Chronic Fatigue Syndrome

Melinda is a 50 year old receptionist at an insurance company who, over the past 6 years, has experienced excessive fatigue to the point of not being able to work anymore. The fatigue started gradually and within a couple of months, she would come home and lay in bed for hours,  at times for a 2-3 days stretch. On top of that, she began to suffer from joint pains, muscle aches, headaches and memory problems. She felt like the energy got sucked out of her. She developed insomnia and her sleep was unrestorative. Her doctors tested her for possible causes but all the tests came back normal. She was placed on antidepressants and they only helped a little.

Melinda is experiencing a condition called chronic fatigue syndrome (CFS) which causes the individual to have profound fatigue and lack of energy that is worsened with activity such as exercise and is not relieved with rest. Individuals with CFS might have other unexplained symptoms such as sleepiness, sore throat, depression, memory problems and muscle aches. Medical workup and tests do not point to specific abnormalities.

Many individuals with CFS suffer from sleep problems including sleepiness during the day, unrefreshed sleep, restless sleep or insomnia. Others might have sleep apnea, leg jerks or restless legs. Poor sleep can worsen the fatigue and pain and makes people stressed and depression even more and that makes their fatigue worse. So it is is vicious cycle. Therefore it is important to address the sleep quality in individuals with CFS in order to improve their quality of life.

How to improve the sleep quality in CFS

  • Review your sleep habits. Do you snore, stop breathing at night, have legs jerks, toss and turn at night, wake up tired from the get go, worry about your sleep? Ask your bed partner to observe any of these signs. If you suspect sleep problems, talk to your doctor and/or a sleep medicine specialist to be evaluated and treated appropriately.
  • Avoid the use of sleeping pills from the get go. It is best to try to improve sleep the “natural way”. Sleeping pills have their place and might be helpful in the short term. Your doctor can assist you. If you are torn between taking the pill or not, remember, bad sleep is harmful to your health- so if taking a pill is what you need to sleep, it is alright as long as your sleep habits are addressed and you ruled out/treated sleep apnea.
  • If you are sleeping well and you are still tired and you need that extra energy, try to get some exercise (initially walking 10 minutes- then perhaps joining a gym). Make sure you get outdoor exposure to get sunshine.
  • A recent study in the 2011 March issue of Lancet shows that individuals with CFS benefit from cognitive-behavioral therapy (CBT) and graded exercise therapy. CBT requires a skilled counselor and it works by having you first recognize negative thought patterns that you have; then they help you work on changing those thoughts into the positive and optimistic realm.