Sleep–wake rhythm disturbances and perceived sleep in adolescent chronic fatigue syndrome

Pedersen, Maria; Ekstedt, Mirjam; Småstuen, Milada Cvancarova; Wyller, Vegard Bruun; Sulheim, Dag; Fagermoen, Even; Winger, Anette; Pedersen, Edvard; Hrubos‐Strøm, Harald

doi:10.1111/jsr.12547

Cited by 22 publications

(15 citation statements)

References 39 publications

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“…Several studies have found that adolescents with CFS report greater sleep disturbances than healthy controls (Josev et al, 2017;Pedersen et al, 2017;Snodgrass et al, 2015). Our findings have further confirmed these existing conclusions.…”

Section: Discussionsupporting

confidence: 91%

Sleep problems in adolescents with CFS: A case-control study nested within a prospective clinical cohort

Loades

Rimes

Chalder

2020

Clin Child Psychol Psychiatry

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Sleep problems have a negative impact on a range of outcomes and are very common in adolescents with chronic fatigue syndrome (CFS). We aimed to (a) establish whether adolescents with CFS have more self-reported sleep problems than illness controls as well as healthy controls, (b) investigate changes in sleep problems and (c) explore the extent to which sleep problems at baseline predict fatigue and functioning at follow-up in adolescents with CFS. The Insomnia Scale was completed by 121 adolescents with CFS, 78 healthy adolescents and 27 adolescents with asthma. Eighty (66%) treatment-naïve adolescents with CFS completed questionnaires approximately 3 months later. Adolescents with CFS reported increased sleep problems compared to healthy controls and adolescents with asthma. In CFS, there was no significant change in sleep problems without treatment over a 3-month follow-up. Sleep problems at baseline predicted a significant proportion of the variance in sleep problems at follow-up. Sleep problems should be targeted in treatment. Regulating the ‘body clock’ via the regulation of sleep could influence outcomes not assessed in this study such as school attainment.

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Section: Discussionsupporting

confidence: 91%

Sleep problems in adolescents with CFS: A case-control study nested within a prospective clinical cohort

Loades

Rimes

Chalder

2020

Clin Child Psychol Psychiatry

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“…24 The Karolinska Sleep Questionnaire is a validated questionnaire charting insomnia and other sleep disturbances, 25 and has previously been applied in research on adolescent fatigue. 26 It consists of 14 items scored 1-6 on Likert scales; the total sum score (range from 14 to 84) is reported in the present paper, and lower scores imply more symptoms of sleep problems. The Hospital Anxiety and Depression Scale charts symptoms of depression and anxiety and is validated for adolescents 27 28 ; it consists of 14 items scored 0-3 on Likert scales, and total sum score (range from 0 to 42) is reported in the present paper.…”

Section: Investigational Programmementioning

confidence: 86%

Cognitive–behavioural therapy combined with music therapy for chronic fatigue following Epstein-Barr virus infection in adolescents: a feasibility study

Malik

Asprusten

Pedersen

et al. 2020

bmjpo

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BackgroundCognitive–behavioural therapy (CBT) is effective in chronic fatigue syndrome. However, CBT has not been investigated in postinfectious chronic fatigue (CF), nor is it known whether addition of therapeutic elements from other disciplines might be feasible. We studied the feasibility of a combined CBT and music therapy intervention for CF following Epstein-Barr virus (EBV) infection in adolescents.MethodsAdolescents (12–20 years old) participating in a postinfectious cohort study who developed CF 6 months after an acute EBV infection were eligible for the present feasibility study. A combined CBT and music therapy programme (10 therapy sessions and related homework) was compared with care as usual in a randomised controlled design. Therapists and participants were blinded to outcome evaluation. Endpoints included physical activity (steps/day), symptom scores, recovery rate and possible harmful effects, but the study was underpowered regarding efficacy. Total follow-up time was 15 months.ResultsA total of 43 individuals with postinfectious CF were included (21 intervention group, 22 control group). Seven individuals left the study during the first 3 months, leaving 15 in the intervention group and 21 in the control group at 3 months’ follow-up. No harmful effects were recorded, and compliance with appointment was high. In intention-to-treat analyses, number of steps/day tended to decrease (difference=−1158, 95% CI −2642 to 325), whereas postexertional malaise tended to improve (difference=−0.4, 95% CI −0.9 to 0.1) in the intervention group at 3 months. At 15 months’ follow-up, there was a trend towards higher recovery rate in the intervention group (62% vs 37%).ConclusionAn intervention study of combined CBT and music therapy in postinfectious CF is feasible, and appears acceptable to the participants. The tendencies towards positive effects on patients’ symptoms and recovery might justify a full-scale clinical trial.Trial registration numberNCT02499302.

