ME/CFS Evidence Browser — Classified Studies on Myalgic Encephalomyelitis

1–20 of 272 studies

Sorted by evidence level and year

E0 ConsensusReviewPEM unclearMeta-Analysis

Neuroendocrine signature of ME/CFS: Meta-analytic evidence for bioactive cortisol deficit and exaggerated feedback sensitivity.

Woo, Tae-Wook, Choi, Yu-Jin, Kim, Jun-Yeol et al.·Molecular psychiatry·2026

A review of 46 studies involving 1,388 ME/CFS patients found that people with ME/CFS were observed to have lower cortisol (a stress hormone) measured in saliva, urine, and hair, and showed altered responses when given hormone-stimulation tests. The authors propose these findings may be associated with some ME/CFS symptoms like fatigue and sleep problems, though the clinical significance and how this relates to individual patient outcomes remains unclear.

Endocrine DisruptionBiomarkersSleepCognitive Impairment

E0 ConsensusReviewPEM unclearSystematic-Review

Comparative effectiveness of non-pharmacological traditional Chinese medicine therapies for chronic fatigue syndrome: a systematic review and network meta-analysis.

Zhang, Yihan, Zhou, You, Xu, Hangying et al.·Frontiers in medicine·2026

A systematic review of 29 studies examined whether traditional Chinese medicine therapies—including massage, moxibustion, and cupping—were associated with improvements in fatigue, sleep, anxiety, and depression in people with chronic fatigue syndrome. The review reported that massage and moxibustion showed associations with reduced fatigue and mood symptoms, while cupping was associated with better sleep quality, though the authors note these findings should be interpreted cautiously given limitations in the underlying studies.

InterventionsSleep

E0 ConsensusReviewPEM unclearSystematic-Review

The efficacy of exercise in patients with myalgic encephalomyelitis/chronic fatigue syndrome: A systematic review and meta-analysis.

Zhao, Liping, Gou, Bo, Zhang, Meng·Journal of psychosomatic research·2026

A systematic review of 17 randomized controlled trials (involving 1,944 patients) found that exercise was associated with reported improvements in fatigue, sleep quality, quality of life, depression, and anxiety in ME/CFS patients. However, exercise did not show significant benefits for heart and lung function or overall physical capacity. The review noted no major differences in safety or tolerability between exercise and control groups, though individual responses vary and respecting personal energy limits is emphasized.

InterventionsSleepPost-Exertional Malaise

E0 ConsensusReviewPEM not requiredMeta-Analysis

[Efficacy and safety of fonturacetam in asthenia: a systematic review and meta-analysis].

Devlikamova, F I, Safina, D R·Zhurnal nevrologii i psikhiatrii imeni S.S. Korsakova·2025

This review combined results from 11 studies testing a medication called fonturacetam (also known as Actitropil) in people with asthenia—a medical term for persistent exhaustion and lack of energy. After one month of treatment at 200 mg daily, patients reported significantly less fatigue, with improvements also seen in sleep, mood, thinking ability, and overall quality of life. About 5.5% of patients experienced mild, temporary side effects that went away within a week.

SleepCognitive Impairment

E0 ConsensusReviewPEM not requiredSystematic-Review

Exploring the Effects of Qigong, Tai Chi, and Yoga on Fatigue, Mental Health, and Sleep Quality in Chronic Fatigue and Post-COVID Syndromes: A Systematic Review with Meta-Analysis.

Fricke-Comellas, Hermann, Heredia-Rizo, Alberto Marcos, Casuso-Holgado, María Jesús et al.·Healthcare (Basel, Switzerland)·2024

This review looked at 13 studies testing whether qigong, tai chi, and yoga help reduce fatigue in people with ME/CFS and long COVID. Overall, these gentle movement practices appeared to help reduce fatigue and improve mood and sleep compared to doing nothing. However, the studies had various quality issues that make it hard to know how much we can trust these results.

Sleep

E0 ConsensusReviewPEM not requiredSystematic-Review

Evaluation of safety and effectiveness of NAD in different clinical conditions: a systematic review.

