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Sleep patterns among patients with chronic fatigue: A polysomnography-based study.

Evelina Pajediene1, Indre Bileviciute-Ljungar2,3,4, Danielle Friberg5

  • 1Department of Neurology, Kaunas Clinics, Hospital of Lithuanian University of Health Sciences, Kaunas, Lithuania.

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Summary

Chronic fatigue patients with daytime sleepiness often have treatable sleep disorders like obstructive sleep apnea. Polysomnography can identify these conditions, guiding treatment before a myalgic encephalomyelitis/chronic fatigue syndrome diagnosis.

Keywords:
chronic fatigue syndromefatiguemyalgic encephalomyelitispolysomnographysleepsleep apnoea

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Area of Science:

  • Sleep Medicine
  • Neurology
  • Internal Medicine

Background:

  • Chronic fatigue is a debilitating condition often investigated for myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS).
  • Excessive daytime sleepiness and persistent tiredness are common symptoms that may indicate underlying sleep disorders.
  • Identifying treatable sleep conditions is crucial for effective patient management.

Purpose of the Study:

  • To investigate the prevalence of treatable sleep disorders in patients presenting with chronic fatigue.
  • To determine the utility of sleep questionnaires and polysomnography (PSG) in diagnosing these disorders.
  • To assess the relationship between diagnosed sleep disorders and ME/CFS criteria.

Main Methods:

  • Patients with suspected ME/CFS and symptoms of excessive daytime sleepiness/tiredness were referred for PSG.
  • Sleep questionnaires were used to screen patients for sleep-related issues.
  • Polysomnography was conducted to diagnose specific sleep disorders.

Main Results:

  • Out of 381 patients, 78 underwent PSG; 40.3% were diagnosed with obstructive sleep apnea, 8.9% with periodic limb movement disorder, and 41.0% with restless legs syndrome.
  • Over half (70.5%) met the diagnostic criteria for ME/CFS.
  • Patients not meeting ME/CFS criteria showed significantly higher respiratory and arousal indexes.

Conclusions:

  • A significant proportion of chronic fatigue patients with excessive daytime sleepiness have undiagnosed sleep disorders.
  • Obstructive sleep apnea, periodic limb movement disorder, and restless legs syndrome are common findings.
  • PSG and questionnaires are valuable tools for diagnosing sleep disorders, which should be treated before a definitive ME/CFS diagnosis is established.