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CFS distinguished from CFS + FM by unique sleep stage pattern

  [ 21 votes ]   [ 4 Comments ] • November 3, 2011

Sleep-Stage Dynamics in Patients with Chronic Fatigue Syndrome with or without Fibromyalgia
– Source: Sleep, Nov 2011

By A Kishi, BH Natelson, et al.


Study Objectives: Chronic fatigue syndrome (CFS) and fibromyalgia (FM) are medically unexplained conditions that often have overlapping symptoms, including sleep-related complaints.

However, differences between the 2 conditions have been reported, and we hypothesized that dynamic aspects of sleep would be different in the 2 groups of patients.

Subjects were:

• 26 healthy control subjects,

• 14 patients with CFS but without FM (CFS alone),

• And 12 patients with CFS and FM (CFS+FM) - all women.

Measurements and Results:
We studied transition probabilities and rates between sleep stages (waking, rapid eye movement [REM] sleep, stage 1 [S1], stage 2 [S2], and slow-wave sleep [SWS]) and duration distributions of each sleep stage.

We found that:

• The probability of transition from REM sleep to waking was significantly greater in subjects with CFS alone than in control subjects, which may be the specific sleep problem for people with CFS alone.

• Probabilities of (a) transitions from waking, REM sleep, and S1 to S2, and (b) those from SWS to waking and S1 were significantly greater in subjects with CFS+FM than in control subjects;

• In addition, rates of these transitions were also significantly increased in subjects with CFS+FM.

• Result (a) might indicate increased sleep pressure in subjects with CFS+FM, whereas result (b) may be the specific sleep problem of subjects with CFS+FM.

• We also found that shorter durations of S2 sleep are specific to patients with CFS+FM, not to CFS alone.

These results suggest that CFS and FM may be different illnesses associated with different problems of sleep regulation.

Source: Sleep (, Nov 2011;34(11):1551-60. PMID:22043126, by Kishi A, Natelson BH, Togo F, Struzik ZR, Rapoport DM, Yamamoto Y. Educational Physiology Laboratory, Graduate School of Education, The University of Tokyo; Japan Society for the Promotion of Science, Tokyo, Japan; Division of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine, NYU School of Medicine, New York, NY; Pain & Fatigue Study Center, Beth Israel Medical Center and Albert Einstein College of Medicine, New York, NY; Department of Work Stress Control, National Institute of Occupational Safety and Health, Kawasaki, Japan

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Article Comments Post a Comment

Your headline is potentially misleading
Posted by: Quila
Nov 3, 2011
The authors of this small study indicates sleep patterns MAY be different. Secondly, it would be much more convincing if they studied FM only patients as well when attempting to contrast the two conditions. Finally, and perhaps there is something in the full paper on this, it would be enlightening to see what is happening in deep sleep in these patient groups. Best, Otis Quila
Reply Reply

Histamine is an excitatory neurotransmitter.
Posted by: Laehcar
Nov 3, 2011
High histamine levels could be a contributing factor in CFS and problems with sleep. Elevated levels of histamine in the body are associated with damage to nerve cells and the central nervous system. Histamine also plays an important role in normal cycles of sleep and wakefulness called circadian rhythms that govern our twenty-four hour day. If levels of histamine don't fall off in the evening deep, restorative sleep will be hard to come by.
Reply Reply

Sleep and PAIN
Posted by: IanH
Nov 3, 2011
You know, there is often a simple explanation when you take into account pain. People with FM are woken from their sleep just like people who have toothache. This study says nothing about the difference between ME and FM. People who have ME with widespread pain (FM) are different from people with just ME in respect to the amount of pain they suffer. But this does not necessarily need a classification difference. Also, I have several patients who, having had ME for over 5 years developed FM at some point in their illness, some did not. (Equally some patients have developed MCS too). The best way to think of this is that some people with ME develop the symptom of wide-spread pain (FM). Without proper bio-markers for each it is not possible to separate them unless the person has FM without ME. To me it is erroneous to think of FM as a disease entity, it is a symptom-set of many underlying illnesses, ME being one of them.
Reply Reply

CFS /FMS/ sleep
Posted by: fotograf
Nov 4, 2011
Mr Otis, you are on the right av. As is the next post, sorry, missed your name. FMS is an umbrella for symptoms suddenly running rampant. Did people present with FMS issues prior to 1980? It seems something is stimulating the nervous system as the sympothetic N system runs 24/7. Sleep studies should include an FMS group. I was dianosed with FMS in 1989. 20 years later I was diagnosed with Lyme, was treated, was thin, gained weight and rosey cheeks and some pain releif. I do not have the sensitve skin issue FMS sufferers nearly always present. I love deep tissue massage and feel that ME might be the underly culprit. Is there a test for ME? Am 55 now and suffer with pain everyday. Sleep is not good. Found Micro dose hydrocordisone to be the most effective in reducing pain, See, Helen Foundation. I made a mistake in dosing and to avoid dev. Cushing syndrome I must wait mid Nov. until able to do another cordisone shower. Cordisone reduces inflammation while supplementing the Adrenals.If the inflammation reduction is so effective why do Motrin type meds do NOTHING to provide pain releif for FMS? Am on a constant battle to not be in pain. So is there a ME test? I tested pos for Epstein Barr in 2009, is there a majic bullet for eliminateing ME? Does anyone know what causes it?


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