**Age/Sex:** 28, Female  
**Height/Weight:** 171 cm, 72 kg  
**Existing Medical Conditions:** Type 1 Diabetes, Sjögren's Syndrome, PCOS, Generalized Anxiety Disorder (GAD), Obstructive Sleep Apnea (OSA), Chronic Sinusitis.  
**Past Surgeries:** Turbinate reduction (nose mussels removed). No other surgeries.  
**Current Treatments:** Mouthguard for sleep apnea, insulin, escitalopram, drospirenone. 

**Primary Complaint:** I am experiencing profound, debilitating exhaustion and severe joint pain all the time. My quality of life has completely tanked—my battery feels like it is constantly on minus. I cannot function after work; I come home and immediately fall asleep, unable to get up to cook or clean. I never feel rested.  
Alongside this crushing fatigue, I have recently noticed a significant amount of unexplained bruising all over my body. Out of all the bruises currently on me, I only know where one came from (walking into a door handle). The other 90% are a total mystery.

**Recent Workup:** I have had extensive laboratory testing recently, but my doctor tells me everything is coming back completely normal.

**My Questions for the Doctors Here:**  
Given that my standard lab work is coming back normal, what other specific tests or blood panels should I ask my doctor for to investigate the sudden influx of unexplained bruises alongside this severe fatigue? (e.g., advanced coagulation factors, specific nutritional deficiencies, or autoimmune flares?)

Could my CPAP alternative (mouthguard) be insufficient for my sleep apnea, contributing to this level of exhaustion, or does this pattern look more like a manifestation of my Sjögren's/autoimmune profile?  
Are there any specific red flags I should watch out for regarding the bruising? 

I am feeling incredibly overwhelmed and desperate for direction. Any insights on what steps to take next with my medical team would be deeply appreciated.

28F - Extreme, debilitating fatigue and multiple unexplained bruises. T1D, Sjögren's, Sleep Apnea. Quality of life is tanking.