Recent study analysed daytime drowsiness in FM/CFS using abnormally fast time to fall asleep (sleep latency); 80% had abnormal tests. They found gene type HLA DQB1*0602 was obtained in 74 (43%) of subjects – which is 5 times what you would expect in the general population (P < 0.0001).
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Pain Pract. 2010 Mar 2. [Epub ahead of print]
A Retrospective Review of the Sleep Characteristics in Patients with Chronic Fatigue Syndrome and Fibromyalgia.
Spitzer AR, Broadman M. abstract here
- 118 patients with CFS and FM
- People will have abnormal sleepiness will fall asleep very quickly.They call this sleep latency. This is averaged over 4-5 naps (“multiple”). Sleep onset rapid eye movement (SOREM) is one way of detecting sleep onset.
- “Our data show that these patients have clear, substantial, objective daytime hypersomnia in the face of, and simultaneous with, this disrupted nocturnal sleep pattern.”
- 80% had a sleep latency of less than 8 minutes
- Felt that the night-time disrupted sleep was primary, and the daytime drowsiness rivelled narcolepsy.
- There was a lack of difference between the fibromyaglia and chronic fatigue cases, making them wonder just how different they actually were.
- HLA DQB1*0602 is a gene marker seen in 90% of narcolepsy cases and in 20% of the general population.
- “our results of 43% positive for this HLA marker in this population are over 5 times higher than the
average prevalence in the 228 populations.” – The gene marker might be related to cerebrospinal fluid hypocretin levels
- Considering a possible viral origin, they mention “the lesions in von Economo’s encephalitis could lead to sleep disorders such as those seen in our patients.”
- sodium oxybate, shown to cause deep sleep in FM sufferers. might be an option.
Comment – One of the problems with Fibromyaglia and Chronic fatigue syndrome has been the lack of objective evidence. Hence, the are diagnosed with psyhciatric disorders and end up going through multiple different doctors. “Objective findings on sleep studies will help quantify the fatigue, provide an objective basis for its presence, reassure patients and physicians, and help guide treatment plans.” Unfortunately, I have seen these abnormal results trivialized and ignored. Sodium Oxybate can cost $500.00+/month and is not covered.