Gindri, Izabelle de Mello, Ferrari, Gustavo, Pinto, Luiz Paulo S et al.·American journal of physiology. Endocrinology and metabolism·2024

This review examined whether taking NAD+ or NADH supplements (molecules that help cells produce energy) are safe and helpful for people with different health conditions, including chronic fatigue syndrome. Researchers looked at 10 clinical trials involving 489 people and found that these supplements were generally well-tolerated, with some people reporting improvements in fatigue, quality of life, and sleep. The most common side effects were mild and included muscle pain, headaches, and sleep disturbances, but nothing serious.

Sleep

E0 ConsensusReviewPEM requiredSystematic-Review

The persistence of myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) after SARS-CoV-2 infection: A systematic review and meta-analysis.

Dehlia, Ankush, Guthridge, Mark A·The Journal of infection·2024

Researchers looked at studies of people with Long COVID to see how many also meet the diagnostic criteria for ME/CFS. They found that about half of Long COVID patients have symptoms that match ME/CFS, including severe fatigue, sleep problems, muscle and joint pain, and post-exertional malaise (feeling much worse after physical activity). This suggests that Long COVID and ME/CFS may be very similar conditions, at least in some patients.

Severe MESleepPost-Exertional Malaise

E0 ConsensusReviewPEM not requiredSystematic-Review

Effects of traditional Chinese mind-body exercises for patients with chronic fatigue syndrome: A systematic review and meta-analysis.

Kong, Lingjun, Ren, Jun, Fang, Sitong et al.·Journal of global health·2023

This research review looked at whether traditional Chinese exercises like Tai Chi and Qigong help people with chronic fatigue syndrome (CFS). Researchers combined results from 13 studies involving 1,187 patients and found that these exercises probably reduce fatigue, depression, and anxiety compared to doing nothing, and may improve sleep and thinking ability. However, the benefits seem to fade over time, and these exercises work about as well as other active treatments like standard exercise programs.

Sleep

E0 ConsensusReviewPEM not requiredSystematic-Review

Effects of yoga on depressive symptoms, anxiety, sleep quality, and mood in patients with rheumatic diseases: Systematic review and meta-analysis.

de Orleans Casagrande, Pedro, Coimbra, Danilo Reis, de Souza, Loiane Cristina et al.·PM & R : the journal of injury, function, and rehabilitation·2023

This review examined whether yoga can help patients with rheumatic diseases (like arthritis and fibromyalgia) feel better emotionally and sleep better. Researchers combined results from 27 studies and found that yoga did help reduce depression and anxiety symptoms and improved sleep quality compared to no treatment. However, yoga was not clearly better than other types of exercise.

Sleep

E0 ConsensusReviewPEM unclearSystematic-Review

Effects of traditional Chinese exercise on sleep quality: A systematic review and meta-analysis of randomized controlled trials.

Liu, Haoyu, Liu, Siling, Xiong, Lu et al.·Medicine·2023

This review examined whether traditional Chinese exercises like Tai Chi and Qigong can help improve sleep quality. Researchers analyzed 20 studies and found that these exercises did help people sleep better, especially those with fibromyalgia, chronic fatigue-like illness, and insomnia. However, the benefit wasn't seen in all groups studied, such as stroke patients or college students.

Sleep

E0 ConsensusReviewPEM unclearMeta-Analysis

Objective sleep measures in chronic fatigue syndrome patients: A systematic review and meta-analysis.

Mohamed, Abdalla Z, Andersen, Thu, Radovic, Sanja et al.·Sleep medicine reviews·2023

This study looked at 24 research papers that measured sleep objectively (using devices and tests, not just patient reports) in people with ME/CFS. The researchers found that ME/CFS patients do indeed have real, measurable sleep problems—they take longer to fall asleep, wake up more during the night, and don't get good-quality sleep. Interestingly, these sleep problems looked slightly different in teenagers compared to adults with ME/CFS.

