Sleep Quality in Adolescents With Chronic Fatigue Syndrome/Myalgic Encephalomyelitis (CFS/ME).
Josev, Elisha K, Jackson, Melinda L, Bei, Bei et al. · Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine · 2017 · DOI
Quick Summary
This study examined sleep problems in teenagers with ME/CFS compared to healthy teenagers. Researchers found that teens with ME/CFS took longer to fall asleep, spent more total time in bed, slept longer overall, woke up later, and reported feeling their sleep was of poorer quality. Anxiety levels were also higher in the ME/CFS group and were connected to worse sleep quality in both groups.
Why It Matters
Sleep disturbances are a core feature of ME/CFS, yet little objective data exists on sleep problems in pediatric populations. This study provides both objective (actigraphy) and subjective (questionnaire) evidence that adolescents with ME/CFS experience significant sleep dysfunction, establishing a clearer understanding of sleep disruption patterns that may inform treatment approaches and highlight the role of anxiety in sleep quality.
Observed Findings
Adolescents with CFS/ME had significantly longer sleep onset latency compared to healthy controls (p < 0.005)
Adolescents with CFS/ME spent more total time in bed and had longer total sleep times (p < 0.005)
Adolescents with CFS/ME had significantly later rise times (p < 0.005)
Subjective sleep quality was significantly poorer in the CFS/ME group (p < 0.001)
Anxiety levels were higher in the CFS/ME group (p < 0.05), and anxiety was significantly associated with worse subjective sleep quality in both groups (p < 0.001)
Inferred Conclusions
Adolescents with ME/CFS experience objectively and subjectively measurable sleep disturbances across multiple parameters compared to healthy peers
Anxiety is elevated in adolescent ME/CFS and plays a significant role in sleep quality perception
Both objective and subjective measures are needed to fully characterize sleep dysfunction in pediatric ME/CFS
Remaining Questions
Do sleep disturbances improve with ME/CFS-targeted treatment, or are they persistent features of the illness?
What mechanisms drive the prolonged sleep times and later wake times observed in adolescents with ME/CFS—are these compensatory responses to poor sleep quality?
What This Study Does Not Prove
This study does not establish whether sleep disturbances cause ME/CFS symptoms, result from ME/CFS, or occur independently. It also cannot determine whether the observed anxiety causes poor sleep quality or whether both are separate consequences of ME/CFS. The cross-sectional design means cause-and-effect relationships cannot be determined from these findings alone.