ME/CFS Evidence Browser — Classified Studies on Myalgic Encephalomyelitis

201–220 of 277 studies

E2 ModerateCohortPEM not requiredObservational

"Chronic Epstein-Barr virus infection" syndrome and polymyalgia rheumatica.

Buchwald, D, Sullivan, J L, Leddy, S et al.·The Journal of rheumatology·1988

This study looked at 23 patients with polymyalgia rheumatica (PMR), a condition causing muscle pain and stiffness, and noticed many also experienced severe fatigue, sleep problems, and recurring sore throats—symptoms similar to ME/CFS. Even after treatment improved their muscle pain, these fatigue-related symptoms continued for months. However, blood tests showed their Epstein-Barr virus antibody levels were normal and similar to healthy people their age, suggesting the virus wasn't the primary cause.

Sleep

E3 PreliminaryPEM unclear

Inspiratory muscle training improves autonomic function in myalgic encephalomyelitis/chronic fatigue syndrome and post-acute sequelae of SARS-CoV-2: A pilot study.

Edgell, Heather, Pereira, Tania J, Kerr, Kathleen et al.·Respiratory physiology & neurobiology·2025

This study tested whether a simple breathing exercise program could help people with ME/CFS and Long COVID feel better. For 8 weeks, participants practiced strengthening their breathing muscles. People in all groups—including those with ME/CFS and Long COVID—showed improvements in how far they could walk, their heart rate, sleep quality, and how their nervous system functioned. Those with ME/CFS also noticed less pain and better blood vessel function.

SleepAutonomic Nervous System

E3 PreliminaryPEM required

Glymphatic System Dysregulation as a Key Contributor to Myalgic Encephalomyelitis/Chronic Fatigue Syndrome.

Nemat-Gorgani, Mohsen, Jensen, Michael Anthony, Davis, Ronald Wayne·International journal of molecular sciences·2025

Your brain has a cleaning system called the glymphatic system that removes toxic waste buildup, especially during sleep. This review suggests that this cleaning system may not be working properly in ME/CFS, which could explain symptoms like fatigue and brain fog. If the glymphatic system is involved in ME/CFS, new treatments designed to fix this cleaning process might help patients feel better.

SleepPost-Exertional Malaise

E3 PreliminaryReviewPEM unclearReview-Narrative

Nutrition and Chronobiology as Key Components of Multidisciplinary Therapeutic Interventions for Fibromyalgia and Associated Chronic Fatigue Syndrome: A Narrative and Critical Review.

Carrasco-Querol, Noèlia, Cabricano-Canga, Lorena, Bueno Hernández, Nerea et al.·Nutrients·2024

This review examines how diet and body rhythms (sleep-wake cycles) affect fibromyalgia and chronic fatigue syndrome. The authors found that what you eat, nutrient levels, gut bacteria, and your natural circadian rhythm all play important roles in these conditions. They conclude that treating FM/CFS effectively requires paying attention to nutrition and sleep timing alongside other therapies.

Sleep

E3 PreliminaryCohortPEM not required

Could Modafinil Be an Option in the Treatment of Sexual Dysfunctions Due to Antidepressant Use in Women? Two Case Reports.

Yilbaş, Barış·Turk psikiyatri dergisi = Turkish journal of psychiatry·2022

Some antidepressant medications can cause sexual side effects like loss of desire and difficulty with arousal. This report describes two women whose sexual problems improved when modafinil (a medication used for sleep disorders and fatigue) was added to their antidepressant treatment. One woman saw significant improvement at 100 mg daily, while the other needed 200 mg daily to see meaningful improvement.

Sleep

E3 PreliminaryMechanismPEM not requiredMechanistic

Study on the active components and mechanism of Suanzaoren decoction in improving cognitive impairment caused by sleep deprivation.

