Measurable sleep disruption in ME/CFS
Australian researchers reviewed the research which used objective measures, rather than patient surveys, to uncover the type and extent of sleep disruption in ME/CFS.
Adult ME/CFS patients:
- spend longer time in bed
- longer sleep onset latency (the time it takes to fall asleep after turning the lights out)
- longer awake time after sleep onset
- reduced sleep efficiency (% of time asleep while in bed)
- decreased stage 2 sleep
- more Stage 3, and longer rapid eye movement sleep latency
Adolescent ME/CFS patients had:
- longer time in bed
- longer total sleep time
- longer sleep onset latency (the time it takes to fall asleep)
- reduced sleep efficiency (% of time spent asleep while in bed)
The four broad stages of Non Rapid Eye Movement sleep include:
- stage 1 – dozing or drowsiness – you hover between being asleep and awake
- stage 2 –you lose awareness of your surroundings, your body temperature starts to drop and your breathing and heart rate slow down
- stages 3 and 4 – deep sleep, also known as ‘delta sleep’ – your blood pressure, heart rate and breathing become very slow and your muscles relax. Growth and repair processes occur during this stage. [from: Sleep explained]
Objective sleep measures in chronic fatigue syndrome patients: a systematic review and meta-analysis, by Abdalla Z Mohamed, Thu Andersen, Sanja Radovic, Peter Del Fante, Richard Kwiatek, Vince Calhoun, Sandeep Bhuta, Daniel F Hermens, Jim Lagopoulos, Zack Y Shan in Sleep Medicine Reviews Vol 69, June 2023 [doi.org/10.1016/j.smrv.2023.101771]
Research abstract
Patients with myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) often report disrupted and unrefreshing sleep in association with worsened fatigue symptoms.
However, the nature and magnitude of sleep architecture alteration in ME/CFS is not known, with studies using objective sleep measures in ME/CFS generating contradictory results. The current manuscript aimed to review and meta-analyse of case-control studies with objective sleep measures in ME/CFS. A search was conducted in PubMed, Scopus, Medline, Google Scholar, and Psychoinfo databases.
After review, 24 studies were included in the meta-analysis, including 20 studies with 801 adults (ME/CFS = 426; controls = 375), and 4 studies with 477 adolescents (ME/CFS = 242; controls = 235), who underwent objective measurement of sleep.
Adult ME/CFS patients spend longer time in bed, longer sleep onset latency, longer awake time after sleep onset, reduced sleep efficiency, decreased stage 2 sleep, more Stage 3, and longer rapid eye movement sleep latency.
However, adolescent ME/CFS patients had longer time in bed, longer total sleep time, longer sleep onset latency, and reduced sleep efficiency.
The meta-analysis results demonstrate that sleep is altered in ME/CFS, with changes seeming to differ between adolescent and adults, and suggesting sympathetic and parasympathetic nervous system alterations in ME/CFS.
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