Systematic Review of Sleep Characteristics in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome

Abstract

(1) Background—Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) is a multifaceted illness characterized by profound and persistent fatigue unrelieved by rest along with a range of other debilitating symptoms. Experiences of unrefreshing and disturbed sleep are frequently described by ME/CFS patients. This is the first systematic review assessing sleep characteristics in ME/CFS. The aim of this review is to determine whether there are clinical characteristics of sleep in ME/CFS patients compared to healthy controls using objective measures such as polysomnography and multiple sleep latency testing. (2) Methods—the following databases—Pubmed, Embase, Medline (EBSCO host) and Web of Science, were systematically searched for journal articles published between January 1994 to 19 February 2021. Articles that referred to polysomnography or multiple sleep latency testing and ME/CFS patients were selected, and further refined through use of specific inclusion and exclusion criteria. Quality and bias were measured using the Joanna Briggs Institute checklist. (3) Results—twenty observational studies were included in this review. The studies investigated objective measures of sleep quality in ME/CFS. Subjective measures including perceived sleep quality and other quality of life factors were also described. (4) Conclusions—Many of the parameters measured including slow- wave sleep, apnea- hypopnea index, spectral activity and multiple sleep latency testing were inconsistent across the studies. The available research on sleep quality in ME/CFS was also limited by recruitment decisions, confounding factors, small sample sizes and non-replicated findings. Future well-designed studies are required to understand sleep quality in ME/CFS patients.

ME/CFS and Long COVID share similar symptoms and biological abnormalities: road map to the literature

“…Positive studies: non-restorative sleep, restlessness, insomnia, sleep apnea more common in people with ME/CFS (187), although formal sleep laboratory studies have produced inconsistent results (188,189). Meta-analysis of studies of ˜1300 adults and adolescents finds longer sleep latency, reduced sleep efficiency, increased longer REM latency, longer bedtime, and altered sleep microstructure (190).…”

Neurophysiological determinants of occupational stress and burnout

“…At the same time, IAF is associated with the features of the white matter structure (fiber density, axon diameter, myelination), and also reflects various other neuronal processes [30]. In turn, PAF is associated with reduced cerebral blood flow and reduced brain oxygenation and correlates negatively with subjective assessments of fatigue, including total fatigue [31] and cognitive readiness [32], including worse results in memory tasks [33] (fig. 3).…”

Assessing sleep and pain among adults with myalgic encephalomyelitis/chronic fatigue syndrome: psychometric evaluation of the PROMIS® sleep and pain short forms

“…Research using various self-report measures found that 87–95% of ME/CFS patients reported unrefreshing sleep [ 1 , 25 – 28 ], and ME/CFS patients showed significantly poorer sleep quality and more daytime dysfunction compared to healthy controls [ 29 – 31 ]. In contrast, studies implementing objective sleep measures [ 32 ] often did not observe more sleep-related difficulties in those with ME/CFS than in healthy controls [ 33 – 35 ].…”