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Sleep, symptoms and more: research round-up

February 01, 2016

Each month, Action for M.E. Volunteer Pharmacist Emily Beardall explains some of the recently published research studies on M.E.

Please note this is not an exhaustive list – we have selected to highlight the studies that are most likely to resonate with the daily lives of those affected by the condition. We will also report separately on further studies of significance, as and when they are published.

You can search online directory PubMed for most studies about M.E. published in peer-reviewed journals.

The following studies were published online between 22 December 2015 and 21 January 2016. In each case, we have used the same name for the illness as the researchers publishing the paper.

How sleep affects fatigue

study in the journal Sleep has looked at whether poor sleep experienced by people with CFS relates to how fatigued they feel the next day, and whether mood and perceptions of sleep quality, such as unrefreshing sleep, play a role. It was found that self-reported poor sleep and low mood on waking caused increased fatigue during the day, and that physical or mental activity before sleeping leads to poor sleep quality. This suggests that by winding down before bedtime, making changes to sleep, and improving mood on waking, may improve fatigue the following day.

Experiences of sleep affecting symptoms 

study in the British Journal of Health Psychology involved interviews with people with CFS about the effect of sleep on their illness. Although each person interviewed described their sleep problems differently, they all spoke of how sleep is a central problem affecting management of their CFS symptoms. They all linked disturbed sleep to worse pain and concentration problems the following day, with the need for a slower start to the day. They felt they needed eight hours or more of unbroken sleep but rarely have this and continually find it difficult to keep a healthy sleep pattern. The authors, including Prof Newton who is one of Action for M.E.’s medical advisors, suggest that this important factor affecting fluctuation of symptoms should be taken into account in clinics and future research.

Relationships and fluctuations in symptom severity

Another study in the British Journal of Health Psychology looked at how the responses of a spouse or partner of a person with CFS/ME can affect symptom severity and disability, by asking both to record scores in a diary six times a day. Negative reactions from partners caused the patients to over-do activity, followed by a temporary worsening of symptoms, which lasted

longer if the reaction caused distress. Contrary to previous research, caring responses made the patient reduce their activity, leading to reduced fatigue and disability caused by post-exertional malaise. The authors concluded that a partner’s responses are important influences on the day-to-day life of a person with CFS/ME, and that addressing a partner’s negative reactions may be helpful in keeping symptoms more stable.

Gender differences

study published in Nature suggests that gut bacteria differ between men and women with ME/CFS and that this affects symptom severity. These differences have also previously been found in autoimmune diseases, such as MS, lupus, and Type 1 diabetes. The study suggests a connection between gut bacteria, sex hormones and the immune system, and that gender differences in gut bacteria may explain why twice as many women as men have these diseases. The authors suggest that this may be helpful in determining treatment options for subgroups of ME/CFS.

Autoimmune antibodies may cause many symptoms in a subgroup of CFS 

study in the journal Brain, Behaviour and Immunity examined the blood samples from CFS patients, some of whom were also involved in the Norwegian rituximab study, compared with that of healthy controls. Around 30% of the people with CFS had high amounts of autoimmune antibodies working against part of the autonomic nervous system. This could account for some of the symptoms such as dizziness and palpitations after standing up and digestive system problems, amongst others, in a subgroup of people with CFS. The patients who had responded well in the rituximab trial had these antibodies before treatment but normal levels afterwards. This research should be seen more as a way of investigating the subgroups of CFS than as a potential treatment at this stage.