Chronic Fatigue Syndrome and Fibromyalgia'
Spitzer AR, Broadman M.
Wayne State University School of Medicine, Detroit, Michigan.
Pain Pract. 2010 Mar 2. [Epub ahead of print]
This study characterizes findings on sleep testing and Human Leukocyte
Antigen (HLA) markers in a group of patients with fibromyalgia (FM)
and chronic fatigue syndrome (CFS). One hundred eighteen patients seen
in a general neurology practice over 5 years meeting standard clinical
criteria for FM or CFS were analyzed retrospectively. Cases of
untreated sleep apnea or restless legs syndrome were excluded prior to
inclusion in this study. Ninety-two patients had multiple sleep
latency testing (MSLT). Seventy-three (80%) were abnormal by standard
criteria. Of 57 females having positive MSLTs, 22 (39%) had one or
more periods of sleep onset rapid eye movement (SOREM), and 5 of 16
(31%) males with positive MSLTs had one or more SOREM. Highly
fragmented sleep, as previously described in FM, was seen but not
analyzed quantitatively. HLA DQB1*0602 was obtained in 74 patients,
and positive in 32 (43%), P < 0.0001 compared with published values in
228 populations. In our patients, who presented with neuromuscular
fatigue or generalized pain, we found a sleep disorder characterized
by objective hypersomnia. Some patients had characteristics of
narcolepsy. Objective assessment by sleep studies can assist the
diagnostic process, aid future research, and provide rationale for
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