more pervasive autonomic dysfunction involving any of the following: night sweats or abnormal lack of sweating, urogenital problems (frequent utis, incontinence, frequency, urgency), gastrointestinal problems (chronic constipation, chronic constipation alternating with diarrhea, poor gastric motility), or esophageal/respiratory problems (sleep apnea, abnormal breath sounds during sleep or while awake) indicate possible autoimmune autonomic ganglionopathy or multiple system atrophy.