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My sleep issue turned out to be related to my diaphragm and chest muscles not tolerating REM sleep. My oxygen levels drop into the 70s during REM. I am exhausted when I wake up and during the day. I can’t take any sleeping pills, not even benadryl because it really causes all my muscles to get weak and sets of the MG. I had a pulmonologist and we were trying Bipap/AVS but she left town and the office never let me know. So just found a new pulmonologist and we are working on it. I’m not tolerating the Bipap due to pretty significant bulbar symptoms and upper airway collapse. I can’t sleep on my sides because I also have a connective tissue disease and apparently my lower esophageal sphincter is not working. So I sleep practically sitting up for the moment. Very frustrating!! I do have trouble falling asleep sometimes and that is so annoying! I’m glad that you can take medications to help. I highly recommend a sleep study. I just bought a pulse oximeter for my finger and wore it overnight a few times and quickly found the problem. Then went for a sleep study. I was really surprised because I did not suspect that I had a sleep disorder. Good luck, Julie