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Poor sleep quality is associated with greater circulating pro-inflammatory cytokines and severity

Discussion in 'Latest ME/CFS Research' started by Cheesus, Jan 3, 2017.

  1. Cheesus

    Cheesus Senior Member

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    Poor sleep quality is associated with greater circulating pro-inflammatory cytokines and severity and frequency of chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME) symptoms in women

    Abstract

    Objective
    Poor sleep quality has been linked to inflammatory processes and worse disease outcomes in the context of many chronic illnesses, but less is known in conditions such as chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME). This study examines the relationships between sleep quality, pro-inflammatory cytokines, and CFS/ME symptoms.

    Methods
    Sixty women diagnosed with CFS/ME were assessed using the Pittsburgh Sleep Quality Index (PSQI), Fatigue Symptom Inventory (FSI) and Center for Disease Control and Prevention (CDC)-based CFS/ME symptom questionnaires. Circulating plasma pro-inflammatory cytokine levels were measured by ELISA. Multiple regression analyses examined associations between sleep, cytokines and symptoms, controlling for age, education, and body mass index.

    Results
    Poor sleep quality (PSQI global score) was associated with greater pro-inflammatory cytokine levels: interleukin-1β (IL-1β) (β = 0.258, p = 0.043), IL-6 (β = 0.281, p = 0.033), and tumor necrosis factor-alpha (TNF-α) (β = 0.263, p = 0.044). Worse sleep quality related to greater fatigue severity (β = 0.395, p = 0.003) and fatigue-related interference with daily activities (β = 0.464, p < 0.001), and more severe and frequent CDC-defined core CFS/ME symptoms (β = 0.499, p < 0.001, and β = 0.556, p < 0.001, respectively).

    Conclusions
    Results underscore the importance of managing sleep-related difficulties in this patient population. Further research is needed to identify the etiology of sleep disruptions in CFS/ME and mechanistic factors linking sleep quality to symptom severity and inflammatory processes.

    http://www.jni-journal.com/article/S0165-5728(16)30449-0/pdf
     
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  2. Molly98

    Molly98 Senior Member

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    Interesting. I don't think that it is always a case of poor sleep leads to a greater inflammatory response and worse symptoms, I think that it can be the other way around, or is this what it is meaning, I am unsure?

    I do not sleep well any night, I am almost always awake in the early hours and struggle to get back to sleep. However, my sleep is much worse if I am suffering with PENE and fatigue from over doing it and this is when I feel my head, neck, back, eyes and well sometimes just all over is inflamed.

    I try my best with good sleep hygiene but see little improvement as I am sure it is the neuro immune reaction and inflammation that is causing the sleep difficulties.

    I have been recording my sleep, PENE, and heart rate for a while and this pattern shows up clearly the worse nights sleep follow days with my neuro- immune symptoms are worse- PENE, exhaustion and feeling of inflammation, not the other way around in my case. I don't know if anyone else finds this also?
     
  3. Cheesus

    Cheesus Senior Member

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    I think you're right about that. The conclusion the author draws - that the results underscore the importance of managing sleep - is not supported by the evidence that they present.

    I typically find that the more I overdo, the worse I sleep. Much the same as you.

    EDIT: Or at least those conclusions are not supported by the abstract. The paper is behind a paywall.
     
    Last edited: Jan 3, 2017
  4. trishrhymes

    trishrhymes Senior Member

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    So the question is:

    Does poor sleep quality cause increased cytokines etc. and worse ME symptoms?

    or does increased cytokines cause poor sleep and worse ME symptoms?

    or does some other factor cause worse ME, poor sleep and increased cytokines etc.?

    And since the research doesn't answer this, is there any reason to assume we can 'manage sleep related difficulties'?

    Any thoughts?

    I see Nancy Klimas is one of the researchers, and I've been impressed with what I've seen of her being interviewed, so I assume she is continuing to try to answer these questions.
     
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  5. Molly98

    Molly98 Senior Member

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    For me it definitely seems to be much more of this one, How about you, what's your experience @trishrhymes ?

    I Know without doubt the times I have PENE and feel worst I won't be able to sleep without taking Baclofen or co-codamol or something with codeine in to help me get to sleep, I still don't sleep through the night but would struggle to sleep at all without them.
     
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  6. Chrisb

    Chrisb Senior Member

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    If it were possible to cure ME by managing sleep-related difficulties few of us would be ill. Sleep-related difficulties have a way of managing us.
     
