Sleep dysfunction

Sleep dysfunction is nearly universal in ME/CFS patients, although it can take a very wide range of forms. These include dysania, hypersomnia, hypnagogia, insomnia, light sleep, myoclonus, nightmares, night sweats, phase shifting, somnolence, and unrefreshing sleep.

Prevalence

Depending on the criteria used for diagnosis, prevalence can vary greatly.

Symptom recognition

Sleep dysfunction is a core requirement to meet the diagnostic criteria for ME/CFS according to the 2003 Canadian Consensus Criteria, the 2007 Nightingale definition, and the 2015 Institute of Medicine report.

Sleep dysfunction is an optional symptom in the 1988 Holmes criteria, the 1991 Oxford criteria, the 1994 Fukuda criteria, the 2005 Reeves criteria, the 2007 NICE guidelines, the 2012 International Consensus Criteria, and the 2014 London criteria.

Sleep dysfunction is not a criteria listed for diagnosis with the 1986 Ramsay definition.

Notable studies

• 2018, The putative role of oxidative stress and inflammation in the pathophysiology of sleep dysfunction across neuropsychiatric disorders: Focus on chronic fatigue syndrome, bipolar disorder and multiple sclerosis (Abstract)
• 2017, Sleep Quality in Adolescents With Chronic Fatigue Syndrome/Myalgic Encephalomyelitis (CFS/ME) (Abstract)
• 2012, Sleep Abnormalities in Chronic Fatigue Syndrome/Myalgic Encephalomyelitis: A Review (Full Text)
• 2007, Paradoxical NREMS Distribution in “Pure” Chronic Fatigue Patients: A Comparison with Sleep Apnea-Hypopnea Patients and Healthy Control Subjects (Abstract)

Treatment

Treatment can include sedatives, antidepressants, cannabidiol (CBD), meditation and good sleep hygiene practices.

Amitriptyline may be helpful for improving quality of sleep in individuals with CFS. While originally considered an antidepressant, it is also prescribed at low doses to specifically manage pain and sleep for a number of conditions.

myalgic encephalomyelitis (M.E.) - A disease often marked by neurological symptoms, but fatigue is sometimes a symptom as well. Some diagnostic criteria distinguish it from chronic fatigue syndrome, while other diagnostic criteria consider it to be a synonym for chronic fatigue syndrome. A defining characteristic of ME is post-exertional malaise (PEM), or post-exertional neuroimmune exhaustion (PENE), which is a notable exacerbation of symptoms brought on by small exertions. PEM can last for days or weeks. Symptoms can include cognitive impairments, muscle pain (myalgia), trouble remaining upright (orthostatic intolerance), sleep abnormalities, and gastro-intestinal impairments, among others. An estimated 25% of those suffering from ME are housebound or bedbound. The World Health Organization (WHO) classifies ME as a neurological disease.

chronic fatigue (CF) - Persistent and abnormal fatigue is a symptom, not an illness. It may be caused by depression, multiple sclerosis, fibromyalgia, chronic fatigue syndrome or many other illnesses. The term "chronic fatigue" should never be confused with the disease chronic fatigue syndrome.

stress Stress can by either physical or psychological, or both. Stress is either 1) a state of emotional or psychological strain or 2) the physical stress (pressure or tension) that a physical object such the human body is placed under, e.g., a stress test is a medical test that monitors the cardiovascular system during strenuous exercise.