Scientists Say Chronic Fatigue Syndrome Is Not Sleepiness

Anyone with chronic fatigue syndrome (CFS) can attest to the frustration of trying to explain to well meaning people how a good night of sleep has no value for relieving their fatigue. Sleep and their fatigue are just not related, they say. Taking a day off won´t help. Now scientists agree.

Scientists at the University Hospital Brugmann Sleep Laboratory in Belgium now have data that supports a clinical distinction between fatigue and sleepiness in a study which examined CFS patients with primary fatigue. The patients did not also suffer primary sleep or psychiatric disorders.

While, unrefreshing sleep is reported in CFS, lack of sleep is not behind the fatigue and sleepiness is not reported during the day.

Sleepiness is defined as being ready or inclined to sleep or drowsy.

Fatigue, on the other hand, is defined as diminution of the irritability or functioning of organs, tissues, or cells after exertion or stimulation. So, one could be fatigued without actually being sleepy. This is the case in CFS and exactly what CFS patients have been saying all along.

A good night of sleep does not reduce fatigue. The fatigue has another source. People who suffer from CFS have unrelenting fatigue severe enough to limit most basic daily living tasks of bathing, cleaning, and dressing can be exhausting. 

Several possible causes of CFS include:

Infectious Agents

Immunology

Hypothalamic-Pituitary Adrenal (HPA) Axis

Neurally Mediated Hypotension

According to the Centers for Disease Control and Prevention (CDC), chronic fatigue syndrome (CFS) "is a serious illness and poses a dilemma for patients, their families, and health care providers."

The CDC says "a variety of studies by CDC and others have shown that between 1 and 4 million Americans suffer from Chronic Fatigue Syndrome (CFS). They are seriously impaired, at least a quarter are unemployed or on disability because of CFS."

A serious illness, CFS poses a dilemma for patients, their families, and health care providers.

A panel of CFS research experts from around the world drafted a definition of CFS in 1994. It was designed for research and diagnosing. They settled on two criteria which must be met to diagnose CFS:

Severe chronic fatigue of six months or longer duration with other known medical conditions excluded by clinical diagnosis; and

2. Concurrently have four or more of the following symptoms: substantial impairment in short-term memory or concentration; sore throat; tender lymph nodes; muscle pain; multi-joint pain without swelling or redness; headaches of a new type, pattern or severity; unrefreshing sleep; and post-exertional malaise lasting more than 24 hours.

Sleepiness or lack of sleep is not part of chronic fatigue syndrome. CFS fatigue is not reduced by sleep. No wonder this group is so disabled.

Reference

Neu D, Hoffmann G, Moutrier R, Verbanck P, Linkowski P, LE Bon O.  Are patients with chronic fatigue syndrome just 'tired' or also 'sleepy'?  J Sleep Res. 2008 Oct 7. [Epub ahead of print]

This article originally appeared in the MCS America News, November 2008 Issue. http://mcs-america.org/december2008.pdf. For more articles on this topic, see: MCSA News.