Spitzer, A Robert, Broadman, Melissa · Pain practice : the official journal of World Institute of Pain · 2010 · DOI
Researchers studied sleep patterns in 118 patients with ME/CFS and fibromyalgia using objective sleep tests. They found that most patients had abnormal sleep studies showing excessive daytime sleepiness, and some had sleep features similar to narcolepsy. A genetic marker (HLA DQB1*0602) associated with narcolepsy was found in 43% of patients, much higher than in the general population.
This study provides objective evidence that ME/CFS and fibromyalgia involve measurable sleep abnormalities beyond subjective complaints, potentially opening new diagnostic and treatment pathways. The high frequency of narcolepsy-associated genetic markers suggests a possible biological mechanism linking these conditions to sleep-wake regulation disorders.
This study does not prove that the HLA marker causes ME/CFS or narcolepsy, only that it is more common in these patients. It does not establish whether sleep abnormalities are primary drivers of fatigue or secondary consequences, nor can retrospective analysis determine causality. The exclusion of untreated sleep apnea and RLS before enrollment means the true prevalence of concurrent sleep disorders in ME/CFS remains unknown.
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 →
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Primary citation
Spitzer, A Robert & Broadman, Melissa (2010). A retrospective review of the sleep characteristics in patients with chronic fatigue syndrome and fibromyalgia.. Pain practice : the official journal of World Institute of Pain. https://doi.org/10.1111/j.1533-2500.2009.00352.x
BibTeX
@article{mecfsatlas-spitzer-2010-retrospective-review,
author = {Spitzer, A Robert and Broadman, Melissa},
title = {A retrospective review of the sleep characteristics in patients with chronic fatigue syndrome and fibromyalgia.},
journal = {Pain practice : the official journal of World Institute of Pain},
year = {2010},
doi = {10.1111/j.1533-2500.2009.00352.x},
note = {PubMed: 20230458},
url = {https://www.mecfsatlas.com/evidence/spitzer-2010-retrospective-review},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-26. https://www.mecfsatlas.com/evidence/spitzer-2010-retrospective-review
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