Abstract
IntroductionUnrefreshing sleep is one of the diagnostic criteria in myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS), which could be explained by sleep disorders, for example obstructive sleep apnea, reported in our previous study with polysomnography. Our previous findings also indicate difficulties in emotional regulation when measuring alexithymia by TAS-20 (Toronto Alexithymia Scale) and level of emotional awareness by LEAS (Level of Emotional Awareness Scale) in ME/CFS patients. However, the reasons for this are unknown. The purpose of this study was to investigate correlations between data from subjective emotional regulation and polysomnography.MethodsTwenty-three ME/CFS patients (5 men and 18 women) of mean age 43, and 30 matched healthy controls (9 males and 21 women) of mean age 45, filled in TAS-20, LEAS, and Hospital Depression and Anxiety Scale (HADS). A polysomnography was performed on patients but not on healthy controls. Thus, values of normal population were used for sleep evaluation in ME/CFS patients.ResultThere were significant differences between patients and controls in several aspects of emotional regulation, for example LEAS-self and LEAS-total. Seventy percent of the patients had increased numbers of awakenings (shifts from any sleep stage to awake), 22% had obstructive sleep apneas, and 27% had periodic limb movements. Correlation analysis showed that number of awakenings significantly correlated with LEAS-self and LEAS-total, p < 0.01, respectively. There were no other significant correlations.ConclusionThis pilot study demonstrated significant correlations between reduced emotional awareness and number of awakenings in polysomnography. Future studies with larger cohorts need to be conducted.
Highlights
Unrefreshing sleep is one of the diagnostic criteria in myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS), which could be explained by sleep disorders, for example obstructive sleep apnea, reported in our previous study with polysomnography
Our recent study indicated that ME/CFS patients had increased alexithymia by scoring in Toronto Alexithymia Scale (TAS-20) and lower levels of emotional awareness by scoring in Level of Emotional Awareness Scale (LEAS), as compared to healthy controls [9]
Comparisons between ME/CFS patients and healthy controls showed that ME/CFS patients had significantly higher scores in TAS-DIF and total TAS-20, as well as significantly lower values in LEAS-self and LEAS total (Table 2)
Summary
Unrefreshing sleep is one of the diagnostic criteria in myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS), which could be explained by sleep disorders, for example obstructive sleep apnea, reported in our previous study with polysomnography. (40.3%) patients were diagnosed with obstructive sleep apnea (OSA), 7 (8.9%) patients with periodic limb movement disorder, and (41.0%) patients with restless legs syndrome Taken together, among those reporting pathological sleep symptoms, 69.3% of patients had one or more sleep disorders. Our recent study indicated that ME/CFS patients had increased alexithymia by scoring in Toronto Alexithymia Scale (TAS-20) and lower levels of emotional awareness by scoring in Level of Emotional Awareness Scale (LEAS), as compared to healthy controls [9]
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