SLEEP DISTURBANCES ME/CFS and FM - Lucinda Bateman MD Bateman Horne Center

Reduce overload) 3) Address the major aspects of illness PAIN: reduce severe pain SLEEP: achieve restorative sleep FITNESS MENTAL HEALTH: insight and support FITNESS: engage in restorative exercise PAIN MENTAL HEALTH SLEEP Unrefreshing sleep Sleep disturbances are common Included in all CFS ME/CFS, ME and FM case definitions or symptom criteria Present in >90% of all diagnosed Slee. [...] 8(6):719-728 Primary Sleep Disorders Central sleep apnea Obstructive sleep apnea Movement disorders (RLS, PLMD) Narcolepsy Obviously cause severe sleep disruption, somnolence, fatigue and other symptoms. [...] (IOM summary in sleep section) Other challenges of interpreting ME/CFS and FM PSG results Use of medications and withdrawal of medications alter sleep architecture (may need 1-2 weeks or more?) Stages of illness might have different sleep issues (especially in ME/CFS) Initial hypersomnia--- later insomnia. [...] Central Sensitivity impact on sleep Pain amplification/hyperalgesia (FM) Pain disrupts sleep and may contribute to alpha wave intrusion* All sensory amplification in ME/CFS and FM may impact sleep Pain… Noise... [...] Aim at all the CAUSES of sleep disruption vs “drugged” to sleep Simplify use of medications and use them skillfully Sleep onset? ...wind down, establish cycles, short acting drugs, earlier dosing of longer acting sedating medications Light sleep and frequent awakening? …reduce interruptions, low dose longer acting meds Early morning awakening? …med rebound or withdrawal? Too much sleep?.