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]

Fibromyalgia patients also suffer from sleep disorders.[2]

Types of Sleep dysfunction[edit | edit source]

Some of these sleep dysfunctions include:

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.[7]
  • 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]

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,[8] the 2007 Nightingale definition,[9] and the 2015 Institute of Medicine report.[10]

Sleep dysfunction is an optional symptom in the 1988 Holmes criteria,[11] the 1991 Oxford criteria,[12] the 1994 Fukuda criteria,[13] the 2005 Reeves criteria,[14] the 2007 NICE guidelines,[15] the 2012 International Consensus Criteria.[16], and the 2014 London criteria.[17]

Sleep dysfunction is not a criteria listed for diagnosis with the 1986 Ramsay definition.[18]

Notable studies[edit | edit source]

  • 2007, Paradoxical NREMS Distribution in “Pure” Chronic Fatigue Patients: A Comparison with Sleep Apnea-Hypopnea Patients and Healthy Control Subjects[19] - (Abstract)
  • 2012, Sleep Abnormalities in Chronic Fatigue Syndrome/Myalgic Encephalomyelitis: A Review[20] - (Full Text)
  • 2017, Sleep Quality in Adolescents With Chronic Fatigue Syndrome/Myalgic Encephalomyelitis (CFS/ME)[21] - (Full text)
  • 2018, Circadian rhythm abnormalities and autonomic dysfunction in patients with Chronic Fatigue Syndrome/Myalgic Encephalomyelitis[22] - (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[23] - (Abstract)
  • 2018, Association of sleep disorders, chronic pain, and fatigue with survival in patients with chronic kidney disease: A meta-analysis of clinical trials[24] - (Abstract)

Treatment[edit | edit source]

Treatment can include non-benzodiazepine hypnotics, or benzodiazepine hypnotics, other sedatives, sedating antidepressants, cannabidiol (CBD), melatonin, vitamin B12, meditation and good sleep hygiene practices.[citation needed]

Amitriptyline, a sedating antidepressant, may be helpful for improving quality of sleep in individuals with CFS.[25][26] While originally considered an antidepressant, it is also prescribed at low doses to specifically manage pain and sleep for a number of conditions.

See also[edit | edit source]

  • Buspirone challenge test (the degree of prolactin released by buspirone in ME/CFS patients correlates to the degree of shift in their sleep/wake cycle).

References[edit | edit source]

