Loades, Maria Elizabeth, Rimes, Katharine A, Chalder, Trudie · Clinical child psychology and psychiatry · 2020 · DOI
This study looked at sleep problems in teenagers with ME/CFS compared to healthy teenagers and those with asthma. Teenagers with ME/CFS reported significantly more sleep difficulties than both comparison groups. When researchers checked in 3 months later without any treatment, sleep problems remained largely unchanged, suggesting that sleep issues in ME/CFS don't improve on their own and may need specific attention during treatment.
Sleep disturbance is prevalent and burdensome in adolescent ME/CFS, yet is often underaddressed in treatment. This study provides evidence that sleep problems are a distinct and persistent feature of adolescent CFS—not merely a symptom of other conditions—and suggests they warrant targeted intervention as part of comprehensive management strategies.
This study does not establish causality or determine whether improving sleep would reduce fatigue or improve functioning; it only shows that sleep problems and subsequent outcomes are associated. The 3-month observation period without treatment does not prove sleep problems are permanent or untreatable—only that they do not spontaneously improve. The study also cannot determine which specific sleep disturbances (insomnia, fragmented sleep, etc.) have the strongest impact on CFS outcomes.
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 →
The first block is for the primary paper and is the citation you should use in research work. The atlas-snapshot line only applies if you are specifically referring to this atlas’s reading of the paper on the date shown.
Primary citation
Loades, Maria Elizabeth, Rimes, Katharine A, & Chalder, Trudie (2020). Sleep problems in adolescents with CFS: A case-control study nested within a prospective clinical cohort.. Clinical child psychology and psychiatry. https://doi.org/10.1177/1359104520918364
BibTeX
@article{mecfsatlas-loades-2020-sleep-problems,
author = {Loades, Maria Elizabeth and Rimes, Katharine A and Chalder, Trudie},
title = {Sleep problems in adolescents with CFS: A case-control study nested within a prospective clinical cohort.},
journal = {Clinical child psychology and psychiatry},
year = {2020},
doi = {10.1177/1359104520918364},
note = {PubMed: 32441119},
url = {https://www.mecfsatlas.com/evidence/loades-2020-sleep-problems},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-26. https://www.mecfsatlas.com/evidence/loades-2020-sleep-problems
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