Paradoxical Nrems Distribution in "Pure" Chronic Fatigue Patients A
Comparison With Sleep Apnea-Hypopnea Patients and Healthy Control Subjects
Journal: J of Chronic Fatigue Syndrome
Authors: Olivier Le Bon MD, PhD, Daniel Neu MD, Filomena Valente PhD,
Paul Linkowski MD, PhD
Objective: The chronic fatigue syndrome (CFS) is a debated clinical
entity, not presently associated with specific sleep abnormalities.
However, higher levels of deep sleep and/or lower levels of light
sleep have been reported in several all-night polysomnography studies
in CFS patients. This distribution of Non-Rapid Eye Movement Sleep
(NREMS) contrasts with what would be expected if sleep was
interrupted by microawakenings, such as in sleep apneas or periodic
limb movements, where more light sleep and less deep sleep are
commonly observed. This "paradoxical" distribution of NREMS could
represent a characteristic feature of chronic fatigue and deserved to
be investigated.
Methods: A retrospective comparison of the NREMS distribution was
performed between 28 "pure" Chronic Fatigue Syndrome patients
(without primary sleep or psychiatric disorders), 27 Apneic-Hypopneic
patients and 27 Healthy Controls.
Results: Data showed CFS patients to have a higher stage 4/stage 2 or
stage 4/light sleep ratios than the other two conditions.
Conclusion: This sleep pattern is closer to what is observed in cases of infections than to what is seen after sleep fragmentation by primary sleep or in psychiatric disorders. Such a particular sleep pattern could provide insights into the pathophysiology of fatigue.
Keywords: Chronic fatigue syndrome, polysomnography, fatigue, NREM distribution
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