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Does Everybody Gradually Improve Throughout The Day?


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Hi all,

I hope you are all doing as well as you can be/are having a good/better day, etc :-)

I have been working hard to improve my symptoms any way i can so that i can gain some quality of life back. i have been keeping a detailed health diary and have started to see a pattern. I tend to be more symptomatic in the earlier part of the day, and tend to be a lot better by early evening, and feeling much more like myself mid/late evening.

Just to recap: I have severe CFS/ME, severe Fibromyalgia, Dysautonomia.

My prolonged bout of insomnia is much improved. Just gone 16 nights without sleep aids (though i had to take 2mg Diazepam last night to calm CNS - pounding, rapid heart). I'm still battling with unexplained high blood pressure (153/92 has been highest). And am taking 1.25 MG Bisoprolol to lower it. I'm still struggling to maintain my blood sugar. I'm much improved by eating 3 smaller meals and 3 snacks in-between meals. But i had a crazy sudden, unexpected, very severe 'hypo' yesterday despite changing how, what, when i eat. I tested 4.2 at the time. I was so close to collapse. I've not been that bad in some months.

I always wake up feeling dazed, out of it, etc. And it takes perhaps an hour for my body to 'wake up' - I never know how i feel/what kind of day i will have until my body awakens. It's as if i'm almost symptom - free for this period.

This is what i've noticed:

My blood pressure is always highest in the morning and settles to a healthy range by the evening (115/73)

I nearly always have bad palpitations in the morning, reducing in severity in the afternoon, and/or very mild/none in the evening

I never have hypos in the evenings. It's usually late morning/midday, or less frequently in the afternoon.

If i have changes in consciousness (Derealization/Depersonalization), it's usually severe in the morning and gradually settles throughout the afternoon. I'm usually clear headed by early/mid evening.

My IBS-D is often very severe in the morning and tends to settle somewhat throughout the day, and is usually much better during the evening

My theory is that when i awaken in the morning there is a 'delay' period of 1+ hr. where my body/CNS is perhaps still in 'sleep mode', so i experience almost no symptoms. (nerves not functioning yet, digestion not functioning yet, etc). Then my body slowly begins to function again as it switches to 'awake mode', - sensations/symptoms then begin. I suspect i have the palpitations because i am becoming active before my body is ready, and it over-compensates, etc.

My body eventually 'catches up' with my activities at some point during the day, responds more normally, and i am less symptomatic.

Does this make sense?

I'd be very interested to know if anyone else has a similar daily pattern,

Thanks in advance,

Mike :-)

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Yes I definitely experienced and experience improvement of symptoms as the day goes on. I think many of us experience that. I feel best around 4 pm typically. I can remember when I was very sick that I would actually feel some days very close to normal in the late afternoon.

My specialist said from the beginning that symptoms would be the worst in the AM b/c of all the fluid lost during the night. He said the first thing I should do is drink fluid (water) on waking. This did help. However I have wondered if the explanation is more complex than that.

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When I read your story, it read like I could have written it. I do say that after I get out of bed, I still need all morning to "wake up".

I cannot wake before like 6 a.m. or I feel so dizzy headed. I do best when I can wake naturally, whether at 6 a.m. or 7:30 a.m. Then I have to lay around for about 20 minutes for my body to feel ready to physically get out of bed. Otherwise I seem to vasodilate, with my hands and feet swelling and feel lightheaded.

I sit all morning in my chair, watching news/tv or on the computer. I drink iced tea for caffeine purposes( helps have bowel movement and wake me up some). I have hypoglycemia issues, but only in the morning, also. I almost never have had hypoglycemia after about 3 p.m. I go through moments of heart racing, lightheadedness, full-head feeling, cold, hot, no energy and more. It is a moment by moment roller coaster all morning. Then, usually by 1:00 p.m., I can do something, like cook, etc., as I begin having a lot less of the morning issues. By night time, I don't have any normal energy, but my head feelings are significantly reduced, and I feel almost my new normal. I don't think I EVER feel my prePOTS normal!

I wonder about cortisol, and whatever else has a diurnal pattern. I do know my cortisol is usually high (over the top of the normal range) in the morning, and has been for years. I don't know if that is pathologic or just a stress-reaction to what ever is going on in the morning.

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Yes, I can relate to this too. Late afternoon I am at my best. Occasionally I will get a weird uncomfortable spell in the evening. I agree that fluid loss does not explain it all. I do seem to have an anxious feeling most mornings after I get up.

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Hi All,

thanks very much for taking the time to reply to my query.

Please forgive the delayed response. I have been profoundly ill for the past week or so and computer use seems to make me much worse afterwards. All i can do is apologize.

I really appreciate your efforts. At least i know i am not alone with this issue.

yesterday was a terrible, terrible example of this problem.

I awoke very fuzzy headed, had to force myself out of bed - a real struggle.

I used my PC for an hour or so, and noticed my head was feeling worse than usual - really profound change in consciousness, not sure how i'd describe it - it's like severe mental side effects of medications? detached, spaced out, etc. i couldn't even speak properly for much of the day. I was like this all day/evening, and my head only began to clear around 11:30pm. I was totally clear headed by 1am. I went to bed and of course couldn't sleep because my mind/body was nice and alert once the symptoms had subsided, so i had an almost sleepless night :-) boo!

I think the changes in consciousness are perhaps one, if not the most difficult symptom for me to deal with. i hate mind-bending experiences - it's why i don't really drink alcohol.

The Dysautonomia really is crazy! I never know where/how i am from one day to the next, and even one hour to the next at times.

I used to feel that i knew my own body very well - now i feel like i am existing in a strangers body that i simply don't understand

Crazy stuff!

THanks again,

Please take good care of yourselves,

Mike :-)

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