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CFS Toolkit - Sleep

The majority of CFS patients complain of some form of sleep-related symptoms. Sleep deprivation or disruption may cause or worsen other symptoms such as fatigue, memory problems, headaches and joint pain. Treating sleep problems should occur early in the CFS treatment program.

  • A doctor should set up a consult with a sleep specialist or schedule a sleep study if a person with CFS symptoms identifies problems consistent with:
    • sleep apnea (pauses in breathing or shallow breaths while sleeping)
    • restless leg syndrome (uncontrolled movements of the lower legs and "crawly" sensations in the calves)
    • sleep phase abnormalities
    • persistent/recurrent daytime sleeping
  • If insurance or other matters prevent a consultation with a sleep specialist, patients should speak to their primary care physicians about sleep problems.
  • People with CFS symptoms should practice good sleeping habits (also known as sleep hygiene).
  • Medications can be considered in the absence of specific sleep disorders if sleep hygiene is not successful. A short-term trial of sedating antihistamines or over-the-counter sleep products may assist initiation of good sleep hygiene.
  • If this approach is not beneficial, then a trial of a prescription sleep medicine in the smallest possible dose may be warranted. Sleep medication for such patients should only be prescribed pending a complete sleep history and evaluation by a sleep specialist.
  • Long term use of hypnotics is not recommended by many sleep specialists.

Sleep hygiene tips

  • Go to bed at the same time each night and rise at the same time each morning.
  • Make sure your bedroom is a quiet, dark, and relaxing environment, which is neither too hot nor too cold.
  • Make sure your bed is comfortable and use it only for sleeping and sex and not for other activities, such as reading, watching TV, or listening to music. Remove all TVs, computers, and other "gadgets" from the bedroom.
  • Physical activity may help promote sleep, but not within a few hours of bedtime.
  • Avoid large meals before bedtime.



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