New insights into controversial diagnosis of adolescent chronic fatigue
Crucial new research could provide some clarity around the controversy surrounding the diagnosis and treatment of chronic fatigue syndrome (CFS) in adolescents.
The research by the Murdoch Children's Research Institute published in the Journal of Clinical Sleep Medicine studied the subjective sleep quality of a small group of adolescents suffering CFS by using self-report measures. Objective measures were also used to assess sleep quality in these teenagers, including the electronic monitoring of the movement of participants while they were in bed.
CFS affects approximately 100 in 100,000 children and adolescents in Australia. Symptoms of the condition include excessive fatigue, sleep disturbance, and impairments in cognitive, autonomic, neurological and/or immune functioning. These symptoms can worsen after participating in even minimal physical or mental activity.
The study looked at objective measures of sleep quality by using an actigraphy watch, which is able to electronically monitor movement in bed. The watch was able to record how long it took participants to fall asleep, bed time and rise time, amount of time awake during the night, and total sleep time.
Over the course of the two-week study, participants were found to take significantly longer to fall asleep, were in bed for longer, had longer total sleep time, and a later rise time, compared with healthy adolescents. They also self-reported poorer sleep and sleep quality.
Lead researcher Dr Elisha Josev said the research gave a more comprehensive understanding of the complex relationship between CFS and sleep, and suggests both objective and subjective factors may be important for doctors to consider when treating adolescent patients with sleep disturbance.
CFS has been the subject of debate among healthcare professionals who differ on the methods used and symptoms observed in diagnosis.
"The onset of CFS in adolescence occurs at an important time of brain maturation, and academic, social and physical development. Treating sleep disturbance and promoting good sleep hygiene, such as avoiding caffeine close to bedtime and maintaining a regular sleep schedule, may not only be important for adolescents' development, but may also have the benefit of reducing exacerbation of their other CFS symptoms," Dr Josev said.
This study was generously funded by the Mason Foundation. Dr Josev's next study will involve brain scanning via MRI (magnetic resonance imaging) to investigate the neurological impacts of chronic fatigue syndrome on adolescents.