  7. trishrhymes

    trishrhymes Senior Member

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    Thanks for asking, but I'm afraid I can't answer - I've never had my cytokines or any of the other stuff measured in 27 years of illness.

    I know if I sleep badly I feel lousy the next day, but that was also true before I had ME.

    I don't know whether consistently sleeping better would help because I react badly to most drugs, even tiny doses of amitriptiline, so don't take anything to help me sleep.
     
  8. perrier

    perrier Senior Member

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    And if I understand there are no medications for cytokine activity? Or are there?
     
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  9. Cheesus

    Cheesus Senior Member

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    The answer could be all three.
     
  10. adreno

    adreno PR activist

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    It is not likely to be either/or. Increased inflammation will likely worsen sleep, and poor sleep will likely increase inflammation as well. A vicious circle, in other words.
     
  11. Valentijn

    Valentijn The Diabolic Logic

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    Full text is at http://sci-hub.cc/10.1016/j.jneuroim.2016.12.008

    But they do seem to be assuming that poor sleep causes the inflammatory cytokines to increase, rather than allowing for the possibility that being sick messes up your ability to sleep. By their logic, maybe sleep management could cure the flu :rolleyes:

    Though they are claiming that inflammatory cytokines promote sleep ... not sure how well that claim holds up:
    Also:
    They re-used a Fukuda group of patients previously published about by Hall et al in 2014 and Lattie et al in 2012.

    There might be issues with some of the comparisons being post-hoc, and I'm not clear on whether they corrected for making multiple comparisons. My brain's a bit too fried to delve into that currently.

    The discussion sounds like they want to get more psychosocial to unravel the mysteries of CFS and treat it:
    So once again, there's undeniable physical abnormalities, and the ridiculous quacks are blaming them on our behavior and thoughts, and pontificating about how best to fix them with some form of CBT.

    Dear Quacks,
    Please bugger off already.
    Sincerely,
    -ME Patients
     
    Last edited: Jan 3, 2017
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  12. Cheesus

    Cheesus Senior Member

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    "We have identified immunological abnormalities"

    Oh that sounds good

    "...therefore the logical course of action is to seek psychiatric help"

    Oh...
     
    Last edited: Jan 3, 2017
  13. Molly98

    Molly98 Senior Member

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    OH Noooooo not CBT again :bang-head::bang-head::bang-head:.

    Ok so most night unless I am bad with PENE I can get to sleep OK but wake up 2-3ish, so considering I am unconscious before waking how can my faulty cognitions be waking me and how can changing cognitions which are not even happening help.

    If it were to be anything psychological then it would have to be unconscious rather than conscious in which case CBT would be useless in treating it.

    I am not waking up anxious or depressed, I am not worrying, I do not even get really frustrated about it because it has become normal and I have just had to accept it. I am waking up because that is part of the nature of the illness I have. Before this illness I never had any problems with sleep, would fall asleep when my head hit the pillow and sleep through to morning.

    Is there no escape in this world from CBT, except when asleep.
     
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  14. Molly98

    Molly98 Senior Member

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    :thumbsup::thumbsup::thumbsup:
     
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  15. Mij

    Mij Senior Member

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    For me it is the other way around. Generally my sleep is ok, but I have had experiences when the onset of a viral infection will switch my sleep off like a light switch- poof gone.
     
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  16. Valentijn

    Valentijn The Diabolic Logic

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    My sleep is consistently pretty good, with the help of supplements. It doesn't improve my other symptoms.

    Though I do wake up to pee a couple times per night. Is there a CBT for that? :rolleyes:
     
  17. Mij

    Mij Senior Member

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    I don't don't think "letting go" of those thoughts is a good idea :p
     
  18. Cheesus

    Cheesus Senior Member

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    I disagree, @Mij.

    I think it would be a good idea if @Valentijn spoke with a therapist about this deleterious habit she has of taking on fluids.
     
  19. John Mac

    John Mac Senior Member

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    Yes,. Cognitive Bladder Training
     
  20. Mary

    Mary Senior Member

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    :rofl: (thank you for the laugh! :))

    FWIW, I'm managing my sleep with a boatload of supplements - niacin, inositol, relora, theanine serene, l-theanine, glycine, 5-htp - it feels ridiculous - I have a big bag I keep in the bathroom just for sleep! and a much bigger bag of other things to help me in various other ways. I'm currently tapering off of lorazepam which I took in the middle of the night (my worst time) for sleep and with the help of my nighttime bag 'o pills, am managing it. But sleeping does nothing for PEM, although I certainly feel more human when I get 7 or 8 hours --
     

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