School of Psychiatry, University of NSW, Sydney, Australia.
Sleep. 2011 May 1;34(5):671-8. doi: 10.1093/sleep/34.5.671.
Disturbances of the internal biological clock manifest as fatigue, poor concentration, and sleep disturbances-symptoms reminiscent of chronic fatigue syndrome (CFS) and suggestive of a role for circadian rhythm disturbance in CFS. We examined circadian patterns of activity, sleep, and cortisol secretion in patients with CFS.
Case-control study, 5-day behavioral observation.
Natural setting/home environment
15 patients with CFS and 15 healthy subjects of similar age, sex, body mass index (BMI), and activity levels.
N/A.
Self-report questionnaires were used to obtain medical history and demographic information and to assess health behaviors, somatic and psychological symptoms, and sleep quality. An actiwatch accelerometer recorded activity and sleep patterns over 5 days with concurrent activity and symptom logs. Diurnal salivary cortisol secretion was measured. Additionally, overnight heart rate monitoring and pain sensitivity assessment was undertaken.
Ratings of symptoms, disability, sleep disturbance, and pain sensitivity were greater in patients with CFS. No between-group differences were found in the pattern or amount of sleep, activity, or cortisol secretion. Afternoon activity levels significantly increased evening fatigue in patients but not control subjects. Low nocturnal heart rate variability was identified as a biological correlate of unrefreshing sleep.
We found no evidence of circadian rhythm disturbance in CFS. However, the role of autonomic activity in the experience of unrefreshing sleep warrants further assessment. The activity symptom-relationship modelled here is of clinical significance in the approach to activity and symptom management in the treatment of CFS.
内部生物钟紊乱表现为疲劳、注意力不集中和睡眠障碍——这些症状类似于慢性疲劳综合征 (CFS)，提示昼夜节律紊乱在 CFS 中的作用。我们研究了 CFS 患者的活动、睡眠和皮质醇分泌的昼夜节律模式。
病例对照研究，5 天行为观察。
自然环境/家庭环境
15 名 CFS 患者和 15 名年龄、性别、体重指数 (BMI) 和活动水平相似的健康对照者。
无。
使用自我报告问卷获取病史和人口统计学信息，并评估健康行为、躯体和心理症状以及睡眠质量。活动记录仪记录了 5 天的活动和睡眠模式，并同时记录活动和症状日志。测量了日间唾液皮质醇分泌。此外，还进行了夜间心率监测和疼痛敏感性评估。
CFS 患者的症状、残疾、睡眠障碍和疼痛敏感性评分较高。在睡眠、活动或皮质醇分泌的模式或量方面，两组之间没有差异。下午的活动水平显著增加了患者的夜间疲劳，但对对照组没有影响。夜间心率变异性低被认为是睡眠质量不佳的生物学相关因素。
我们没有发现 CFS 存在昼夜节律紊乱的证据。然而，自主活动在睡眠质量不佳中的作用值得进一步评估。这里建立的活动与症状之间的关系对 CFS 治疗中活动和症状管理的方法具有临床意义。
