and I get up and move around a bit I don't wake up so sore. I don't know if that is an option for you, but if you do wake up, you might try it.
posted by mythical anthropomorphic amphibian at 2:52 PM on March 1, 2015

I know this sounds weird, but I had the same issue. Diagnosis: celiac disease. Too much inflammation + antibodies attacking my own tissue.
Can't hurt to get a blood test.
posted by Neekee at 3:00 PM on March 1, 2015 [2 favorites]

Morning pain specifically can point to any number of autoimmune things. I have lupus and fibro - mornings are the worst. It's not so much that I can't or don't wake up early, but it can take an hour or two to get moving at all. Longer if I'm flared up.
Check in with your GP, they can refer you to a rheumatologist if you have other things that match.

Either way, I'd put a bottle of water and some alive on my nightstand and take immediately, no matter how much you wake up. And maybe at night as late as you can manage for it to be working when you wake up.
posted by crankyrogalsky at 3:39 PM on March 1, 2015 [2 favorites]

Can you get a consult at a chronic pain clinic?
posted by dancing leaves at 3:57 PM on March 1, 2015

Have you talked to your doctor about muscle relaxers? If you're tensing your muscles all night, it could be worth a try.
posted by Ursula Hitler at 4:09 PM on March 1, 2015

I'd get that in the morning when my mold and pollen allergies were triggered. Allergies are an immune response, and tied into inflammation.

There are blood tests that indicate inflammation; you may want to talk to your physician about it.

Try also looking at a non-sedative antihistamine as a temporary measure? I end up using some herbal nostrum; nettle extract in alcohol from health food stores, which works well enough for me and doesn't make me sleepy. I don't know anything about more common antihistamines, and am also skeptical of most herbal nostrums.

I'd guess your physician may be thinking about doing some allergy testing as an antihistamine seems to work for you aside from the grogginess.
posted by sebastienbailard at 4:44 PM on March 1, 2015

How do you feel when you don't take the Promethazine?

It seems there are some side effects that can affect muscle tone and tension (with overdose, looks like. I am just reading what's here.)

(I don't really see a way dreams could be contributing to muscle pain. There is of course such a thing as nocebo, but I don't know how common it really is... I tend to think pain usually means something is happening to your body.)
posted by cotton dress sock at 5:51 PM on March 1, 2015

Is your bedroom cold at night? Maybe you don't feel cold when you go to sleep; maybe you turn the heat down immediately before bed, and fall asleep quickly so you don't know it's getting cold. Or your body gets too cold due to thyroid issues, or menopause, or who knows why.

Your temperature stays low all night, but you don't feel cold enough to wake up. So the coldness causes tense muscles. (Just a theory.)

It also sounds like food sensitivities causing too much cortisol at night.
posted by serena15221 at 5:52 PM on March 1, 2015

I would also pay attention to your level of hydration at the end of the day and how close to bedtime you eat. For me I know if I eat less than 3-4 hours before going to sleep I will not only have a restless sleep and possibly indigestion but also wake up tired and achey.
posted by eatcake at 5:53 PM on March 1, 2015

It sounds like your doctor hasn't really investigated this at all. There are some good suggestions in this thread, but I think you should try another doctor.
posted by Specklet at 6:13 PM on March 1, 2015 [2 favorites]

My physician had told me to try taking promethazine (her psychiatrist had told her to use it to treat her insomnia)

You need a new doctor. This has been going on for a year, and your current doctor's best guess is nothing more than what her own psychiatrist prescribed for her.

It could be autoimmune, a vitamin/mineral deficiency, food intolerance, who knows. Get a new doctor, and new blood tests.
posted by invisible ink at 7:10 PM on March 1, 2015 [5 favorites]

Would a sleep tracker like a Fitbit or an iPhone app help you narrow down anything about your sleep that might be impacting this? I use Sleep Cycle on my phone, and can see which parts of the night I am still versus restless. Something like that might easily confirm or eliminate the hypothesis that not moving at night is causing the soreness.
posted by instamatic at 8:23 PM on March 1, 2015

Did your doctor check your thyroid levels? That's how I felt - although not all day - when my levels were out of whack.
posted by dawkins_7 at 8:39 PM on March 1, 2015

I would agree with getting a second opinion. It doesn't seem clear that your muscle aches are related to sleep (although the fact that they improve if you take a nap during the day is odd). Definitely doesn't make sense to chalk this up to a psychiatric issue unless you've had a full medical workup already. I've got to believe that there's some other reason that your physician is just treating you with promethazine for 'sleep'... this is not a medication typically used for insomnia, by psychiatrists or by primary care doctors.

Promethazine (Phenergan) is a prescription medicine typically used for nausea, although it's getting less common these days with the advent of Zofran (an anti nausea med with fewer side effects). It CAN be used for sleep certainly, drowsiness is a side effect, but it's way down the list of common medications used for sleep these days, because it has a ton of other potential side effects, and there are now many other medications for sleep that are usually recommended to be tried first, like trazodone or Ambien for example. Bottom line is, I feel like there is more to this story medically, and that having another doctor look through your records and give you further recommendations is probably your best bet.
posted by treehorn+bunny at 8:57 PM on March 1, 2015

Try water, for dehydration.

Magnesium supplement for muscle cramping.

Have a hot shower immediately before sleeping, to relax your muscles.

Use electric matress pad on very low to maintain a steady warm temperature, in case your body is tensing up when you are slightly cold (which often happens after you fall asleep).

Try these pillow placements to allow your spine and body to relax.

If you normally sleep in fetal position, try sleeping straightened out on your back (with pillow under knees), sometimes I just start hunching up in the fetal position, and get tense all over.
posted by Elysum at 12:21 AM on March 2, 2015

Had something similar when I was Vitamin D deficient. The low energy lasted all day, and my body ached constantly.
posted by Ms. Moonlight at 12:55 AM on March 2, 2015

I've had severe muscle tension after a good night's sleep for a few years. Different mattresses, vitamins, exercise did not help at all, but I got fantastic release from pain via longitudal myofascial therapy. I was helped on the very first session, so at least it didn't take long to assess the effectiveness of the therapy.
posted by tatiana131 at 2:56 PM on March 2, 2015 [1 favorite]

Psoriatic arthritis, rheumatoid arthritis, lyme disease, and various nutritional deficiencies all have these symptoms.

Get blood tests for the following:
- Iron, vitamin D, and vitamin B12 levels
- Lyme disease
- Rheumatoid factors
- Inflammation (e.g. sed rate)

Psoriatic arthritis can't be diagnosed with a blood test alone but if the blood test finds inflammation with no obvious cause they can then do a bone scan to check for psoriatic arthritis.
posted by Jacqueline at 6:48 AM on March 3, 2015

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