Abstract
Sleep problems have a negative impact on a range of outcomes and are very common in adolescents with chronic fatigue syndrome (CFS). We aimed to (a) establish whether adolescents with CFS have more self-reported sleep problems than illness controls as well as healthy controls, (b) investigate changes in sleep problems and (c) explore the extent to which sleep problems at baseline predict fatigue and functioning at follow-up in adolescents with CFS. The Insomnia Scale was completed by 121 adolescents with CFS, 78 healthy adolescents and 27 adolescents with asthma. Eighty (66%) treatment-naïve adolescents with CFS completed questionnaires approximately 3 months later. Adolescents with CFS reported increased sleep problems compared to healthy controls and adolescents with asthma. In CFS, there was no significant change in sleep problems without treatment over a 3-month follow-up. Sleep problems at baseline predicted a significant proportion of the variance in sleep problems at follow-up. Sleep problems should be targeted in treatment. Regulating the ‘body clock’ via the regulation of sleep could influence outcomes not assessed in this study such as school attainment.
Highlights
Chronic fatigue syndrome (CFS) is characterised by ongoing severe and disabling fatigue, of at least 3 months duration, which is not the result of another medical condition (NICE, 2007)
The current study aimed to examine self-reported sleep disturbances in a clinical cohort of adolescents with CFS compared to adolescents with asthma and healthy adolescents and to investigate the impact of sleep disturbances on outcome in CFS
We found that adolescents with CFS reported increased sleep disturbances in all aspects of sleep compared to both healthy adolescents and illness controls
Summary
Chronic fatigue syndrome (CFS) is characterised by ongoing severe and disabling fatigue, of at least 3 months duration, which is not the result of another medical condition (NICE, 2007). Other accompanying dificulties can include sleep disturbances, as well as attention and concentration problems, nausea, dizziness, headaches and muscle and joint pain (NICE, 2007). It affects approximately 1–2% of adolescents (Brigden et al, 2017) and causes significant disability, including significantly decreased school attendance (Crawley & Sterne, 2009). Sleep problems are common in adolescents with chronic health conditions and may result from underlying disease-related pathology, treatment regimens or inpatient hospital stays (Lewandowski et al, 2011). In adolescents with chronic pain, for example, sleep problems are common and persistent and predict poorer quality of life over time (Palermo et al, 2012). Lower subjective sleep quality is associated with higher activity limitations, assessed objectively using actigraphy (Palermo et al, 2008)
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