  1. 1.01.1 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. "Fibromyalgia Sufferers Have Difficulty Maintaining Continuous Sleep, Study Says". National Pain Report. Mar 25, 2016. Retrieved Aug 20, 2018. 
  3. "Symptoms of ME/CFS – American ME and CFS Society". ammes.org. Retrieved Aug 29, 2018. 
  4. "The role of insomnia in the treatment of chronic fatigue". Journal of Psychosomatic Research. 78 (5): 427–432. May 1, 2015. doi:10.1016/j.jpsychores.2014.11.022. ISSN 0022-3999. 
  5. Viola-Saltzman, Mari; Watson, Nathaniel F.; Bogart, Andy; Goldberg, Jack; Buchwald, Dedra (Oct 15, 2010). "High prevalence of restless legs syndrome among patients with fibromyalgia: a controlled cross-sectional study". Journal of clinical sleep medicine: JCSM: official publication of the American Academy of Sleep Medicine. 6 (5): 423–427. ISSN 1550-9389. PMID 20957840. 
  6. Cambras, Trinitat; Castro-Marrero, Jesús; Zaragoza, Maria Cleofé; Díez-Noguera, Antoni; Alegre, José (Jun 6, 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. ISSN 1932-6203. PMID 29874259. 
  7. De Becker, Pascale; McGregor, Neil; De Meirleir, Kenny (December 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. doi:10.1046/j.1365-2796.2001.00890.x. 
  8. Carruthers, Bruce M.; Jain, Anil Kumar; De Meirleir, Kenny L.; Peterson, Daniel L.; Klimas, Nancy G.; Lerner, A. Martin; Bested, Alison C.; Flor-Henry, Pierre; Joshi, Pradip (2003). "Myalgic Encephalomyelitis/Chronic Fatigue Syndrome". Journal of Chronic Fatigue Syndrome. 11 (1): 7–115. doi:10.1300/j092v11n01_02. ISSN 1057-3321. 
  9. "The Nightingale, Myalgic Encephalomyelitis (M.E.) Definition" (PDF). investinme.org. Jan 2007. 
  10. "Proposed Diagnostic Criteria for ME/CFS". nationalacademies.org. 2015. 
  11. Holmes, G. P.; Kaplan, J. E.; Gantz, N. M.; Komaroff, A. L.; Schonberger, L. B.; Straus, S. E.; Jones, J. F.; Dubois, R. E.; Cunningham-Rundles, C. (1988). "Chronic fatigue syndrome: a working case definition". Annals of Internal Medicine. 108 (3): 387–389. ISSN 0003-4819. PMID 2829679. 
  12. Sharpe, M. C.; Archard, L. C.; Banatvala, J. E.; Borysiewicz, L. K.; Clare, A. W.; David, A.; Edwards, R. H.; Hawton, K. E.; Lambert, H. P. (1991). "A report--chronic fatigue syndrome: guidelines for research". Journal of the Royal Society of Medicine. 84 (2): 118–121. ISSN 0141-0768. PMID 1999813. 
  13. Fukuda, K.; Straus, S. E.; Hickie, I.; Sharpe, M. C.; Dobbins, J. G.; Komaroff, A. (Dec 15, 1994). "The chronic fatigue syndrome: a comprehensive approach to its definition and study. International Chronic Fatigue Syndrome Study Group". Annals of Internal Medicine. 121 (12): 953–959. ISSN 0003-4819. PMID 7978722. 
  14. Reeves, William C.; Wagner, Dieter; Nisenbaum, Rosane; Jones, James F.; Gurbaxani, Brian; Solomon, Laura; Papanicolaou, Dimitris A.; Unger, Elizabeth R.; Vernon, Suzanne D. (Dec 15, 2005). "Chronic fatigue syndrome--a clinically empirical approach to its definition and study". BMC medicine. 3: 19. doi:10.1186/1741-7015-3-19. ISSN 1741-7015. PMID 16356178. 
  15. "Chronic fatigue syndrome/myalgic encephalomyelitis (or encephalopathy): diagnosis and management | Guidance and guidelines | NICE". www.nice.org.uk. Aug 2007. Retrieved Aug 29, 2018. 
  16. Carruthers, B. M.; Sande, M. I. van de; Meirleir, K. L. De; Klimas, N. G.; Broderick, G.; Mitchell, T.; Staines, D.; Powles, A. C. P.; Speight, N. (Oct 1, 2011). "Myalgic encephalomyelitis: International Consensus Criteria". Journal of Internal Medicine. 270 (4). doi:10.1111/j.1365-2796.2011.02428.x/full. ISSN 1365-2796. 
  17. "ME/CFS Medical Update (Layman's version) Winter 2001". www.axfordsabode.org.uk. Retrieved Aug 29, 2018. 
  18. "Ramsay's Definition of M.E., 1986". www.cfids-me.org. Retrieved Aug 29, 2018. 
  19. Bon, Olivier Le; Neu, Daniel; Valente, Filomena; Linkowski, Paul (2007). "Paradoxical NREMS Distribution in "Pure" Chronic Fatigue Patients". Journal of Chronic Fatigue Syndrome. 14 (2): 45–59. doi:10.1300/j092v14n02_05. ISSN 1057-3321. 
  20. 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 
  21. Josev, Elisha K.; Jackson, Melinda L.; Bei, Bei; Trinder, John; Harvey, Adrienne; Clarke, Cathriona; Snodgrass, Kelli; Scheinberg, Adam; Knight, Sarah J. (Sep 15, 2017). "Sleep Quality in Adolescents With Chronic Fatigue Syndrome/Myalgic Encephalomyelitis (CFS/ME)". Journal of Clinical Sleep Medicine. 13 (09): 1057–1066. doi:10.5664/jcsm.6722. ISSN 1550-9389. PMC 5566461Freely accessible. PMID 28760189. 
  22. 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 
  23. 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 
  24. Yang, Xiu Hong; Zhang, Bao Long; Gu, Yan Hong; Zhan, Xiao Li; Guo, Li Li; Jin, Hui Min (2018). "Association of sleep disorders, chronic pain, and fatigue with survival in patients with chronic kidney disease: a meta-analysis of clinical trials". Sleep Medicine. 51: 59–65. doi:10.1016/j.sleep.2018.06.020. ISSN 1389-9457. 
  25. "ME/CFS Guidelines - Management Guidelines for General Practitioners" (PDF). sacfs.asn.au. 
  26. "Treatment - Chronic fatigue syndrome (CFS/ME)". nhs.uk. Retrieved Aug 29, 2018. 

Myalgic encephalomyelitis or M.E. has different diagnostic criteria to chronic fatigue syndrome; neurological symptoms are required but fatigue is an optional symptom.<ref name="ICP2011primer">{{Citation

Myalgic encephalomyelitis or chronic fatigue syndrome


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