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“…In adults, circadian disruption has been linked to several negative consequences, such as an increased risk of cardiovascular and psychiatric disease, metabolic syndrome, diabetes, and cancer (Baron and Reid 2014;Eismann et al 2010;Mitchell et al 2017), in addition to negative effects on cognitive functioning (Luik et al 2015) and fatigue (Pedersen et al 2017). Little is known about the pediatric sleep-wake rhythm (Mitchell et al 2017).…”

Section: Introductionmentioning

confidence: 99%

Actigraphic estimates of sleep and the sleep-wake rhythm, and 6-sulfatoxymelatonin levels in healthy Dutch children

Rensen

Steur

Wijnen

et al. 2020

Chronobiology International

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Sleep and the sleep-wake rhythm are essential for children's health and well-being, yet reference values are lacking. This study therefore aimed to assess actigraphic estimates of sleep and the 24h sleep-wake rhythm, as well as 6-sulfatoxymelatonin (aMT6s) levels in healthy children of different age groups. Additionally, relationships between the outcomes and sex, highest parental educational level (as an indication of socioeconomic status (SES)), and body-mass-index (BMI) were explored. In this cross-sectional study, healthy Dutch children (2-18 years) wore an actigraph (GT3x) for 7 consecutive days, collected first-morning void urine and completed a sleep log and sociodemographic questionnaire. Actigraphically estimated sleep variables were sleep onset latency (SOL), sleep efficiency (SE), total sleep time (TST), and wake after sleep onset (WASO). Nonparametric sleep-wake rhythm variables were intradaily variability (IV); interdaily stability (IS); the activity counts and timing of the least active 5-h period (L5counts and midpoint) and of the most active 10-h period (M10 counts and midpoint); and the relative amplitude (RA), i.e. the ratio of the difference and the sum of M10 and L5 counts. Finally, creatinine-corrected aMT6s levels were obtained by isotope dilution mass spectrometry. Effects of age group (preschool 2-5 years/schoolaged 6-12 years/teenager 13-18 years), sex, highest parental educational level and BMI (Z-scores) were explored. Ninety-four children participated, equally divided across age groups (53% boys). Teenagers slept less, but more efficiently, than younger children, while their 24 h sleep-wake rhythm was the least stable and most fragmented (likely due to fragmentation of daytime activity). Additionally, aMT6s levels significantly declined over the age groups. Children from highly educated parents had lower sleep efficiency, but a more stable sleep-wake rhythm. Finally, sex or increase in BMI was not associated with any of the outcomes in this study. In conclusion, this study provides reference values of healthy children across different age groups and different sociodemographic factors. In the future, this information may help to better interpret outcomes in clinical populations. ARTICLE HISTORY

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Sleep–wake rhythm disturbances and perceived sleep in adolescent chronic fatigue syndrome

Cited by 22 publications

References 39 publications

Sleep problems in adolescents with CFS: A case-control study nested within a prospective clinical cohort

Sleep problems in adolescents with CFS: A case-control study nested within a prospective clinical cohort

Cognitive–behavioural therapy combined with music therapy for chronic fatigue following Epstein-Barr virus infection in adolescents: a feasibility study

Actigraphic estimates of sleep and the sleep-wake rhythm, and 6-sulfatoxymelatonin levels in healthy Dutch children

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