One of the most common sleep related symptoms in MCAS patients is chronic, debilitating fatigue.
It’s also a common symptom of many auto-immune disorders and there’s even a theory about allergies being linked to CFS (chronic fatigue syndrome):
CFS has sometimes been referred to as the “chronic fatigue immune dysfunction syndrome.” … One theory is that allergens, like viral infections, may trigger a cascade of immune abnormalities that lead to CFS. However, most allergic people do not have CFS.
Of course we aren’t simply “allergic people” (if only!). Our mast cell dysfunction can trigger allergic reactions and chronic inflammation in parts of the brain, like the hypothalamus which coincidentally have direct control over our sleep cycle:
The ventrolateral preoptic nucleus (VLPO or VLPN) of the hypothalamus is one area of the brain that is particularly involved in the switch between wakefulness and sleep. Neurons in this small area help to promote sleep by inhibiting activity in areas of the brainstem that maintain wakefulness.
Unsurprisingly, researchers have found a link between the hypothalamus region and chronic fatigue syndrome:
Hypothalamic-pituitary-adrenal (HPA) axis dysfunction has been found in a high proportion of chronic fatigue syndrome (CFS) patients and includes enhanced corticosteroid-induced negative feedback, basal hypocortisolism, attenuated diurnal variation, and a reduced responsivity to challenge.
That brings me back to my own research into mast cell degranulation and inflammation in the brain, which I wrote about recently, specifically inflammation in the thalamus and hypothalamus:
The thalamus is involved in sensory and motor signal relay and the regulation of consciousness and sleep.
The thalamus may also be involved in the regulation of some types of memory. The thalamus and the cerebral cortex operate in a feedback loop, especially when it comes to the sleep/wake cycle. The thalamus not only sends signals to the cortex, but the cortex in turn sends signals back to the thalamus.
So, to summarize:
Mast cell degranulation causes inflammation in the brain which equals sleep (and other) problems.
That didn’t take long to connect the dots, but the question is, what can we do about it?
I hate to pull out the old standard ‘take your medicines and avoid your triggers’ advice, but you know what? It actually worked for me. I’m no longer debilitated by the fatigue and I sleep much better at night. After a lifetime of sleep problems.
Of course fatigue is just one aspect of CFS, so finding relief is much more complex than this. However, understanding the connection between MCAD and chronic fatigue is a step in the right direction.