Libman, Eva, Creti, Laura, Baltzan, Marcel et al. · Journal of health psychology · 2009 · DOI
This study looked at whether sleep apnea (a condition where breathing stops and starts during sleep) is common in people with ME/CFS and how it affects mood and psychological well-being. The researchers found that 68% of ME/CFS patients had sleep apnea, but those who did were not significantly more ill than those without it. Both the ME/CFS and sleep apnea groups showed more psychological difficulties than healthy controls, but the researchers suggest these emotional struggles are likely a natural response to living with a chronic illness rather than a separate psychiatric condition.
This study challenges a longstanding diagnostic criterion that may exclude ME/CFS patients from diagnosis if they have sleep apnea, potentially preventing them from receiving appropriate care. It suggests that sleep apnea is actually quite common in ME/CFS and may need to be managed as a co-occurring condition rather than ruled out as a disqualifying factor.
This study does not prove that sleep apnea causes ME/CFS or vice versa—it only shows they frequently occur together. The findings do not establish whether treating sleep apnea improves ME/CFS outcomes or whether the high rate of sleep apnea reflects shared underlying biological mechanisms. As a cross-sectional study, it cannot determine the temporal relationship or causal direction between these conditions.
About the PEM badge: “PEM required” means post-exertional malaise was an explicit required diagnostic criterion for participant inclusion in this study — not that PEM was studied, observed, or discussed. Studies using criteria that do not require PEM (e.g. Fukuda, Oxford) are tagged “PEM not required”. How the atlas works →
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