Moldofsky, H · Ciba Foundation symposium · 1993 · DOI
This study examined how sleep problems, tiredness, and muscle pain are connected in ME/CFS and fibromyalgia. Both conditions share similar unusual brain wave patterns during sleep that make sleep feel unrefreshing even though people sleep. The research suggests that problems with the immune system and sleep-wake cycle are linked, and interfering with either one can trigger the other and cause ME/CFS symptoms.
This work is foundational for understanding the biological mechanisms underlying ME/CFS, proposing testable links between sleep physiology, immune dysfunction, and symptom generation. Recognition that immune-sleep dysregulation is bidirectional has implications for future therapeutic targets and helps explain why sleep abnormalities are so central to ME/CFS symptomatology.
This mechanistic review does not establish causality or provide quantitative data on prevalence, severity, or specificity of alpha-rhythm intrusion in ME/CFS versus controls. It does not determine whether the immune-sleep abnormalities are primary drivers of ME/CFS or secondary consequences, nor does it validate proposed interventions.
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
Moldofsky, H (1993). Fibromyalgia, sleep disorder and chronic fatigue syndrome.. Ciba Foundation symposium. https://doi.org/10.1002/9780470514382.ch15
BibTeX
@article{mecfsatlas-moldofsky-1993-fibromyalgia-sleep,
author = {Moldofsky, H},
title = {Fibromyalgia, sleep disorder and chronic fatigue syndrome.},
journal = {Ciba Foundation symposium},
year = {1993},
doi = {10.1002/9780470514382.ch15},
note = {PubMed: 8491102},
url = {https://www.mecfsatlas.com/evidence/moldofsky-1993-fibromyalgia-sleep},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-25. https://www.mecfsatlas.com/evidence/moldofsky-1993-fibromyalgia-sleep
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