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Sleep characteristics of persons with chronic fatigue syndrome and non-fatigued controls: results from a population-based study.

Reeves WC, Heim C, Maloney EM, Solomon Youngblood L, Unger ER, Decker MJ, Jones JF, Rye DB
Sleep characteristics of persons with chronic fatigue syndrome and non-fatigued controls: results from a population-based study. BMC Neurology 2006;6:41
The complete electronic version of this article is available at http://www.biomedcentral.com/1471-2377/6/41

Summary

Most persons with CFS complain of unrefreshing sleep and this is one of the syndrome defining symptoms. However, previous studies of sleep pathology accompanying CFS have produced inconsistent findings and have not identified a characteristic disturbance in sleep architecture of distinctive pattern of polysomnographic abnormalities associated with CFS. This paper reports findings from 2-overnight polysomnographic studies and a multiple sleep latency evaluation of 43 individuals with CFS identified from the general population of Wichita and 43 non-fatigued matched controls from the same population. There were no significant differences in occurrence of primary sleep disorders between those with CFS and their matched controls. Similarly, there were no differences in any measured sleep parameters between the two groups, nor were there differences between the two groups with respect to daytime multiple sleep latency tests. Sleep abnormalities are an unlikely contributor to the pathophysiology of CFS – although the illness may involve sleep-state misperception.

Abstract

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.

Conclusion: 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.

Page last modified on October 24, 2007

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