Actigraphic assessment of sleep disorders in children with chronic fatigue syndrome.
ABSTRACT Children with chronic fatigue syndrome (CFS) often suffer from sleep disorders, which cause many physiological and psychological problems. Understanding sleep characteristics in children with CFS is important for establishing a therapeutic strategy. We conducted an actigraphic study to clarify the problems in sleep/wake rhythm and physical activity in children with CFS.
Actigraphic recordings were performed for 1-2 weeks in 12 CFS children. The obtained data were compared with those of healthy age-matched children used as the control.
Sleep patterns were divided into two groups based on subjects' sleep logs: irregular sleep type and delayed sleep phase type. Compared to the control group, total sleep time was longer and physical activity was lower in both groups of CFS. Continuous sleep for more than 10h was not uncommon in CFS. In the irregular sleep type, impaired daily sleep/wake rhythms and disrupted sleep were observed.
Using actigraphy, we could identify several characteristics of the sleep patterns in CFS children. Actigraphic analysis proved to be useful in detecting sleep/wake problems in children with CFS.
SourceAvailable from: Melinda L Jackson[Show abstract] [Hide abstract]
ABSTRACT: 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 findings. 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 significant 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 profiles, 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. CITATION: Jackson ML; Bruck D. Sleep abnormalities in chronic fatigue syndrome/myalgic encephalomyelitis: a review. J Clin Sleep Med 2012;8(6):719-728.Journal of clinical sleep medicine: JCSM: official publication of the American Academy of Sleep Medicine 01/2012; 8(6):719-28. DOI:10.5664/jcsm.2276 · 2.93 Impact Factor
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ABSTRACT: The bedtime of preschoolers/pupils/students in Japan has become progressively later with the result sleep duration has become progressively shorter. With these changes, more than half of the preschoolers/pupils/students in Japan recently have complained of daytime sleepiness, while approximately one quarter of junior and senior high school students in Japan reportedly suffer from insomnia. These preschoolers/pupils/students may be suffering from behaviorally induced insufficient sleep syndrome due to inadequate sleep hygiene. If this diagnosis is correct, they should be free from these complaints after obtaining sufficient sleep by avoiding inadequate sleep hygiene. However, such a therapeutic approach often fails. Although social factors are often involved in these sleep disturbances, a novel clinical notion – asynchronization – can further a deeper understanding of the pathophysiology of these disturbances. The essence of asynchronization is a disturbance in various aspects (e.g., cycle, amplitude, phase and interrelationship) of the biological rhythms that normally exhibit circadian oscillation, presumably involving decreased activity of the serotonergic system. The major trigger of asynchronization is hypothesized to be a combination of light exposure during the night and a lack of light exposure in the morning. In addition to basic principles of morning light and an avoidance of nocturnal light exposure, presumable potential therapeutic approaches for asynchronization involve both conventional ones (light therapy, medications (hypnotics, antidepressants, melatonin, vitamin B12), physical activation, chronotherapy) and alternative ones (kampo, pulse therapy, direct contact, control of the autonomic nervous system, respiration (qigong, tanden breathing), chewing, crawling). A morning-type behavioral preference is described in several of the traditional textbooks for good health. The author recommends a morning-type behavioral lifestyle as a way to reduce behavioral/emotional problems, and to lessen the likelihood of falling into asynchronization.Brain & development 04/2009; DOI:10.1016/j.braindev.2008.07.006 · 1.74 Impact Factor
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ABSTRACT: Background: Chronic Fatigue Syndrome (CFS) affects 0.23–2.6% of the adult population. Sleep-related complaints are amongst the most frequently reported symptoms in these patients. Although a biopsychosocial model of CFS offers a plausible framework for understanding the condition, the role of sleep and how it functions within this model remains unclear. Purpose: This narrative review describes the findings of studies of sleep in CFS and considers the reasons behind the diversity of results. The review also discusses the difficulties that exist in establishing relationships between sleep, behaviour, cognition, physiology, and the physical symptoms of CFS. Methods: A search of Medline for the terms “CFS,” “chronic fatigue syndrome,” AND “sleep” was performed to identify articles concerning sleep and CFS from 1988 to the present. Results: Subjective sleep dysfunction was frequently reported in the CFS sleep studies. However, objective sleep research in CFS has shown no consistent picture of sleep disturbance, particularly with regard to polysomnography. This may be attributable to the heterogeneity of sleep phenotypes in the CFS population as well as the variability in sleep assessment protocols, case definitions, and exclusion criteria used across studies. Conclusions: Given the high prevalence of disturbed sleep in this population in combination with inconsistent findings, exploration of new protocols for the objective assessment of sleep in CFS (e.g., three-night PSG protocol) is recommended. Understanding the distinct sleep characteristics in this population could serve to improve insight into perpetuating factors of CFS symptoms which is relevant for diagnosis and therapy.07/2014; 2(3):163-184. DOI:10.1080/21641846.2014.935607