11 Sleep

From: Reviving the Broken Marionette: Treatments for CFS/ME and Fibromyalgia

CFS/ME and fibromyalgia are frequently associated with major sleep disturbances. This is even a part of the Canadian diagnostic criteria for CFS/ME.1 Most likely the disordered sleep is not the cause of the fatigue or other symptoms, but it can often worsen them and lower quality of life. Even modest sleep deprivation increases the secretion of inflammatory cytokines such as IL–6, which can contribute to pain, fatigue, malaise and flu–like symptoms.2 IL–6 in particular causes muscular hyperalgesia (heightened sensitivity to pain).

The sleep problems can include low quality of sleep, sleep apnea, insomnia, hypersomnia and hypnagogic states. Other related problems such as nocturia and involuntary movements are also common. According to Dr. Robert Bennett restless legs syndrome is the most common sleep disorder in fibromyalgia and up to one fifth of the patients suffer from sleep apnea.3

Patients often experience frequent awakenings during the night and cannot easily fall asleep again. Thus quick–acting medications may not always be of much help. The quality of sleep may suffer because of frequent need to urinate. In such cases medication for nocturia should be considered.

From: <a href="https://www.researchgate.net/publication/232704796_Traumatic_Brain_Injury_and_Sleep_Disorders">https://www.researchgate.net/publication/232704796_Traumatic_Brain_Injury_and_Sleep_DisordersSleep disturbance is common after traumatic brain injury (TBI). Insomnia, fatigue, and sleepiness are the most frequent post-TBI sleep complaints with narcolepsy (with or without cataplexy), sleep apnea (obstructive or central), periodic limb movement disorder, and parasomnias occurring less commonly. In addition, depression, anxiety, and pain are common TBI comorbidities with substantial influence on sleep quality. Diagnosis of sleep disorders after TBI may involve polysomnography, multiple sleep latency testing, or actigraphy. Treatment is disorder-specific and includes the use of medications, continuous positive airway pressure, or behavioral modifications. Unfortunately, treatment of sleep disorders associated with TBI often does not improve sleepiness or neuropsychologic function.
(PDF) Traumatic Brain Injury and Sleep Disorders. Available from: </a><a href="https://www.researchgate.net/publication/232704796_Traumatic_Brain_Injury_and_Sleep_Disorders">https://www.researchgate.net/publication/232704796_Traumatic_Brain_Injury_and_Sleep_Disorders</a><a href="https://www.researchgate.net/publication/232704796_Traumatic_Brain_Injury_and_Sleep_Disorders"> [accessed Sep 17 2018].</a>