Cheng, Li, Wang, Fei, Li, Zi-Heng et al.·Journal of ethnopharmacology·2022

This study examined how an ancient Chinese herbal remedy called Suanzaoren Decoction (SZRD) might help improve thinking and memory problems caused by poor sleep. Researchers used computer analysis and laboratory experiments to identify the active ingredients in the herbs and understand how they work in the body, finding that the remedy may work through pathways related to estrogen in the brain.

SleepCognitive Impairment

E3 PreliminaryReviewPEM unclearReview-Narrative

Possible Application of Melatonin in Long COVID.

Cardinali, Daniel P, Brown, Gregory M, Pandi-Perumal, Seithikurippu R·Biomolecules·2022

This review examines whether melatonin, a natural hormone that regulates sleep, might help people with long COVID who experience symptoms similar to ME/CFS—such as brain fog, fatigue, and muscle pain. Melatonin has several properties that could potentially help: it reduces inflammation, fights harmful molecules in the body, supports immune function, and protects nerve cells. The authors suggest melatonin might be worth studying further as a treatment for the lingering cognitive and pain symptoms some long COVID patients experience.

Pain and SensitizationSleepCognitive Impairment

E3 PreliminaryPEM not required

Building-related illness (BRI) in all family members caused by mold infestation after dampness damage of the building.

Kramer, Axel, Wichelhaus, Thomas A, Kempf, Volkhard et al.·GMS hygiene and infection control·2021

A family of five living in a house with severe mold damage all developed health problems. The mother developed symptoms very similar to ME/CFS, including extreme fatigue, cognitive problems, sleep issues, and respiratory complaints. After the family moved out, symptoms improved gradually—the father recovered in 2 weeks, the children in 6 months, and the mother took 18 months to fully recover.

SleepCognitive Impairment

E3 PreliminaryCohortPEM not requiredCase-Control

Sleep state misperception: is there a CNS structural source?

Truzzi, Giselle de Martin, Teixeira, Igor de Lima, do Prado, Lucila Bizari Fernandes et al.·Sleep science (Sao Paulo, Brazil)·2021

This case report describes one patient with AIDS who experienced sleep state misperception—feeling like she wasn't sleeping even though she actually was sleeping—and had a brain lesion in a specific region called the left nucleocapsular area. Sleep tests confirmed she was sleeping normally, but her brain wasn't perceiving it correctly. The researchers suggest that damage to certain brain structures might explain why some people feel unrefreshed despite actually sleeping.

Sleep

E3 PreliminaryReviewPEM unclearReview-Narrative

Fibromyalgia and Associated Disorders: From Pain to Chronic Suffering, From Subjective Hypersensitivity to Hypersensitivity Syndrome.

Maugars, Yves, Berthelot, Jean-Marie, Le Goff, Benoit et al.·Frontiers in medicine·2021

This article reviews what scientists know about fibromyalgia as of 2020, including how it's diagnosed and why it happens. The authors explain that fibromyalgia involves the brain processing pain signals too intensely, and that people with fibromyalgia often experience many other symptoms like fatigue, sleep problems, and sensitivity to sounds, lights, and touch. They also discuss how fibromyalgia shares common features with other conditions like ME/CFS, all involving a heightened sensitivity to stimuli controlled by the central nervous system.

Sleep

E3 PreliminaryReviewPEM not requiredReview-Narrative

Central sensitivity and fibromyalgia.

Mezhov, Veronica, Guymer, Emma, Littlejohn, Geoffrey·Internal medicine journal·2021

Fibromyalgia and ME/CFS are conditions where the nervous system becomes oversensitive, causing widespread pain, fatigue, sleep problems, and brain fog. These conditions often occur together and share similar underlying problems with how the brain and spinal cord process pain and other signals. This review explains what causes these conditions and how doctors can recognize and treat them using a combination of education, exercise, stress management, and medications.

SleepCognitive Impairment

E3 PreliminaryCohortPEM unclearObservational

An Open-Label, Pilot Trial of HRG80™ Red Ginseng in Chronic Fatigue Syndrome, Fibromyalgia, and Post-Viral Fatigue.

