Alpha-Delta Sleep in Patients With a Chief Complaint of Chronic Fatigue

Manu, Peter; Lane, Thomas J; Matthews, Dale A.; Castriotta, Richard J.; Watson, Robert; Abeles, Moshe

doi:10.1097/00007611-199404000-00008

Cited by 81 publications

(29 citation statements)

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“…The appearance of alpha-delta sleep, or alpha intrusions, during SWS has been reported in some early studies of CFS/ME patients. 37,56 The appearance of alpha-delta sleep in these patients was initially thought to be the cause of non-restorative sleep. However, whether the patients in these studies had a "pure" diagnosis of CFS/ME or potentially some feature of FM is unclear.…”

Section: 43mentioning

confidence: 99%

Sleep Abnormalities in Chronic Fatigue Syndrome/Myalgic Encephalomyelitis: A Review

Jackson

Bruck

2012

Journal of Clinical Sleep Medicine

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Chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ ME) is a chronic, disabling illness that affects approximately 0.2% of the population. Non-restorative sleep despite sufficient or extended total sleep time is one of the major clinical diagnostic criteria; however, the underlying cause of this symptom is unknown. This review aims to provide a comprehensive overview of the literature examining sleep in CFS/ ME and the issues surrounding the current research fi ndings. Polysomnographic and other objective measures of sleep have observed few differences in sleep parameters between CFS/ME patients and healthy controls, although some discrepancies do exist. This lack of signifi cant objective differences contrasts with the common subjective complaints of disturbed and unrefreshed sleep by CFS/ME patients. The emergence of new, more sensitive techniques that examine the microstructure of sleep are showing promise for detecting differences in sleep between patients and healthy individuals. There is preliminary evidence that alterations in sleep stage transitions and sleep instability, and other physiological mechanisms, such as heart rate variability and altered cortisol profi les, may be evident. Future research investigating the etiology of non-restorative sleep in CFS/ME may also help us to undercover the causes of non-restorative sleep and fatigue in other medical conditions. keywords: Chronic fatigue syndrome, myalgic encephalomyelitis, sleep, non-restorative sleep, sleep disorders, fatigue, sleepiness Citation: Jackson ML; Bruck D. Sleep abnormalities in chronic fatigue syndrome/myalgic encephalomyelitis: a review.

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Section: 43mentioning

confidence: 99%

Sleep Abnormalities in Chronic Fatigue Syndrome/Myalgic Encephalomyelitis: A Review

Jackson

Bruck

2012

Journal of Clinical Sleep Medicine

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“…Research efforts have deter mined the high frequency of fatigue in the community [1. 2] and among those seeking primary care [3,4], It has also been established that, in the absence of an overt physical cause (e.g., malignancy, congestive heart failure, hypothy roidism, anemia), a majority of patients with a chief com plaint of chronic fatigue have mood disorders [5,6], sleep abnormalities [7,8], fibromyalgia [9. 10] or chronic fatigue syndrome (CFS) [11.…”

mentioning

confidence: 99%

Hypochondriasis Influences Quality-of-Life Outcomes in Patients with Chronic Fatigue

Manu

Affleck

Tennen

et al. 1996

Psychother Psychosom

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Background: To determine how hypochondriacal symptoms influence the quality-of-life outcomes of patients with a chief complaint of chronic fatigue. Methods: Cross-sectional cohort study of a consecutive sample of 71 patients (mean duration of fatigue of 4.1 years). Forty-eight (68%) patients met criteria for current major depression and 32 (45%) met criteria for chronic fatigue syndrome (CFS). All patients received a comprehensive medical and psychiatric evaluation. Quality-of-life and physical, depressive and hypochondriacal symptom scores were assessed through reliable self-report questionnaires and a structured interview. A path model expressing the relation between predictor variables (hypochondriasis and depression), intervening variables (physical symptoms) and quality of life was postulated and evaluated using structural equation methods. Results: The paths linking hypochondriasis with physical symptoms and mental health and the path connecting physical symptoms and quality of life were each statistically significant. The model applied especially well to patients who fulfilled CFS criteria. Conclusions: The quality of life of chronic fatigue patients correlates with the severity of their physical symptoms and their hypochondriacal disposition toward illness.

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“…Although the results and procedures were varied; sleep efficiency was reduced in 7 of 7 studies [14,[16][17][18][19][20][21], time in bed was increased in 2 out of 2 studies [17,18] and wake after sleep onset was increased in 3 out of 3 studies [17,18,22]. Control subjects in these studies varied from patients with MDD to co-twin controls.…”

Section: Introductionmentioning

confidence: 99%

“…Several articles have suggested that a pattern of alpha/delta activity during non-REM sleep could be a part of the sleep physiology of CFS patients [15,20,26]. Such EEG patterns have been shown in patients with fibromyalgia [27,28], but its influence in CFS is still not clear.…”

Section: Introductionmentioning

confidence: 99%

“…Such EEG patterns have been shown in patients with fibromyalgia [27,28], but its influence in CFS is still not clear. Manu [20] stated that "Alpha-delta sleep is not a marker of fibromyalgia or CFS…" (p.465). Others have reported an association between alpha-delta intrusion and anxiety [26], but there was no control group of healthy subjects in this study for comparison; Whelton [15] compared CFS patients to healthy controls.…”

Section: Introductionmentioning

confidence: 99%

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Aspects of Slow-Wave EEG Activity During Sleep in Twins Discordant for Chronic Fatigue Syndrome

Goldberg¹,

Watson²,

Buchwald³

et al. 2009

TOSLPJ

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Chronic Fatigue Syndrome (CFS) is a disease characterized by high levels of daytime fatigue. Complaints such as unrefreshing sleep and insomnia are common. Polygraphic studies of sleep in CFS patients have found evidence of disturbed sleep, but controls in these studies were often not adequate to evaluate differences specific to CFS. Watson, et al.[1] and Ball, et al.[2] used a co-twin control design to eliminate virtually all sources of confounding variance and found a small difference between levels of Stage 2 sleep (lower in CFS) and Stage 3 sleep (higher in CFS), where CFS ill twins showed a higher level of sleep complaint than the healthy twins which was not reflected in their sleep physiology. The current study will apply more sensitive measures of sleep EEG to these data to examine differences more closely. A cotwin control study was performed on 10 pairs of identical twins discordant for CFS. Data from the second sleep night were analyzed using fast-fourier analysis (FFT) and finally measures of slow-wave activity (SWA). Data for NREM periods was analyzed. There was a significant interaction in SWA for Twin x NREM period for the first 2 NREM periods with the healthy twins having more SWA in the first NREM period and less in the second NREM period. While overall SWA activity did not differentiate the groups, the distribution of SWA in the first 2 NREM periods could be associated with the experience of unrefreshing sleep. Typically, SWA in the first NREM period is associated with deep restorative sleep. Lower SWA in NREMP 1 in the ill CFS twins suggests that this process is compromised resulting in the experience of less refreshing sleep.

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Alpha-Delta Sleep in Patients With a Chief Complaint of Chronic Fatigue

Cited by 81 publications

References 0 publications

Sleep Abnormalities in Chronic Fatigue Syndrome/Myalgic Encephalomyelitis: A Review

Sleep Abnormalities in Chronic Fatigue Syndrome/Myalgic Encephalomyelitis: A Review

Hypochondriasis Influences Quality-of-Life Outcomes in Patients with Chronic Fatigue

Aspects of Slow-Wave EEG Activity During Sleep in Twins Discordant for Chronic Fatigue Syndrome

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