In a previous post it was mentioned that lyme patients often have low cortisol in the day and high at night...this can be an early sign of adrenal insufficiency. I can only speak from my experience...I have lyme, co-infections, hypothyroid and Addison Disease. Sleeping problems, hypoglycemia, and adrenaline rushes were some of my early symptoms of Adrenal failure.
My cortisol levels would drop too low and then my blood sugar would fall too low...when the body does not have the ability to produce the cortisol it needs to keep the blood sugar from continuing to plummet it reverts to its' emergency backup...adrenaline. So I would wake up at night sweating, heart racing, wide awake because I had had an adrenaline rush to bring the blood sugar back up. At this point if I tested the blood sugar it would be high because of the adrenaline, but would not stay stable. It would begin to drop because the cortisol is what stabilizes the blood sugar.
Many low cortisol symptoms can be the same as lyme...muscle aches, joint pain, brain fog, nausea, feeling irritable, depressed, etc.
The only way to know for sure if adrenal insufficiency is a problem is to run tests on cortisol and aldosterone levels, ACTH, DHEA-S, and the ACTH stim test is the gold standard for diagnosing adrenal problems.
Unfortunately, my experience has been that many, many drs. do not acknowledge adrenal insuficiency, especially if you don't have the hyperpigmentation (darkening of the skin). If the adrenal problems are caused by lyme and infections the hyperpigmentation often does not develop because of the more rapid onset.
All of this is to say that low cortisol could be contributing to your problems, but you will need to find a doctor who will listen to you and run the right tests to know for sure.
Hope this is helpful.
Feel better soon :-)