I have never heard this symptom discussed here, and am quite interested. I had these prior to becoming ill, but I do not have POTS. In all honesty, I never considered it. These went on for a couple of years, and then stopped. ??? How many here have gone through this?
There is so much posted on these forums that it's hard to keep up! I'll start by saying I'm sorry that you went through this combo of symptoms. But this happened before you got ill? I didn't have any symptoms of ME/CFS or NMH/POTS (types of Orthostatic Intolerance) until after I got ill. (Maybe I'm confused by what you mean by ill?)
The specific symptom combination in the title ("3am wake up/adrenaline rush/pain/sweating") may not have been posted or discussed here before. But I do know that several of the individual symptoms have been discussed. So, I've gone through some parts of what was posted.
Night sweats is one topic that has been discussed before (a search should find some of the posts). I got night sweats a lot at the beginning of my illness--first 4-5 years, I think. I don't get them as often now, perhaps a few times a year. They seem to be related to autonomic dysfunction and/or Orthostatic Intolerance.
I also get the frequent awakening. Sometimes, it's just "Huh, I'm awake, I wonder why?" Sometimes it has felt more like a rapid heartbeat awakens me. So, there's a range for me (but no pain for me). I wake up every night. On good nights it's only 4-5 times. On bad nights it can be 12-14 times, maybe more. What it means is that my sleep comes in 20-30 minute stretches.
I always go back to sleep. I'm not nervous, anxious, etc. I'm so used to waking up by now that most of the time I'm not even annoyed. I just roll over and go back to sleep. I don't even look at the clock. I think maybe my daily meditation is helping me with acceptance instead of anger over it (e.g., getting angry is a waste of time and energy whereas going back to sleep, since I am lucky and able to do so, is much more helpful for me).
The more I do during the day -- especially any activity that triggers my problems with NMH -- the worse I sleep at night. Activities that trigger NMH for me include standing, sitting upright, heat, forgetting to take my meds, etc. The more I rest, the better I sleep at night. But the more I rest, the more depressed and frustrated I feel. So, I try to find a balance between 100% rest (which would drive me crazy) and pushing too hard (sleep starts getting worse and worse).
Sleep problems (which includes frequent awakening) are often listed as a symptom of Orthostatic Intolerance (aka, Chronic Orthostatic Intolerance). Here's a symptom list from
http://emedicine.medscape.com/article/902155-overview#aw2aab6b3 :
Chronic Orthostatic Intolerance
In chronic orthostatic intolerance, patients are ill on a day-to-day basis. Chronic orthostatic intolerance may be confused with syncope because chronic illness is sometimes punctuated by acute syncopal episodes. However, this is unusual during real life (albeit common during artificial testing environments), and the author's work suggests no increase in the incidence of syncope above that in the general population. The physician should rely on the patient's history to determine whether chronic illness is present. Thus, chronic orthostatic intolerance is defined by a history of symptoms of orthostatic intolerance present on a day-to-day basis. Defining symptoms of chronic orthostatic intolerance include dizziness in all patients, with high incidence of the following conditions:
- Altered vision (blurred, "white outs", "black outs")
- Fatigue
- Exercise intolerance (frequently post-exercise malaise)
- Nausea
- Neurocognitive deficits
- Sleep problems
- Heat Intolerance
- Palpitations
A large proportion of patients also experience the following symptoms:
- Headache
- Tremulousness
- Difficulty breathing or swallowing
- Sweating
- Pallor
- Other vasomotor symptoms
These symptoms are divisible into symptoms of sympathetic activation and symptoms of reduced cerebral blood flow.
I hope this helps as a start.
The summary is that yes, I've gone through some of these symptoms. But not all of them all at the same time. And
there may be completely different causes for me than for other patients.
For me I'm sure that a large part of these sleep problems are due to my autonomic problems. But the details are hard to pin down. At least I have found that, for me, more rest = better sleep. It's just hard because I can already so little and I don't want to do even less.
One last thing that helps me is skipping dinner at night. And I often substitute a liter of some electrolyte solution like pedialyte (unflavored, generic) for my third liter of water (drink about 3 liters daily). But not eating seems to be opposite of so many ME/CFS patients who have posted that they need to eat lots of snacks, including one before bed, due to blood sugar problems. So, I may be the only one who gets better sleep by not eating dinner.