Sleep characteristics of persons with Chronic Fatigue Syndrome and non-fatigued controls: Results from a population-based study

Journal: BMC Neurology. 2006 Nov 16;6(1):41 [E-publication ahead of print]. Note: This is an Open Access article. The complete text in PDF is available for free at http://www.biomedcentral.com/content/pdf/1471-2377-6-41.pdf ] Authors: William C. Reeves, Christine Heim, Elizabeth M. Maloney, Laura Solomon Youngblood, Elizabeth R Unger, Michael J. Decker, James F Jones, David B. Rye. Viral Exanthems & Herpesvirus Branch, Division of Viral & Rickettsial Diseases, Centers for Disease Control & Prevention, Atlanta, GA, USA (Reeves, Maloney, Youngblood, Unger, Jones); Department of Psychiatry and Behavioral Sciences (Heim) and Department of Neurology (Decker, Rye), Emory University School of Medicine, Atlanta, GA, USA. [E-mail: wcr1@cdc.gov ] PMID: 17109739

Background: The etiology and pathophysiology of Chronic Fatigue Syndrome (CFS) remain inchoate. Attempts to elucidate the pathophysiology must consider sleep physiology, as unrefreshing sleep is the most commonly reported of the 8 case-defining symptoms of CFS. Although published studies have consistently reported inefficient sleep and documented a variable occurrence of previously undiagnosed primary sleep disorders, they have not identified characteristic disturbances in sleep architecture or a distinctive pattern of polysomnographic abnormalities associated with CFS.

Methods: This study recruited CFS cases and non-fatigued controls from a population based study of CFS in Wichita, Kansas. Participants spent two nights in the research unit of a local hospital and underwent overnight polysomnographic and daytime multiple sleep latency testing in order to characterize sleep architecture.

Results: Approximately 18% of persons with CFS and 7% of asymptomatic controls were diagnosed with severe primary sleep disorders and were excluded from further analysis. These rates were not significantly different. Persons with CFS had a significantly higher mean frequency of obstructive apnea per hour (p=.003); however, the difference was not clinically meaningful. Other characteristics of sleep architecture did not differ between persons with CFS and controls.

Conclusions: Although disordered breathing during sleep may be associated with CFS, this study generally did not provide evidence that altered sleep architecture is a critical factor in CFS. Future studies should further scrutinize the relationship between subjective sleep quality relative to objective polysomnographic measures.

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