Alpha-delta sleep in patients with a chief complaint of chronic fatigue

Our prospective, standardized cohort study was designed to assess

the presence of alpha wave intrusions during non-rapid eye

movement sleep (alpha-delta sleep) and its relationship to

fibromyalgia, major depression, and chronic fatigue syndrome

(CFS) in patients with a chief complaint of chronic fatigue.

The study group comprised 30 consecutive patients seen at a

university hospital referral clinic for evaluation of chronic

fatigue. All patients had nocturnal polysomnography,

dolorimetric tender point assessment for fibromyalgia, a

comprehensive history, physical, and laboratory evaluation,

and a structured psychiatric interview. Alpha-delta sleep was

identified in 8 of the 30 patients (26%), major depression in

20 (67%), CFS in 15 (50%), and fibromyalgia in 4 (13%). Ten of

the 30 patients (33%) had a primary sleep disorder (sleep

apnea, periodic limb movements, or narcolepsy). Alpha-delta

sleep was not significantly correlated with fibromyalgia, CFS,

major depression, or primary sleep disorders, but was

significantly more common among patients who had chronic

fatigue without major depression. We conclude that primary

sleep disorders are relatively common among patients with

chronic fatigue and must be diligently sought and treated.

Alpha-delta sleep is not a marker of fibromyalgia or CFS, but

may contribute to the illness of nondepressed patients with

these conditions.

Manu P, Lane TJ, Matthews DA, Castriotta RJ, Watson RK, Abeles M

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