Milrad, Sara F, Hall, Daniel L, Jutagir, Devika R et al. · Journal of neuroimmunology · 2017 · DOI
This study looked at 60 women with ME/CFS to understand how sleep quality affects their symptoms and inflammation levels. Researchers found that women who slept poorly had higher levels of inflammatory substances in their blood and experienced more severe fatigue and ME/CFS symptoms. The findings suggest that improving sleep quality might help reduce both inflammation and symptom severity in people living with ME/CFS.
Sleep problems are common and distressing in ME/CFS, but their relationship to inflammation and symptom severity has been under-studied. This research provides empirical evidence linking poor sleep to both inflammatory markers and worse symptoms, supporting sleep management as a potential therapeutic target and justifying further investigation of sleep interventions in ME/CFS care.
This study demonstrates association, not causation—it does not prove that poor sleep causes inflammation or symptom worsening, only that they occur together. The cross-sectional design cannot establish the direction of effects; it is possible that severe symptoms and inflammation disrupt sleep, rather than sleep disruption driving inflammation. The findings apply specifically to women and may not generalize to men or other populations with ME/CFS.
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
Milrad, Sara F, Hall, Daniel L, Jutagir, Devika R, Lattie, Emily G, Ironson, Gail H, Wohlgemuth, William, et al. (2017). Poor sleep quality is associated with greater circulating pro-inflammatory cytokines and severity and frequency of chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME) symptoms in women.. Journal of neuroimmunology. https://doi.org/10.1016/j.jneuroim.2016.12.008
BibTeX
@article{mecfsatlas-milrad-2017-poor-sleep,
author = {Milrad, Sara F and Hall, Daniel L and Jutagir, Devika R and Lattie, Emily G and Ironson, Gail H and Wohlgemuth, William and Nunez, Maria Vera and Garcia, Lina and Czaja, Sara J and Perdomo, Dolores M and Fletcher, Mary Ann and Klimas, Nancy and Antoni, Michael H},
title = {Poor sleep quality is associated with greater circulating pro-inflammatory cytokines and severity and frequency of chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME) symptoms in women.},
journal = {Journal of neuroimmunology},
year = {2017},
doi = {10.1016/j.jneuroim.2016.12.008},
note = {PubMed: 28038892},
url = {https://www.mecfsatlas.com/evidence/milrad-2017-poor-sleep},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-30. https://www.mecfsatlas.com/evidence/milrad-2017-poor-sleep
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