SleepAutonomic Nervous System

E0 ConsensusReviewPEM unclearSystematic-Review

Systematic Review of Sleep Characteristics in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome.

Maksoud, Rebekah, Eaton-Fitch, Natalie, Matula, Michael et al.·Healthcare (Basel, Switzerland)·2021

Many ME/CFS patients report that their sleep feels unrefreshing and disturbed, even when they sleep for long hours. This review looked at 20 studies that used objective sleep monitoring equipment (like devices that measure brain waves and breathing during sleep) to understand what's actually happening with sleep in ME/CFS patients. The researchers found that the results across different studies were inconsistent, meaning there's no clear pattern yet about what makes ME/CFS sleep different from healthy sleep.

Sleep

E0 ConsensusReviewPEM requiredReview-Narrative

A Comprehensive Update of the Current Understanding of Chronic Fatigue Syndrome.

Noor, Nazir, Urits, Ivan, Degueure, Arielle et al.·Anesthesiology and pain medicine·2021

This review summarizes what researchers currently understand about ME/CFS, a complex illness causing severe fatigue and other symptoms. The condition may involve problems with the immune system, stress response, or nervous system, and can be triggered by infections like Epstein-Barr virus, though not always. Diagnosis requires six months of fatigue plus four symptoms like memory problems, sore throat, or post-exertion malaise, and doctors must rule out other conditions first. Treatment options include therapy, medication, and newer approaches like electrical stimulation, though more research is needed to find the best approaches.

SleepImmune SystemPost-Exertional Malaise

E0 ConsensusReviewPEM not requiredSystematic-Review

Identification of mental health and quality of life outcomes in primary care databases in the UK: a systematic review.

Carreira, Helena, Williams, Rachael, Strongman, Helen et al.·BMJ open·2019

Researchers reviewed 120 studies that used UK patient medical records to track mental health and quality of life problems like depression, anxiety, fatigue, and cognitive issues. They found that different studies used different definitions and coding systems to identify these conditions, making it hard to compare results across studies. The authors recommend that researchers agree on standard definitions and validated code lists so findings are more consistent and reliable.

Pain and SensitizationSleepCognitive Impairment

E0 ConsensusReviewPEM not requiredSystematic-Review

Do evidence based interventions for chronic fatigue syndrome improve sleep? A systematic review and narrative synthesis.

Russell, Charlotte, Kyle, Simon D, Wearden, Alison J·Sleep medicine reviews·2017

This review looked at whether two common treatments for ME/CFS—cognitive behavioural therapy (CBT) and graded exercise therapy (GET)—actually help people sleep better. The researchers found only 8 studies that measured sleep as an outcome. GET showed some promise for improving sleep, but results were inconsistent across different studies. CBT had very limited evidence, with only one study out of two showing sleep improvements. Overall, we know very little about whether adding specific sleep management techniques to these treatments makes a difference.

Sleep

E0 ConsensusReviewPEM not requiredSystematic-Review

Exercise therapy for chronic fatigue syndrome.

Larun, Lillebeth, Brurberg, Kjetil G, Odgaard-Jensen, Jan et al.·The Cochrane database of systematic reviews·2017

This review looked at eight research studies testing whether exercise therapy helps people with ME/CFS feel less fatigued and improve their daily functioning. Overall, patients who did exercise therapy felt less tired and reported better sleep and physical function compared to those who received standard care or relaxation therapy. Exercise therapy appeared to work about as well as cognitive-behavioral therapy (talking therapy), though more research is needed to figure out the best type, intensity, and duration of exercise for each patient.

Sleep

E0 ConsensusReviewPEM not requiredSystematic-Review

Exercise therapy for chronic fatigue syndrome.

Larun, Lillebeth, Brurberg, Kjetil G, Odgaard-Jensen, Jan et al.·The Cochrane database of systematic reviews·2016

This review looked at eight studies testing whether exercise therapy helps people with ME/CFS feel less fatigued. Overall, exercise therapy reduced fatigue more than doing nothing or standard care, and patients also reported improvements in sleep, physical function, and general health. The review found no evidence that exercise made things worse, though more research is needed to determine the best type and intensity of exercise for each person.

