Mathis, Johannes · Praxis · 2018 · DOI
This article discusses how doctors can tell the difference between several sleep-related conditions that cause excessive daytime sleepiness or fatigue. The authors explain that complaints like tiredness and fatigue are common, but they can have many different causes. Careful diagnosis using sleep studies and other tests is needed to distinguish narcolepsy, idiopathic hypersomnia, and chronic fatigue syndrome from one another, since each condition requires different treatments.
ME/CFS patients frequently experience severe fatigue and post-exertional malaise that can be confused with hypersomnolence or narcolepsy. This editorial highlights the critical need for careful differential diagnosis and objective testing to distinguish ME/CFS from primary sleep disorders, which is essential for appropriate treatment and avoiding misdiagnosis that could delay patients receiving evidence-based care.
This editorial does not provide new empirical data, diagnostic criteria validation, or evidence comparing outcomes between conditions. It does not establish the prevalence of misdiagnosis between ME/CFS and central hypersomnolence disorders, nor does it provide specific biomarkers or diagnostic algorithms. As a review/editorial, it reflects expert opinion rather than original research findings.
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
Mathis, Johannes (2018). [Narcolepsy and Other 'Central Disorders of Hypersomnolence'].. Praxis. https://doi.org/10.1024/1661-8157/a003107
BibTeX
@article{mecfsatlas-mathis-2018-narcolepsy-other,
author = {Mathis, Johannes},
title = {[Narcolepsy and Other 'Central Disorders of Hypersomnolence'].},
journal = {Praxis},
year = {2018},
doi = {10.1024/1661-8157/a003107},
note = {PubMed: 30326812},
url = {https://www.mecfsatlas.com/evidence/mathis-2018-narcolepsy-other},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-30. https://www.mecfsatlas.com/evidence/mathis-2018-narcolepsy-other
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