I’m totally following your logic, Ed. Besides waking up tired, you’re also exhausted during the daytime with shortness of breath upon exertion. The standard for RBC in men is 4.7 to 6.1 million/mcL. Your count is under that at 3.9 with some abnormalities in the shapes of your red blood cells. That can inhibit the oxygen carrying ability of the cell. So, along with the decrease in amount of cells, it carries to reason this could be making you tired, especially since your heart, lungs and other organs check out fine.

It just occurred to me, you might want to consider purchasing an oximeter for a few dollars at a drugstore. I’m sure you’ve had this done at the doctor’s office. It’s the little monitor that clips on your figure tip and gives an immediate reading of your blood oxygen level. You could wear it any time. Then if the readings are low, particular between the times when you’re tired or breathless, that could be useful information for you and your medical team.
When’s your sleep study?

Have your Iron levels been checked? I had the exact symptoms as you but found my Iron levels were extremely low which affects your Red Cell levels.. (This occurred a couple of months after the Pfizer vaccine) There is another discussion on the forum for low iron. I have had two Iron infusions and my levels are on the way back up.