Sleep dysfunction

Sleep dysfunction is 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.

Symptom recognition

 * In the Holmes criteria, sleep disturbance is an optional criteria for diagnosis, under the section Minor Symptom Criteria.
 * With the Systemic Exertion Intolerance Disease criteria, unrefreshing sleep is a core requirement for diagnosis.

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
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.