MGSnuggler,

Acetylcholine is necessary for many bodily functions, including sleep.

http://thebrain.mcgill.ca/flash/d/d_...11_cl_cyc.html

https://books.google.com/books?id=kW...ulness&f=false

When you have too much acetylcholine, you can become depressed. Too little, and you can become weak and sleepy, particularly for MGers.

This is biochemistry 101. I guess a lot of doctors had low acetylcholine during that course.

Yes, JJ, there IS scientific proof!

If you hang out at home, resting between doing things, you might not get sleepy or need a nap.

If you run a few errands, your body uses up acetylcholine faster. When I do that, my body puts me to sleep after I get home. There's no fighting it! I'm out like a light.

We have a reduced area where acetylcholine can get into the muscle receptors due to the antibody attack. So it's not only how much we "use up," but how quickly our body can adjust to that need.

Think of it as a "supply and demand" situation.

And other factors that can make it worse are heat/cold, stress, lack of sleep, infection, etc.

I realize that doctors like things simple, but this is not a simplistic disease! Many factors come into play, such as how many cholinesterase inhibitors you consume every day (besides Mestinon, such as caffeine).

HOWEVER, ruling out other causes for fatigue is crucial. Many of us have had B12 deficiencies. On Cellcept, you might have iron deficiency anemia. A under active thyroid can cause similar issues.

So see your primary doctor for a once over to make sure nothing else is going on! And don't feel guilty about napping! Don't doctors know that it's one of the first signs of MG?!!!

Annie