Chapter 15 in Handbook of Sleep Disorders in Medical Conditions - Chronic Fatigue Syndrome and Fibromyalgia, Togo, Kishi & Natelson, 2019

Discussion in 'General ME/CFS news' started by MeSci, Mar 19, 2019.

  1. MeSci

    MeSci Senior Member (Voting Rights)

    Cornwall, UK
    Source: Handbook of Sleep Disorders in Medical Conditions

    2019, Pages 325-343

    Date: March 15, 2019


    Chapter 15 - Chronic Fatigue Syndrome and Fibromyalgia
    Fumiharu Togo(1), Akifumi Kishi(1), Benjamin H. Natelson(2) 1 Educational Physiology Laboratory, Graduate School of Education, The University of Tokyo, Tokyo, Japan

    2 Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY, United States


    Patients with chronic fatigue syndrome (CFS) and fibromyalgia (FM) often have sleep-related problems. In this chapter, we will review studies on sleep in CFS and FM patients in order to better understand their sleep problems, effects of treatment of their sleep problems, and differences between these two conditions.

    Polysomnographic studies have shown sleep problems in CFS and FM, that is, increased Stage 1 sleep, reduced slow-wave sleep, more arousals, prolonged sleep onset, reduced sleep efficiency, and microarousals or subcortical arousals during sleep, while dynamic aspects of sleep show different patterns between CFS and FM patients. Studies on pharmacological and nonpharmacological interventions such as antidepressants, graded exercise, and cognitive behavior therapy have been shown to produce improvements in sleep problems. However, limited research has been conducted on the effects of nonpharmacological interventions on sleep problems in patients with CFS or FM for revealing the optimal strategy for exercise therapy and cognitive behavior therapy in patients with CFS and/or FM.
  2. James Morris-Lent

    James Morris-Lent Senior Member (Voting Rights)

    United States
    I thought graded exercise was devised for CFS. How can it be known to improve 'sleep problems'? I don't think that's ever been studied.
    Wonko and MEMarge like this.
  3. Andy

    Andy Committee Member

    Hampshire, UK
  4. Snowdrop

    Snowdrop Senior Member (Voting Rights)

    Shouldn't Natelson at least know better by now (regarding exercise for better sleep in ME).
    It's clearly stated in the Health Commissioner's (NY) letter that GET is not appropriate.
    Medfeb and andypants like this.
  5. Griffin

    Griffin Established Member

    I have Reverse Sleep Disorder, Periodic Limb Movement in Sleep (PLMS) and I've been caught on video sleep walking at Sleep Clinic, so I have an interest in this. PLMS means limbs jerking, bringing one up from deep sleep to almost awake, so an active sleep life, unrefreshing, never mind the sleep walking. It's a wonder I am ever awake. I've been to Sleep Clinic 3 times. No luck, except diagnoses.

    The Reverse Sleep Disorder began with Sleep Phase disorder when I was very young. It got worse as I got older, and finally a course of radiotherapy turned it into day for night, following 2 months of sleep 24/7. (alarm to eat and drink).

    Provided I don't attempt to sleep during the night, I fall asleep with no problem early morning 5 or 6 am. So I guess I can say I have Delayed Sleep - problems falling asleep - and I struggled for years with this. Once I accepted that I should not even try to sleep at night, problem solved.

    One question I ask myself, have I in fact had ME since I was a small child? (I've always felt exhausted although I thought everyone did as a child). Is the sleep linked to the ME, or is the ME linked to the sleep, or are they not linked at all?

    This article gives me no answers!

    Nor do I feel inclined to exercise and send myself into a crash to further research on this matter (what a strange conclusion they end with in the Abstract).

    I also question the selection of candidates. It seems almost haphazard. People who feel tired?

    Why the proliferation of poor research? Is it be published or no job? It concerns me greatly.
    Last edited: Mar 25, 2019
  6. Mij

    Mij Senior Member (Voting Rights)

    I am able to do moderate exercise (walking briskly 2-3 times/week), sometimes it improves my sleep, other times it makes it worse and I'll wake up with swollen lymph nodes.
    MEMarge likes this.
  7. lansbergen

    lansbergen Senior Member (Voting Rights)

    I did that too and with overall improvement my sleep became better and better.

    I always was a nightowl and still am but now my body tells me about midnight it is time to go to bed. I fall asleep fast and sleep like a baby. I only wake up to pee and then fall asleep again.
    MEMarge and MeSci like this.
  8. Griffin

    Griffin Established Member

    I don't get sleep signals until 5 or 6 am. It used to be 4 to 5 am but got worse a couple of years ago.

    Some days I have to wake up after too few hours of sleep but even that doesn't mean I sleep any earlier the next night.
    MEMarge, MeSci and NelliePledge like this.
  9. Sly Saint

    Sly Saint Senior Member (Voting Rights)

    if anyone wants to complain to Natelson directly

    Snowdrop and MEMarge like this.
  10. junkcrap50

    junkcrap50 Established Member (Voting Rights)

    Thanks for posting this. While it does mention "graded exercise", which is wrong, harmful/dangerous, unethical, and contraindicated in CFS, I think the article/chapter is very helpful. It gives a pretty good and accurate representation of sleep architecture in CFS, which I think is an important and underdiagnosed problem for us. (It's very frequently overlooked in sleep studies and by sleep doctors in general, as well.) It is easy to hand to a sleep medicine specialist and help them learn about our disease and sleep problems. It comes from a reputable source and gives a nice overview and review. Of course, still need an open minded, curious doctor regardless - as always is the case with CFS.
  11. Wonko

    Wonko Senior Member (Voting Rights)

    'bvious innit.
    Exercise is good.
    Exercise is tiring, if done properly.
    Tired people sleep.

    Ergo GET improves sleep problems.

    Logic innit.

    Why'd they need a study, at least until someone decides they need another wing on the country house.

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