Significantly Elevated Cortisol Levels, only at night.
Hello, here is information about what I have going on. Feel free to ask any questions, and I am only looking for suggestions and comments about what I should do from here.
I am 22 years old, male, and weight 195 pounds, with a muscular build.
-Severe Brain Fog
-Depression Symptoms, mostly loss of motivation and pleasure from activities I used to enjoy
-Sleep issue being that I wake up in the middle of the night gasping for breath, feeling like I had a rush of adrenaline with heart racing
I have been experiencing these symptoms my entire life and they have gotten progressively worse, with the exception for the sleep issue, which has gotten worse since I gained weight over the past few months.
I took an at home cortisol test, and my levels were extremely elevated from the 1st collection I took, immediately after waking at 8am. The 4th collection after dinner was slightly low. This was a urine test. I slept all night without issue before the test.
1st collection: 88 ug/g (normal range 7.8-29.5)
2nd collection: 23.7 ug/g (normal range 23.4-68.9)
3rd collection: 10 ug/g (normal range 30.6-88.5)
4th collection: 15.2 ug/g (normal range 15.5-44.7)
I believe I have REM-induced sleep apnea, which explains why my entire life I seemed to not dream much. I am working with a sleep doctor on this now, but progress is slow. My main question is as follows:
My 1st collection cortisol level was very elevated, nearly 3 times the normal amount. What can explain such a high cortisol level? Could emotional stress cause it to be this high? Could it be explained by the apnea? Or are levels this high only seen with an adrenal tumor/Cushing's disease?
I am trying to find the root cause of the issues I have had my entire life. I believe there is a physical aspect causing the psychological issues to be this bad. I have bought a CPAP machine from a friend and am using it, since progress from sleep doctor and getting diagnosed is very slow. I feared without doing this on my own I would not be able to function day to day anymore due to lack of sleep, or that I might have a cardiovascular event due to the severe adrenaline/heart pounding events. My first sleep study did not pick up any apneas, but I only obtained light sleep, and only 2.5 hrs of it due to anxiety from the study/environment. Since using the CPAP I have been experiencing rebound REM, very vivid dreams almost every night. If my mask comes loose, or I have a leak in air pressure, I wake up gasping for breath, and the dream turns violent in an attempt to wake me up.
I guess my main concern and reason for posting is to find out whether its worth it right now to pursue investigating with my primary doctor the elevated cortisol levels, if there is a chance that my root cause is related to that, or if I should just keep using my CPAP and working with a sleep doctor to see if my symptoms slowly improve over time. Since using the CPAP for about a week now, I do not feel any better. I really need information/suggestions because being that I am young, look healthy, and have normal routine blood work, doctors in my area have always been dismissive. Every diagnostic test I have had aside from routine blood work I had to bring it up and ask for it. I have been going to therapy my whole life, and tried antidepressants when I was in my teens for several years. Treating only the psychological aspects has gotten me no progress.
Thank you in advance, help is much needed.