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Sleep patterns among patients with chronic fatigue: a polysomnography-based study
Pajediene E1, Bileviciute-Ljungar I2, Friberg D3.
Author information
1 Department of Neurology, Kaunas Clinics, Hospital of Lithuanian University of Health Sciences, Linköping, Sweden.
2 Department of Clinical Sciences, Karolinska Institutet and Department of Rehabilitation Medicine, Danderyd University Hospital, Stockholm, Department of Medical and Health Sciences, Faculty of Medicine and Health Sciences, Linköping University, Pain and Rehabilitation Centre, Anaesthetics, Operations and Specialty Surgery Centre, Region Östergotland, Linköping, Sweden.
3 Department of Clinical Science, Intervention and Technology (CLINTEC), Division of Otorhinolaryngology, Karolinska University Hospital, Stockholm, Sweden.
Clin Respir J. 2017 Jul 28. doi: 10.1111/crj.12667. [Epub ahead of print]
Abstract
OBJECTIVES:
To detect treatable sleep disorders among patients complaining of chronic fatigue by using sleep questionnaires and polysomnography.
METHODS:
Patients were referred to hospital for investigations and rehabilitation due to a suspected diagnosis of myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS). The criteria for further referral to full-night polysomnography (PSG) were symptoms of excessive daytime sleepiness and/or tiredness in the questionnaires.
RESULTS:
Of a total of 381 patients, 78 (20.5%) underwent PSG: 66 women and 12 men, mean age 48.6, standard deviation ±9.9 years. On the basis of the PSG, 31 (40.3%) patients were diagnosed with obstructive sleep apnoea, 7 (8.9%) patients with periodic limb movement disorder, 32 (41.0%) patients with restless legs syndrome, and 54 (69.3%) patients had one or more other sleep disorder. All patients were grouped into those who fulfilled the diagnostic criteria for ME/CFS (n = 55, 70.5%) and those who did not (n = 23, 29.5%). The latter group had significantly higher respiratory (p = 0.01) and total arousal (p = 0.009) indexes, and a higher oxygen desaturation index (p = 0.009).
CONCLUSIONS:
More than half of these chronic fatigue patients, who also have excessive daytime sleepiness and/or tiredness, were diagnosed with sleep disorders such as obstructive sleep apnoea, periodic limb movement disorder and/or restless legs syndrome. Patients with such complaints should undergo polysomnography, fill in questionnaires, and be offered treatment for sleep disorders before the diagnose ME/CFS is set. This article is protected by copyright. All rights reserved.
KEYWORDS:
chronic fatigue syndrome; fatigue; myalgic encephalomyelitis; polysomnography; sleep; sleep apnoea
https://www.ncbi.nlm.nih.gov/pubmed/28752613
(Indre Ljungar is one of the most active BPS proponents in Sweden.)
Pajediene E1, Bileviciute-Ljungar I2, Friberg D3.
Author information
1 Department of Neurology, Kaunas Clinics, Hospital of Lithuanian University of Health Sciences, Linköping, Sweden.
2 Department of Clinical Sciences, Karolinska Institutet and Department of Rehabilitation Medicine, Danderyd University Hospital, Stockholm, Department of Medical and Health Sciences, Faculty of Medicine and Health Sciences, Linköping University, Pain and Rehabilitation Centre, Anaesthetics, Operations and Specialty Surgery Centre, Region Östergotland, Linköping, Sweden.
3 Department of Clinical Science, Intervention and Technology (CLINTEC), Division of Otorhinolaryngology, Karolinska University Hospital, Stockholm, Sweden.
Clin Respir J. 2017 Jul 28. doi: 10.1111/crj.12667. [Epub ahead of print]
Abstract
OBJECTIVES:
To detect treatable sleep disorders among patients complaining of chronic fatigue by using sleep questionnaires and polysomnography.
METHODS:
Patients were referred to hospital for investigations and rehabilitation due to a suspected diagnosis of myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS). The criteria for further referral to full-night polysomnography (PSG) were symptoms of excessive daytime sleepiness and/or tiredness in the questionnaires.
RESULTS:
Of a total of 381 patients, 78 (20.5%) underwent PSG: 66 women and 12 men, mean age 48.6, standard deviation ±9.9 years. On the basis of the PSG, 31 (40.3%) patients were diagnosed with obstructive sleep apnoea, 7 (8.9%) patients with periodic limb movement disorder, 32 (41.0%) patients with restless legs syndrome, and 54 (69.3%) patients had one or more other sleep disorder. All patients were grouped into those who fulfilled the diagnostic criteria for ME/CFS (n = 55, 70.5%) and those who did not (n = 23, 29.5%). The latter group had significantly higher respiratory (p = 0.01) and total arousal (p = 0.009) indexes, and a higher oxygen desaturation index (p = 0.009).
CONCLUSIONS:
More than half of these chronic fatigue patients, who also have excessive daytime sleepiness and/or tiredness, were diagnosed with sleep disorders such as obstructive sleep apnoea, periodic limb movement disorder and/or restless legs syndrome. Patients with such complaints should undergo polysomnography, fill in questionnaires, and be offered treatment for sleep disorders before the diagnose ME/CFS is set. This article is protected by copyright. All rights reserved.
KEYWORDS:
chronic fatigue syndrome; fatigue; myalgic encephalomyelitis; polysomnography; sleep; sleep apnoea
https://www.ncbi.nlm.nih.gov/pubmed/28752613
(Indre Ljungar is one of the most active BPS proponents in Sweden.)