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, sleep phase shifting, somnolence, and unrefreshing sleep.

Prevalence

 * 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.

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, Circadian rhythm abnormalities and autonomic dysfunction in patients with Chronic Fatigue Syndrome/Myalgic Encephalomyelitis (Full Text)
 * 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.