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. 2017 Feb 15:303:43-50.
doi: 10.1016/j.jneuroim.2016.12.008. Epub 2016 Dec 14.

Poor sleep quality is associated with greater circulating pro-inflammatory cytokines and severity and frequency of chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME) symptoms in women

Sara F Milrad  1 , Daniel L Hall  2 , Devika R Jutagir  1 , Emily G Lattie  3 , Gail H Ironson  1 , William Wohlgemuth  4 , Maria Vera Nunez  5 , Lina Garcia  6 , Sara J Czaja  6 , Dolores M Perdomo  6 , Mary Ann Fletcher  5 , Nancy Klimas  5 , Michael H Antoni  7
Affiliations

Poor sleep quality is associated with greater circulating pro-inflammatory cytokines and severity and frequency of chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME) symptoms in women

Sara F Milrad et al. J Neuroimmunol. .

Abstract

Objective: Poor sleep quality has been linked to inflammatory processes and worse disease outcomes in the context of many chronic illnesses, but less is known in conditions such as chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME). This study examines the relationships between sleep quality, pro-inflammatory cytokines, and CFS/ME symptoms.

Methods: Sixty women diagnosed with CFS/ME were assessed using the Pittsburgh Sleep Quality Index (PSQI), Fatigue Symptom Inventory (FSI) and Center for Disease Control and Prevention (CDC)-based CFS/ME symptom questionnaires. Circulating plasma pro-inflammatory cytokine levels were measured by ELISA. Multiple regression analyses examined associations between sleep, cytokines and symptoms, controlling for age, education, and body mass index.

Results: Poor sleep quality (PSQI global score) was associated with greater pro-inflammatory cytokine levels: interleukin-1β (IL-1β) (β=0.258, p=0.043), IL-6 (β=0.281, p=0.033), and tumor necrosis factor-alpha (TNF-α) (β=0.263, p=0.044). Worse sleep quality related to greater fatigue severity (β=0.395, p=0.003) and fatigue-related interference with daily activities (β=0.464, p<0.001), and more severe and frequent CDC-defined core CFS/ME symptoms (β=0.499, p<0.001, and β=0.556, p<0.001, respectively).

Conclusions: Results underscore the importance of managing sleep-related difficulties in this patient population. Further research is needed to identify the etiology of sleep disruptions in CFS/ME and mechanistic factors linking sleep quality to symptom severity and inflammatory processes.

Keywords: Chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME); Fatigue; Inflammation; Poor sleep quality; Pro-inflammatory cytokines.

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Conflict of interest statement

The authors report no conflicts of interest.

Figures

Figure 1
Figure 1
Relationships between CFS-Related Symptoms and Global PSQI Score
Figure 2
Figure 2
Relationships between Circulating Serum Cytokine Levels and Global PSQI Score
See this image and copyright information in PMC

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