Nakamura, Toru, Schwander, Stephan K, Donnelly, Robert et al. · Clinical and vaccine immunology : CVI · 2010 · DOI
Researchers studied immune signaling molecules called cytokines in people with ME/CFS and fibromyalgia while they slept in a lab, comparing them to healthy people. Instead of finding signs of excessive inflammation (which some theories predicted), they found slightly elevated levels of a calming immune molecule called interleukin-10. These small changes might help explain why many ME/CFS patients struggle with disrupted sleep.
This study challenges the common assumption that ME/CFS is driven by excessive inflammation, suggesting instead a dysregulation pattern characterized by increased anti-inflammatory signaling. Understanding these immune abnormalities during sleep is particularly relevant since sleep disturbance is a cardinal symptom affecting quality of life in ME/CFS patients.
This study does not prove that elevated interleukin-10 causes ME/CFS or sleep problems—only that an association exists. The small magnitude of observed changes raises questions about clinical significance. Additionally, cross-sectional overnight measurement does not establish whether this cytokine pattern is a primary cause, secondary consequence of illness, or adaptive response to infection.
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
Nakamura, Toru, Schwander, Stephan K, Donnelly, Robert, Ortega, Felix, Togo, Fumiharu, Broderick, Gordon, et al. (2010). Cytokines across the night in chronic fatigue syndrome with and without fibromyalgia.. Clinical and vaccine immunology : CVI. https://doi.org/10.1128/CVI.00379-09
BibTeX
@article{mecfsatlas-nakamura-2010-cytokines-across,
author = {Nakamura, Toru and Schwander, Stephan K and Donnelly, Robert and Ortega, Felix and Togo, Fumiharu and Broderick, Gordon and Yamamoto, Yoshiharu and Cherniack, Neil S and Rapoport, David and Natelson, Benjamin H},
title = {Cytokines across the night in chronic fatigue syndrome with and without fibromyalgia.},
journal = {Clinical and vaccine immunology : CVI},
year = {2010},
doi = {10.1128/CVI.00379-09},
note = {PubMed: 20181767},
url = {https://www.mecfsatlas.com/evidence/nakamura-2010-cytokines-across},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-30. https://www.mecfsatlas.com/evidence/nakamura-2010-cytokines-across
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