Sivertsen, Børge, Hysing, Mari, Harvey, Allison G et al. · Frontiers in psychology · 2021 · DOI
This study looked at sleep problems in over 50,000 Norwegian college students and found that insomnia (difficulty sleeping) is much more common in people with both mental and physical health conditions. Students with ME/CFS had particularly high rates of insomnia—about 65% of women and an unspecified percentage of men experienced insomnia when they also had ME/CFS. The study also found that people with these conditions slept shorter amounts overall.
This study provides epidemiological evidence that sleep disturbance is a prominent comorbidity in ME/CFS using formal diagnostic criteria. For ME/CFS patients, understanding the prevalence and severity of insomnia can help validate their experiences and guide clinical assessment and treatment prioritization. The strong association (RR = 2.66 in women) suggests that sleep dysfunction deserves attention as both a symptom and potential therapeutic target in ME/CFS management.
This cross-sectional study cannot establish whether insomnia causes ME/CFS, results from ME/CFS, or shares common underlying biological mechanisms with it. The study also does not explain why insomnia prevalence differs between sexes or which specific features of ME/CFS (e.g., post-exertional malaise, autonomic dysfunction) drive sleep disturbance. Additionally, self-reported diagnoses may not reflect clinically confirmed ME/CFS cases, limiting specificity.
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
Sivertsen, Børge, Hysing, Mari, Harvey, Allison G, & Petrie, Keith J (2021). The Epidemiology of Insomnia and Sleep Duration Across Mental and Physical Health: The SHoT Study.. Frontiers in psychology. https://doi.org/10.3389/fpsyg.2021.662572
BibTeX
@article{mecfsatlas-sivertsen-2021-epidemiology-insomnia,
author = {Sivertsen, Børge and Hysing, Mari and Harvey, Allison G and Petrie, Keith J},
title = {The Epidemiology of Insomnia and Sleep Duration Across Mental and Physical Health: The SHoT Study.},
journal = {Frontiers in psychology},
year = {2021},
doi = {10.3389/fpsyg.2021.662572},
note = {PubMed: 34194368},
url = {https://www.mecfsatlas.com/evidence/sivertsen-2021-epidemiology-insomnia},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-26. https://www.mecfsatlas.com/evidence/sivertsen-2021-epidemiology-insomnia
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