Sleep dysfunction

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Sleep dysfunction is nearly universal in ME/CFS patients, although it can take a very wide range of forms. A 2017 study by Davidson, et al, found up to 96.8% of people with CFS report unrefreshing sleep and many describe changes in sleep over the course of their illness.[1]

Some of these sleep dysfunctions include:

  • dysania[2] (a state of finding it hard to get out of bed in the morning; in ME/CFS it can an extended period lasting several hours after awakening)
  • hypersomnia (sleeping too much)
  • hypnagogia (transitional state from wakefulness to sleep during which lucid thought, lucid dreaming, hallucinations and, sleep paralysis can occur)
  • insomnia (difficulty falling asleep, staying asleep, and/or waking up too early in the morning)
  • light sleep (a non-REM stage and the easiest sleep stage to awaken from)
  • myoclonus (an involuntary twitch which occurs when a person is beginning to fall asleep, causing them to jump and awaken)
  • nightmares (a frightening or unpleasant dream)
  • night sweats (excessive sweating while you sleep)
  • sleep phase shifting[3] (a shift in circadian rhythm; a sleep-wake cycle that does not correspond to the day-night cycle)
  • somnolence (sleepiness)
  • unrefreshing sleep (poor-quality sleep that doesn't relieve fatigue)

Prevalence[edit | edit source]

  • Depending on the criteria used for diagnosis, prevalence can vary greatly.
  • In a 2001 Belgian study, 91.9% of patients meeting the Fukuda criteria and 94.8% of patients meeting the Holmes criteria, in a cohort of 2073 CFS patients, reported sleep disturbances.[4]

Symptom recognition[edit | edit source]

Sleep dysfunction is a core requirement to meet the diagnostic criteria for ME/CFS according to the 2003 Canadian Consensus Criteria,[5] the 2007 Nightingale definition,[6] and the 2015 Institute of Medicine report.[7]

Sleep dysfunction is an optional symptom in the 1988 Holmes criteria,[8] the 1991 Oxford criteria,[9] the 1994 Fukuda criteria,[10] the 2005 Reeves criteria,[11] the 2007 NICE guidelines,[12] the 2012 International Consensus Criteria[13], and the 2014 London criteria.[14]

Sleep dysfunction is not a criteria listed for diagnosis with the 1986 Ramsay definition.[15]

Notable studies[edit | edit source]

Treatment[edit | edit source]

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. [21][22] While originally considered an antidepressant, it is also prescribed at low doses to specifically manage pain and sleep for a number of conditions.

References[edit | edit source]

  1. Davidson, Sean L.; Gotts, Zoe M.; Ellis, Jason G.; Newton, Julia L. (Mar 2017), "Two year follow-up of sleep diaries and polysomnography in chronic fatigue syndrome: a cohort study", Fatigue: Biomedicine, Health & Behavior, doi:10.1080/21641846.2017.1297280 
  2. https://ammes.org/symptoms-of-mecfs/
  3. Cambras T, Castro-Marrero J, Zaragoza MC, Díez-Noguera A, Alegre J (2018) Circadian rhythm abnormalities and autonomic dysfunction in patients with Chronic Fatigue Syndrome/Myalgic Encephalomyelitis. PLoS ONE 13(6): e0198106. https://doi.org/10.1371/journal.pone.0198106
  4. De Becker, P; McGregor, N; De Meirleir, K (Sep 2001), "A definition-based analysis of symptoms in a large cohort of patients with chronic fatigue syndrome.", Journal of Internal Medicine, 250 (3): 234-240, PMID 11555128 
  5. http://www.tandfonline.com/doi/abs/10.1300/J092v11n01_02#.VmfS2GHXJhE
  6. http://www.nightingale.ca/documents/Nightingale_ME_Definition_en.pdf
  7. http://iom.nationalacademies.org/~/media/Files/Report%20Files/2015/MECFS/MECFS_ProposedDiagnosticCriteria?_ga=1.14761526.1865741811.1437002921
  8. https://www.ncbi.nlm.nih.gov/pubmed/2829679
  9. https://www.ncbi.nlm.nih.gov/pubmed/1999813
  10. https://www.ncbi.nlm.nih.gov/pubmed/7978722
  11. https://www.ncbi.nlm.nih.gov/pubmed/16356178
  12. https://www.nice.org.uk/guidance/CG53/chapter/1-Guidance#diagnosis
  13. http://onlinelibrary.wiley.com/doi/10.1111/j.1365-2796.2011.02428.x/full
  14. http://www.axfordsabode.org.uk/me/mecrit2014.htm
  15. The Clinical Features of Myalgic Encephalomyelitis
  16. Olivier Le Bon, Daniel Neu, Filomena Valente & Paul Linkowski. (2007). Health-Related Quality of Life in Chronic Fatigue Syndrome versus Rheumatoid Arthritis as Control Group. Journal of Chronic Fatigue Syndrome, Vol. 14, Iss. 2, pp. 45-59. DOI:10.1300/J092v14n02_05
  17. Jackson, ML; Bruck, D (2012), "Sleep Abnormalities in Chronic Fatigue Syndrome/Myalgic Encephalomyelitis: A Review, Journal of Clinical Sleep Medicine", Journal of Clinical Sleep Medicine, 8 (6): 719-28, doi:10.5664/jcsm.2276 
  18. Josev, EK; Jackson, ML; Bei, B; Trinder, J; Harvey, A; Clarke, C; Snodgrass, K; Scheinberg, A; Knight, SJ (2017), "Sleep Quality in Adolescents With Chronic Fatigue Syndrome/Myalgic Encephalomyelitis (CFS/ME)", Academy of Sleep Medicine, 13 (9): 1057–1066, doi:10.5664/jcsm.6722 
  19. Cambras, T.; Castro-Marrero, J.; Zaragoza, MC.; Díez-Noguera, A.; Alegre, J. (2018), "Circadian rhythm abnormalities and autonomic dysfunction in patients with Chronic Fatigue Syndrome/Myalgic Encephalomyelitis", PLoS ONE, 13 (6): e0198106, doi:10.1371/journal.pone.0198106 
  20. Morris, Gerwyn; Stubbs, Brendon; Köhler, Cristiano A.; Walder, Ken; Slyepchenko, Anastasiya; Berk, Michael; Carvalho, André F. (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", Sleep Med Reviews, doi:10.1016/j.smrv.2018.03.007, PMID 29759891 
  21. http://sacfs.asn.au/download/guidelines.pdf
  22. http://www.nhs.uk/Conditions/Chronic-fatigue-syndrome/Pages/Treatment.aspx


The information provided at this site is not intended to diagnose or treat any illness.

From MEpedia, a crowd-sourced encyclopedia of ME and CFS science and history