Abstract
BackgroundSince chronic fatigue syndrome (CFS) and fibromyalgia (FM) often co-exist, some believe they reflect the same process, somatization. Against that hypothesis are data suggesting FM but not CFS was common in patients with sleep-disordered breathing (SDB). The presence of discrete case definitions for CFS and FM allowed us to explore rates of CFS alone, CFS with FM, and FM alone in SDB patients compared to those with sleep complaints that fulfilled criteria for insomnia.MethodsParticipants were 175 sequential patients with sleep-related symptoms (122 had SDB and 21 had insomnia) and 39 healthy controls. Diagnoses were made by questionnaires, tender point count, and rule out labs; sleepiness was assessed with Epworth Sleepiness Scale and mood with Beck Depression Inventory.ResultsRates of CFS, FM or CFS + FM were high: 13% in SDB and 48% in insomnia. CFS occurred frequently in SDB and insomnia, but FM occurred frequently only in insomnia. SDB patients with CFS and/or FM had higher daytime sleepiness than those without these disorders.ConclusionCFS patients should complete Epworth scales, and sleep evaluation should be considered for those with scores ≥ 16 before receiving the diagnosis of CFS; the coexistence of depressed mood in these patients suggests some may be helped by treatment of their depression. That FM was underrepresented in SDB suggests FM and CFS may have different underlying pathophysiological causes.
Highlights
Since chronic fatigue syndrome (CFS) and fibromyalgia (FM) often co-exist, some believe they reflect the same process, somatization
That decision seemed appropriate because, in contrast to early studies that suggested a high rate of sleep disorders in CFS [6,7,8], later studies including our own found no difference in rates of sleep disorders between patients with CFS and healthy controls [9,10,11]
We evaluated a consecutive cohort of patients with sleep complaints for these diagnoses; the patients underwent diagnostic PSG
Summary
Since chronic fatigue syndrome (CFS) and fibromyalgia (FM) often co-exist, some believe they reflect the same process, somatization. Against that hypothesis are data suggesting FM but not CFS was common in patients with sleep-disordered breathing (SDB). The core symptoms of pain, fatigue, sleep problems and cognitive difficulties exist across both syndromes and lead to significant co-morbidity between them. The fact that these two syndromes co-exist so often has led some to question whether they are, distinct diagnostic entities. That decision seemed appropriate because, in contrast to early studies that suggested a high rate of sleep disorders in CFS [6,7,8], later studies including our own found no difference in rates of sleep disorders between patients with CFS and healthy controls [9,10,11]. Except for our own work [11] and one other early study [12], a number of other studies suggests that FM is often accompanied by sleep-disordered breathing (SDB) [13,14,15,16]
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