I think you're considering all the right things...Lupus, Lyme, Sleep Apnea and/or Hyperthyroid, etc.
Have you been treating the Lupus at all in the last 5 years? I wouldn't be surprised if it comes back with different symptoms. Trot on back to your rheumy!
My rheumy is very clear on his terms, he says Lupus can be "quiet" but just by the nature of the disease it is never in "remission". That seems to be a common way to look at it by all rheumys here (major metropolitan area).
Let us know!
Lynnwood, Lupus & Sjogren's ModeratorDIAGNOSING LUPUS & LUPUS RESOURCES
"Life is far too important to be taken seriously" - Oscar Wilde