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Abstract
Background: Chronic Fatigue Syndrome (CFS) affects 0.23–2.6% of the adult population. Sleep-related complaints are amongst the most frequently reported symptoms in these patients. Although a biopsychosocial model of CFS offers a plausible framework for understanding the condition, the role of sleep and how it functions within this model remains unclear. Purpose: This narrative review describes the findings of studies of sleep in CFS and considers the reasons behind the diversity of results. The review also discusses the difficulties that exist in establishing relationships between sleep, behaviour, cognition, physiology, and the physical symptoms of CFS. Methods: A search of Medline for the terms “CFS,” “chronic fatigue syndrome,” AND “sleep” was performed to identify articles concerning sleep and CFS from 1988 to the present. Results: Subjective sleep dysfunction was frequently reported in the CFS sleep studies. However, objective sleep research in CFS has shown no consistent picture of sleep disturbance, particularly with regard to polysomnography. This may be attributable to the heterogeneity of sleep phenotypes in the CFS population as well as the variability in sleep assessment protocols, case definitions, and exclusion criteria used across studies. Conclusions: Given the high prevalence of disturbed sleep in this population in combination with inconsistent findings, exploration of new protocols for the objective assessment of sleep in CFS (e.g., three-night PSG protocol) is recommended. Understanding the distinct sleep characteristics in this population could serve to improve insight into perpetuating factors of CFS symptoms which is relevant for diagnosis and therapy.
Acknowledgments
Author contributions: Zoe Gotts in drafting of the manuscript, Professor Jason Ellis, Professor Julia Newton, and Dr Vincent Deary in revision of the manuscript, for important intellectual content, supervision, and final approval of the version to be published.
Additional information
Notes on contributors
Zoe M. Gotts
Zoe M. Gotts (Ph.D.) is a post-doctoral health researcher in sleep and fatigue-related chronic conditions, working in the Northumbria Centre for Sleep Research (NCSR), Faculty of Health and Life Sciences, Northumbria University, United Kingdom.
Jason G. Ellis
Jason G. Ellis (Ph.D.) is Professor of Sleep Science and the Director of Northumbria Centre for Sleep Research (NCSR), Faculty of Health and Life Sciences, Northumbria University, United Kingdom.
Julia L. Newton
Julia L. Newton (Ph.D.) is Clinical Professor of Ageing and Medicine and Dean of Clinical Medicine at the School of Clinical Medical Sciences, Newcastle University, United Kingdom.
Vincent Deary
Vincent Deary (Ph.D.) is a senior lecturer in health psychology in the Faculty of Health and Life Sciences, Northumbria University, United Kingdom. He is also a practitioner health psychologist and cognitive behavioural therapist, and founder member of the Northern Association for Persistent Physical Symptoms.