Teitelbaum, Jacob, Goudie, Sarah·Pharmaceuticals (Basel, Switzerland)·2021

This study tested a special form of red ginseng called HRG80 in people with ME/CFS, fibromyalgia, and post-COVID fatigue. Over one month, 188 patients took daily ginseng supplements and reported their symptoms. About 60% of participants felt better, with improvements in energy, mental clarity, sleep, and stamina.

Pain and SensitizationSleepCognitive Impairment

E3 PreliminaryCohortPEM not requiredCase-Control

Not what it seems to be: Depression versus periodic limb movement disorder.

Gupta, Ravi, Kundu, Kaustuv, Khayyam, Khwaja et al.·Indian journal of psychiatry·2020

This case report describes a patient who was initially diagnosed with depression and wasn't getting better with antidepressant medications. Doctors later realized he actually had a sleep disorder called periodic limb movement disorder (PLMD), where the legs move involuntarily during sleep. When treated with a medication called ropinirole, his symptoms improved significantly. This story highlights how sleep problems can look like depression or chronic fatigue, and getting the right diagnosis matters.

Sleep

E3 PreliminaryCohortPEM unclear

Auricular acupuncture for insomnia of chronic fatigue syndrome: a case report.

Zhang, Feng, Shen, Yifeng, Li, Jie et al.·Acupuncture in medicine : journal of the British Medical Acupuncture Society·2020

This study looked at whether auricular acupuncture (tiny needles placed in specific points on the ear) could help improve sleep in one patient with ME/CFS. The patient received acupuncture treatment and reported improvements in their insomnia symptoms. However, this is just one person's experience, so we cannot yet say whether this treatment would work for other ME/CFS patients.

Sleep

E3 PreliminaryMechanismPEM unclearCross-Sectional

Intra brainstem connectivity is impaired in chronic fatigue syndrome.

Barnden, Leighton R, Shan, Zack Y, Staines, Donald R et al.·NeuroImage. Clinical·2019

This study used brain imaging (fMRI) to compare how different parts of the brainstem communicate in people with ME/CFS versus healthy people. The brainstem is a critical control center that regulates automatic body functions like heart rate, breathing, and sleep. Researchers found that in ME/CFS patients, certain communication pathways between brainstem regions were weaker or missing, which could explain many ME/CFS symptoms like fatigue, cognitive problems, and autonomic dysfunction.

Sleep

E3 PreliminaryPEM not required

[Clinical efficacy of neurometabolic therapy of dissomical disorders in asthenic syndrome].

Esipov, A V, Ivolgin, A F, Khritinin, D F et al.·Zhurnal nevrologii i psikhiatrii imeni S.S. Korsakova·2019

This study tested whether a medication called cytoflavin, which helps cells produce energy, could help 100 patients with fatigue and sleep problems. Patients received cytoflavin as an infusion, either alone or combined with melatonin or another sleep medication. By day 14, 97% of patients reported significant improvement in fatigue and sleep quality.

Sleep

E3 PreliminaryTrialPEM not requiredRCT

Treatment for Gulf War Illness (GWI) with KPAX002 (methylphenidate hydrochloride + GWI nutrient formula) in subjects meeting the Kansas case definition: A prospective, open-label trial.

Holodniy, Mark, Kaiser, Jon D·Journal of psychiatric research·2019

Researchers tested a combination treatment called KPAX002—containing a stimulant medication (methylphenidate) plus vitamins and nutrients meant to support energy production in cells—in 17 people with Gulf War Illness. After 12 weeks, patients reported about 25% improvement in their overall symptoms, including better fatigue, brain fog, sleep, and pain. The treatment was generally safe and well-tolerated, though a larger, more rigorous study is needed to confirm these results.

Pain and SensitizationSleepCognitive Impairment

E3 PreliminaryPEM not requiredRegistry-Resource

Supplementation with Robuvit® in post-traumatic stress disorders associated to high oxidative stress.