Sleep

E0 ConsensusReviewPEM not requiredSystematic-Review

Exercise therapy for chronic fatigue syndrome.

Larun, Lillebeth, Brurberg, Kjetil G, Odgaard-Jensen, Jan et al.·The Cochrane database of systematic reviews·2016

This review looked at eight studies involving 1,518 people with ME/CFS to see if exercise therapy helps. Most studies showed that exercise reduced fatigue and improved sleep and physical function compared to no treatment or relaxation. Exercise therapy seemed to work about as well as cognitive-behavioral therapy, though the quality of evidence varied.

Sleep

E0 ConsensusReviewPEM not requiredSystematic-Review

Exercise therapy for chronic fatigue syndrome.

Larun, Lillebeth, Brurberg, Kjetil G, Odgaard-Jensen, Jan et al.·The Cochrane database of systematic reviews·2015

This review looked at eight studies involving 1,518 people with ME/CFS to see whether exercise therapy helps. The researchers found that people who did exercise therapy reported feeling less fatigued and experienced improvements in sleep, physical functioning, and overall health compared to those receiving no special treatment. Exercise therapy appeared safe, with no serious harmful effects reported, though the studies had some limitations.

Sleep

E0 ConsensusReviewPEM not requiredSystematic-Review

Sleep Disturbances in Pediatric Chronic Fatigue Syndrome: A Review of Current Research.

Snodgrass, Kelli, Harvey, Adrienne, Scheinberg, Adam et al.·Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine·2015

Children and teens with ME/CFS commonly struggle with sleep problems, but we don't know much about exactly what types of sleep issues they experience or how severe they are. This review looked at six studies comparing sleep in young people with ME/CFS to healthy children, and found that most studies showed children with ME/CFS have more sleep disturbances. However, the researchers note that more high-quality studies are needed to truly understand sleep problems in pediatric ME/CFS.

Sleep

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Evidence browser

Neuroendocrine signature of ME/CFS: Meta-analytic evidence for bioactive cortisol deficit and exaggerated feedback sensitivity.

Comparative effectiveness of non-pharmacological traditional Chinese medicine therapies for chronic fatigue syndrome: a systematic review and network meta-analysis.

The efficacy of exercise in patients with myalgic encephalomyelitis/chronic fatigue syndrome: A systematic review and meta-analysis.

[Efficacy and safety of fonturacetam in asthenia: a systematic review and meta-analysis].

Exploring the Effects of Qigong, Tai Chi, and Yoga on Fatigue, Mental Health, and Sleep Quality in Chronic Fatigue and Post-COVID Syndromes: A Systematic Review with Meta-Analysis.

Evaluation of safety and effectiveness of NAD in different clinical conditions: a systematic review.

The persistence of myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) after SARS-CoV-2 infection: A systematic review and meta-analysis.

Effects of traditional Chinese mind-body exercises for patients with chronic fatigue syndrome: A systematic review and meta-analysis.

Effects of yoga on depressive symptoms, anxiety, sleep quality, and mood in patients with rheumatic diseases: Systematic review and meta-analysis.

Effects of traditional Chinese exercise on sleep quality: A systematic review and meta-analysis of randomized controlled trials.

Objective sleep measures in chronic fatigue syndrome patients: A systematic review and meta-analysis.

Systematic Review of Sleep Characteristics in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome.

A Comprehensive Update of the Current Understanding of Chronic Fatigue Syndrome.

Identification of mental health and quality of life outcomes in primary care databases in the UK: a systematic review.

Do evidence based interventions for chronic fatigue syndrome improve sleep? A systematic review and narrative synthesis.

Exercise therapy for chronic fatigue syndrome.

Exercise therapy for chronic fatigue syndrome.

Exercise therapy for chronic fatigue syndrome.

Exercise therapy for chronic fatigue syndrome.

Sleep Disturbances in Pediatric Chronic Fatigue Syndrome: A Review of Current Research.

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