Shao, Xiao, Yang, Fan, Qin, Le-le et al. · Frontiers in psychiatry · 2026 · DOI
This observational study of 610 ME/CFS patients found that roughly half also had circadian rhythm sleep-wake disorders (difficulty sleeping at normal times). The researchers identified several factors associated with this comorbidity, including female sex, higher fatigue severity, certain shift work patterns, and reduced deep sleep. They developed a prediction model to help identify patients at higher risk, though the study's retrospective design and unknown case definition quality mean these findings are preliminary and require validation in other patient populations.
Sleep and circadian dysfunction are reported frequently in ME/CFS populations and contribute significantly to symptom burden. This study provides preliminary evidence that female ME/CFS patients, those with higher fatigue severity, and those on shift work schedules may be at elevated risk for comorbid circadian rhythm disorders. If replicated, such a risk model could support targeted sleep management interventions in clinical settings.
This observational study does not establish causation; it identifies associations in a single retrospective cohort. It does not confirm the mechanisms linking fatigue severity, sex, shift work, or sleep architecture to circadian dysfunction. The model's generalisability beyond this cohort is unknown, and the study provides no direct evidence that using this prediction tool improves patient 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
Shao, Xiao, Yang, Fan, Qin, Le-le, Shi, Jia-Ning, Chen, Min, Ge, Wen-Jin, et al. (2026). Associated factors and a risk prediction model for comorbid circadian rhythm sleep-wake disorders in patients with chronic fatigue syndrome: implications for early screening and sleep health management.. Frontiers in psychiatry. https://doi.org/10.3389/fpsyt.2026.1826328
BibTeX
@article{mecfsatlas-shao-2026-associated-factors,
author = {Shao, Xiao and Yang, Fan and Qin, Le-le and Shi, Jia-Ning and Chen, Min and Ge, Wen-Jin and Jiang, Tian-Jun and Yue, Jing-Wen and Feng, Wen and Wang, Jing-Han and Zhang, Zhen-Xian},
title = {Associated factors and a risk prediction model for comorbid circadian rhythm sleep-wake disorders in patients with chronic fatigue syndrome: implications for early screening and sleep health management.},
journal = {Frontiers in psychiatry},
year = {2026},
doi = {10.3389/fpsyt.2026.1826328},
note = {PubMed: 42548707},
url = {https://www.mecfsatlas.com/evidence/shao-2026-associated-factors},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-08-08. https://www.mecfsatlas.com/evidence/shao-2026-associated-factors
Contribute
Private, reviewed by a human. Not a public comment thread.