Belcaro, Gianni, Luzzi, Roberta, Hosoi, Morio et al.·Minerva medica·2018

This study looked at whether a plant-based supplement called Robuvit® could help people with PTSD (post-traumatic stress disorder) recover faster alongside standard therapy. Over 4 weeks, people who took Robuvit® along with therapy showed greater improvements in symptoms like intrusive memories, nightmares, flashbacks, sleep problems, and fatigue compared to those who received therapy alone.

Sleep

E3 PreliminaryMechanismPEM unclearObservational

Open-label pilot for treatment targeting gut dysbiosis in myalgic encephalomyelitis/chronic fatigue syndrome: neuropsychological symptoms and sex comparisons.

Wallis, Amy, Ball, Michelle, Butt, Henry et al.·Journal of translational medicine·2018

This study tested whether treating an overgrowth of Streptococcus bacteria in the gut could help ME/CFS patients, particularly those with brain fog and sleep problems. Forty-four patients received alternating weeks of an antibiotic and a probiotic for 4 weeks. The treatment reduced the problematic bacteria and improved several symptoms including sleep quality, attention, and memory, though it did not significantly affect fatigue or mood.

SleepCognitive Impairment

E3 PreliminaryReviewPEM not requiredReview-Narrative

[Narcolepsy and Other 'Central Disorders of Hypersomnolence'].

Mathis, Johannes·Praxis·2018

This article discusses how doctors can tell the difference between several sleep-related conditions that cause excessive daytime sleepiness or fatigue. The authors explain that complaints like tiredness and fatigue are common, but they can have many different causes. Careful diagnosis using sleep studies and other tests is needed to distinguish narcolepsy, idiopathic hypersomnia, and chronic fatigue syndrome from one another, since each condition requires different treatments.

Sleep

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"Chronic Epstein-Barr virus infection" syndrome and polymyalgia rheumatica.

Inspiratory muscle training improves autonomic function in myalgic encephalomyelitis/chronic fatigue syndrome and post-acute sequelae of SARS-CoV-2: A pilot study.

Glymphatic System Dysregulation as a Key Contributor to Myalgic Encephalomyelitis/Chronic Fatigue Syndrome.

Nutrition and Chronobiology as Key Components of Multidisciplinary Therapeutic Interventions for Fibromyalgia and Associated Chronic Fatigue Syndrome: A Narrative and Critical Review.

Could Modafinil Be an Option in the Treatment of Sexual Dysfunctions Due to Antidepressant Use in Women? Two Case Reports.

Study on the active components and mechanism of Suanzaoren decoction in improving cognitive impairment caused by sleep deprivation.

Possible Application of Melatonin in Long COVID.

Building-related illness (BRI) in all family members caused by mold infestation after dampness damage of the building.

Sleep state misperception: is there a CNS structural source?

Fibromyalgia and Associated Disorders: From Pain to Chronic Suffering, From Subjective Hypersensitivity to Hypersensitivity Syndrome.

Central sensitivity and fibromyalgia.

An Open-Label, Pilot Trial of HRG80™ Red Ginseng in Chronic Fatigue Syndrome, Fibromyalgia, and Post-Viral Fatigue.

Not what it seems to be: Depression versus periodic limb movement disorder.

Auricular acupuncture for insomnia of chronic fatigue syndrome: a case report.

Intra brainstem connectivity is impaired in chronic fatigue syndrome.

[Clinical efficacy of neurometabolic therapy of dissomical disorders in asthenic syndrome].

Treatment for Gulf War Illness (GWI) with KPAX002 (methylphenidate hydrochloride + GWI nutrient formula) in subjects meeting the Kansas case definition: A prospective, open-label trial.

Supplementation with Robuvit® in post-traumatic stress disorders associated to high oxidative stress.

Open-label pilot for treatment targeting gut dysbiosis in myalgic encephalomyelitis/chronic fatigue syndrome: neuropsychological symptoms and sex comparisons.

[Narcolepsy and Other 'Central Disorders of Hypersomnolence'].

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