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Systemic exertion intolerance disease/chronic fatigue syndrome is common in sleep centre patients with hypersomnolence: A retrospective pilot study.

ABSTRACT: Symptoms of the central disorders of hypersomnolence extend beyond excessive daytime sleepiness to include non-restorative sleep, fatigue and cognitive dysfunction. They share much in common with myalgic encephalomyelitis/chronic fatigue syndrome, recently renamed systemic exertion intolerance disease, whose additional features include post-exertional malaise and orthostatic intolerance. We sought to determine the frequency and correlates of systemic exertion intolerance disease in a hypersomnolent population. One-hundred and eighty-seven hypersomnolent patients completed questionnaires regarding sleepiness and fatigue; questionnaires and clinical records were used to assess for systemic exertion intolerance disease. Sleep studies, hypocretin and cataplexy were additionally used to assign diagnoses of hypersomnolence disorders or sleep apnea. Included diagnoses were idiopathic hypersomnia (n = 63), narcolepsy type 2 (n = 25), persistent sleepiness after obstructive sleep apnea treatment (n = 25), short habitual sleep duration (n = 41), and sleepiness with normal sleep study (n = 33). Twenty-one percent met systemic exertion intolerance disease criteria, and the frequency of systemic exertion intolerance disease was not different across sleep diagnoses (p = .37). Patients with systemic exertion intolerance disease were no different from those without this diagnosis by gender, age, Epworth Sleepiness Scale, depressive symptoms, or sleep study parameters. The whole cohort reported substantial fatigue on questionnaires, but the systemic exertion intolerance disease group exhibited more profound fatigue and was less likely to respond to traditional wake-promoting agents (88.6% versus 67.7%, p = .01). Systemic exertion intolerance disease appears to be a common co-morbidity in patients with hypersomnolence, which is not specific to hypersomnolence subtype but may portend a poorer prognosis for treatment response.

SUBMITTER: Maness C

PROVIDER: S-EPMC6173992 | biostudies-literature | 2019 Jun

REPOSITORIES: biostudies-literature

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Systemic exertion intolerance disease/chronic fatigue syndrome is common in sleep centre patients with hypersomnolence: A retrospective pilot study.

Maness Caroline C Saini Prabhjyot P Bliwise Donald L DL Olvera Victoria V Rye David B DB Trotti Lynn M LM

Journal of sleep research 20180406 3

Symptoms of the central disorders of hypersomnolence extend beyond excessive daytime sleepiness to include non-restorative sleep, fatigue and cognitive dysfunction. They share much in common with myalgic encephalomyelitis/chronic fatigue syndrome, recently renamed systemic exertion intolerance disease, whose additional features include post-exertional malaise and orthostatic intolerance. We sought to determine the frequency and correlates of systemic exertion intolerance disease in a hypersomnol ...[more]

PMID: 29624767

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Project description:BACKGROUND:Chronic Fatigue Syndrome/Myalgic Encephalomyelitis/Systemic Exertion Intolerance Disease (CFS/ME/SEID) is a complex illness that has an unknown aetiology. It has been proposed that metabolomics may contribute to the illness pathogenesis of CFS/ME/SEID. In metabolomics, the systematic identification of measurable changes in small molecule metabolite products have been identified in cases of both monogenic and heterogenic diseases. Therefore, the aim of this systematic review was to evaluate if there is any evidence of metabolomics contributing to the pathogenesis of CFS/ME/SEID. METHODS:PubMed, Scopus, EBSCOHost (Medline) and EMBASE were searched using medical subject headings terms for Chronic Fatigue Syndrome, metabolomics and metabolome to source papers published from 1994 to 2020. Inclusion and exclusion criteria were used to identify studies reporting on metabolites measured in blood and urine samples from CFS/ME/SEID patients compared with healthy controls. The Joanna Briggs Institute Checklist was used to complete a quality assessment for all the studies included in this review. RESULTS:11 observational case control studies met the inclusion criteria for this review. The primary outcome of metabolite measurement in blood samples of CFS/ME/SEID patients was reported in ten studies. The secondary outcome of urine metabolites was measured in three of the included studies. No studies were excluded from this review based on a low-quality assessment score, however there was inconsistency in the scientific research design of the included studies. Metabolites associated with the amino acid pathway were the most commonly impaired with significant results in seven out of the 10 studies. However, no specific metabolite was consistently impaired across all of the studies. Urine metabolite results were also inconsistent. CONCLUSION:The findings of this systematic review reports that a lack of consistency with scientific research design provides little evidence for metabolomics to be clearly defined as a contributing factor to the pathogenesis of CFS/ME/SEID. Further research using the same CFS/ME/SEID diagnostic criteria, metabolite analysis method and control of the confounding factors that influence metabolite levels are required.

Project description:This study aimed to compare the time course of measures of performance, fatigue, and perceived exertion during repeated-sprint ability (RSA) testing performed on a non-motorized treadmill (NMT) and cycling ergometer (CE). Fourteen physically active participants performed two 10 ×6 s-1 RSA tests with a 1:4 work-to-rest ratio (24 s recovery) on NMT and CE. Measures of performance [peak and mean power output (PPO and MPO), cadence, and the time to reach PPO (TTP)] and of fatigue (fatigue index and decrement score) and ratings of perceived exertion (RPE) were collected during each session. The level of significance was set at p < 0.05. Participants completed the RSA test at a MPO of 1,041 ± 141 W on CE and 431 ± 48 W on NMT, achieving PPO of 2,310 ± 339 W on CE and 1,763 ± 289 W on NMT. Participants' weight was significantly correlated with PPO and MPO on CE (p < 0.001) and with MPO on NMT (p < 0.001). PPO on CE and NMT was significantly correlated only for absolute measures of power (p < 0.01). Cadence was higher and decreased throughout the RSA on NMT compared to CE, where it decreased only at the seventh bout. TTP was significantly shorter and more affected by fatigue on NMT than on CE. Fatigue indices were significantly greater on NMT compared to CE, with significant correlations between the decrement score and absolute and relative PPO on CE and NMT, between the fatigue index and absolute and relative PPO only on NMT, and no significant correlations with MPO. During RSA, RPE increased more on NMT compared to CE from bouts 3 to 7. During recovery, RPE was consistently higher on NMT at 1, 3, and 5 min post exercise compared to CE. These findings indicate that RSA performed on NMT induces greater fatigue and physiological load than CE, which originated in the lower resistive torque typically used on NMT compared to CE, resulting in a front loaded power output profile from the greater acceleration and cadence. From these results, we discuss that despite providing highly correlated measures of power output, NMT and CE should not be used interchangeably to assess RSA as they elicit markedly different responses. We also discuss these results from the fundamental differences in active muscle mass and power application patterns between running and cycling, which could form the basis of future studies.

Dataset Information

Systemic exertion intolerance disease/chronic fatigue syndrome is common in sleep centre patients with hypersomnolence: A retrospective pilot study.

Publications

Systemic exertion intolerance disease/chronic fatigue syndrome is common in sleep centre patients with hypersomnolence: A retrospective pilot study.

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