Hi @peggynurse. Some 10'ish years ago, I was put on Metoprolol (no idea what dosage). Suddenly I could not stay awake more than about 6 hours. Did not matter how much I slept at night or what time I went to be or what time I woke up. After about 4 hours I would start to get foggy and sleepy, and by 6 hours I would be dozing off at my desk, or worse - behind the wheel! I ended up on short-work-days for a while until I changed from Metoprolol to Diltiazem (Tiazac). Within a week or so, my sleep situation was back to normal. Still on it today. My OHCM symptoms always included fatigue, but it was an "exhausted from a hard workout but I'm not sleepy" kind of fatigue rather than an "I just can't keep my eyes open" kind of fatigue - if that makes any sense.