Treatment of the narcoleptiform sleep disorder in chronic fatigue syndrome and fibromyalgia with sodium oxybate – Source: Pain Practitioner, Jan-Feb 2010

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[Note: to read the full text of this article free, click here. Note Table 5, which provides the constellation of symptoms and findings the researchers used to identify patients generally fitting their description of “Narcoleptiform Syndrome” – “a sleep disorder with many features of narcolepsy.”]

This study investigates the response of the underlying sleep disorder associated with Chronic Fatigue Syndrome (CFS) and fibromyalgia (FM) to treatment. We retrospectively reviewed 118 cases clinically consistent with CFS or FM, treated in a neurology practice.

Abnormal findings on sleep studies and associated human leukocyte antigen markers, and a clinical pattern suggestive of narcolepsy, are present in a high proportion of patients. [Narcolepsy is a chronic neurological disorder of excessive daytime sleepiness caused by the brain’s inability to regulate sleep-wake cycles normally, and likely involves multiple factors interacting.]

When considered appropriate based on the clinical picture and test results, treatment with sodium oxybate was offered to these patients. [Sodium Oxybate (brand name Xyrem) is a potent central nervous system depressant used to prevent episodes of muscle weakness (cataplexy) in narcolepsy patients, though how it works to do this is not known.]

• Sixty percent of patients treated with oxybate experienced significant relief of pain,

• While 75% experienced significant relief of fatigue.

We postulate that the response to oxybate in CFS and FM suggests a disturbance of sleep similar to narcolepsy. These findings support this novel approach to intervention and further research.

The inability to distinguish CFS and FM by testing and response to treatment suggests that they may represent variations of the same disorder or may be closely related disorders.

Source: Pain Practitioner, Jan-Feb 2010;10(1):54-9. PMID: 20629967, by Spitzer AR, Broadman M. Neurology Department, Wayne State University School of Medicine, Detroit, Michigan, USA. [Email:]