- Last Updated: 07 November 2015 07 November 2015
H. Modolfsky’s early studies have documented a variety of circadian sleep disturbances in CFS patients, such as altered diurnal patterns in cortisol, prolactin, and NK cell function, as well as alpha wave intrusion on sleep EEG, and a reduced state of stage III and IV sleep. A more recent study by Nathanial Watson has shown a higher percentage of REM sleep in CFS twins (Twin Study of 22 discordant twins 1). This finding suggests an element of sleep-state dysregulation.
Dr. Klimas mentioned there are several new Stage IV sleep inducer medications being used. The strongest of these is Xyrem (a form of gamma hydroxybutyrate (GHB))—a beneficial drug in treatment of narcolepsy; but it is also known for its illegal use as a date-rape drug. Currently, it is only available through enrollment in a special program (not through retail pharmacies) and is so potent, it must be taken when already in bed.
Remeron is a medication—actually, this is an antidepressant that promotes stage III and IV sleep—that Klimas has prescribed, often in ¼ doses. She recommended that individuals with sleep problems consult with sleep doctors and pointed out these physicians are in two specialties: pulmonology and neurology. It is also important to choose a doctor who will provide continuing care after the initial evaluation.
1. Watson et al, “Comparison of Subjective and Objective Measures of Insomnia in Monozygotic Twins Discordant for Chronic Fatigue Syndrome,” Sleep May 1; 26(3) (2003): 324-8.