Over the last three years, I periodically wake up in the middle of the night, vomit and then feel absolutely fine until it happens again. What to investigate?
I am a 30-year-old female. This has been going on for approximately three years. I otherwise am not prone to stomach bugs, vomiting for other reasons, etc. Frankly, I can't remember any other time I've vomited not between midnight and 2 AM probably since college. I am slightly overweight, mild asthma, environmental allergies. I take medication for ADHD and history of depression. Lexapro, Concerta, armodafinil. I take an oral contraceptive pill all of these medication's pre-date the start of these bizarre episode episodes.
Here's how they go. I eat dinner probably around 7 PM. Usually it's something normal but I've noticed it's slightly more likely to happen if I've had a really rich or filling meal. It's also more likely to occur if I've had alcohol, but again not exclusive probably half-and-half now of times I've had alcohol and times I have not.
I go to bed around normal probably 10 or so p.m. I then wake up in a cold sweat, elevated heart rate and incredibly nauseous around midnight to 2 AM. It's always out of a dead sleep so I don't feel fully awake or alert. Sometimes I can get through the episodes without vomiting, but most of the time I do end up vomiting. Sometimes I will actually try to induce vomiting because I know I will immediately feel better after vomiting. Typically my stomach is nearly empty and it's a very acidic vomit with no solid matter in it.
I then feel totally fine alert fully awake and then return to bed as if nothing happened. Sometimes I will also have some G.I. changes the next day but nothing major like I have a bug or ate something really bad. I also will often take something like a Pepto-Bismol after these vomiting episodes or before in an effort to prevent them when I start feeling nauseous, so I'm not sure if the slight changes in stool or just due to the Pepto.
These episodes tend to occur in bunches. For instance, this has happened the last two nights in a row with no clear rhyme or reason. I then can go a week a month several months without anything only to have it suddenly repeat.
I have several theories, but I really have no idea what is going on here given how specific in time limited these episodes are. Theories:
This is some sort of acid reflux, induced event, although I don't know why I don't go on to have any stomach symptoms the next day like heartburn or whatever if that is the case. There's also no real link between what I eat and the episode episodes other than it seems to be slightly more common if I have over eaten.
Some sort of reaction between medication and how empty my stomach is. But again it's so rare and the medication is so consistent that it really doesn't seem to make sense.
Early signs of something medical? Gallbladder attacks? Low blood sugar events? Again they only happen during the night but it's also the only time I'm fasting for that period of time.
Maybe a stretch but could be some kind of sleep disordered event? I know there are weird sleep disorders out there. Could I be sleepwalking? Sleep vomiting is the opposite of sleep eating? Again, I don't feel fully in my right mind in these moments, but I also feel incredibly ill so I don't know what that is all about. I also do remember the event events… As far as I know it's not happening when I'm not awake. I do have excessive daytime sleepiness that is medically treated. I sleep soundly with no wake ups other than these episodes obviously but I have questioned a possible sleep disorder given my daytime sleepiness I have had symptoms like the presentation of narcolepsy.
So far because of the infrequent nature of this, the doctors, I've mentioned it to. You don't seem super alarmed. Thinking probably just something I ate or you know I ate too much. I would love to hear any series of things to look into or to advocate my doctors look at to rule out anything medical or concerning and try to figure out how to get these episodes to stop.