Zerón-Rugerio, María Fernanda, Zaragozá, Maria Cleofé, Domingo, Joan Carles et al. · Chronobiology international · 2024 · DOI
This study looked at sleep patterns and daily body rhythms in ME/CFS patients and compared them to healthy people. Researchers found that ME/CFS patients had lower activity levels, worse sleep quality, and unhealthy cholesterol levels compared to healthy controls. The study also found that problems with blood vessel function may connect sleep disruptions to heart health problems in ME/CFS patients.
This study provides objective evidence that sleep and circadian rhythm disturbances in ME/CFS are associated with measurable cardiovascular risk factors and endothelial dysfunction. Understanding these connections may help explain why ME/CFS patients experience fatigue and inform future interventions targeting both circadian health and cardiovascular risk. The findings also extend understanding to post-COVID ME/CFS, suggesting shared pathophysiological mechanisms.
This study does not establish causation—it is unclear whether circadian disruption causes cardiovascular dysfunction or vice versa. The small sample size and reliance on self-reported outcome measures for some variables limit generalizability. The cross-sectional nature of many analyses prevents determining whether these associations precede ME/CFS onset or develop as a consequence of the illness.
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
Zerón-Rugerio, María Fernanda, Zaragozá, Maria Cleofé, Domingo, Joan Carles, Sanmartín-Sentañes, Ramon, Alegre-Martin, Jose, Castro-Marrero, Jesús, et al. (2024). Sleep and circadian rhythm alterations in myalgic encephalomyelitis/chronic fatigue syndrome and post-COVID fatigue syndrome and its association with cardiovascular risk factors: A prospective cohort study.. Chronobiology international. https://doi.org/10.1080/07420528.2024.2380020
BibTeX
@article{mecfsatlas-zern-rugerio-2024-sleep-circadian,
author = {Zerón-Rugerio, María Fernanda and Zaragozá, Maria Cleofé and Domingo, Joan Carles and Sanmartín-Sentañes, Ramon and Alegre-Martin, Jose and Castro-Marrero, Jesús and Cambras, Trinitat},
title = {Sleep and circadian rhythm alterations in myalgic encephalomyelitis/chronic fatigue syndrome and post-COVID fatigue syndrome and its association with cardiovascular risk factors: A prospective cohort study.},
journal = {Chronobiology international},
year = {2024},
doi = {10.1080/07420528.2024.2380020},
note = {PubMed: 39037125},
url = {https://www.mecfsatlas.com/evidence/zern-rugerio-2024-sleep-circadian},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-26. https://www.mecfsatlas.com/evidence/zern-rugerio-2024-sleep-circadian
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