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Volume 13 No. 09
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Accepted Papers

Scientific Investigations

Sleep Quality in Adolescents With Chronic Fatigue Syndrome/Myalgic Encephalomyelitis (CFS/ME)

Elisha K. Josev, PhD1,2; Melinda L. Jackson, PhD2,3; Bei Bei, PhD4,5; John Trinder, PhD2; Adrienne Harvey, PhD1,6; Cathriona Clarke, BSc1; Kelli Snodgrass, MD1; Adam Scheinberg, MMed (Clin Epi)1,7,8; Sarah J. Knight, PhD1,7,9
1Clinical Sciences, Murdoch Childrens Research Institute, Royal Children's Hospital, Melbourne, Australia; 2Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, Australia; 3School of Health and Biomedical Sciences, Royal Melbourne Institute of Technology, Melbourne, Australia; 4Monash Institute of Cognitive and Clinical Neurosciences, School of Psychological Sciences, Monash University, Melbourne, Australia; 5Centre for Women's Mental Health, Department of Psychiatry, University of Melbourne, Royal Women's Hospital, Melbourne, Australia; 6Developmental Medicine, Royal Children's Hospital, Melbourne, Australia; 7Victorian Paediatric Rehabilitation Service, Royal Children's Hospital, Melbourne, Australia; 8Department of Paediatrics, Monash University, Melbourne, Australia; 9Department of Paediatrics, University of Melbourne, Melbourne, Australia

Study Objectives:

Little is known about the type and severity of sleep disturbances in the pediatric chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME) population, compared with healthy adolescents. Using a range of objective and subjective measures, the aim of this study was to investigate sleep quality, the relationship between objective and subjective measures of sleep quality, and their associations with anxiety in adolescents with CFS/ME compared with healthy controls.


Twenty-one adolescents with CFS/ME aged 13 to 18 years (mean age 15.57 ± 1.40), and 145 healthy adolescents aged 13 to 18 years (mean age 16.2 ± 1.00) wore actigraphy watches continuously for 2 weeks to collect a number of objective sleep variables. The Pittsburgh Sleep Quality Index was used to obtain a subjective measure of sleep quality. Anxiety was measured by the Spence Children's Anxiety scale.


On average over the 2-week period, adolescents with CFS/ME were found to have (1) significantly longer objective sleep onset latency, time in bed, total sleep time, and a later rise time (all P < .005), and (2) significantly poorer subjective sleep quality (P < .001), compared with healthy adolescents. The CFS/ME patient group displayed higher levels of anxiety (P < .05), and in both groups, higher levels of anxiety were significantly related to poorer subjective sleep quality (P < .001).


This study provides objective and subjective evidence of sleep disturbance in adolescents with CFS/ME compared with healthy adolescent controls.


Josev EK, Jackson ML, Bei B, Trinder J, Harvey A, Clarke C, Snodgrass K, Scheinberg A, Knight SJ. Sleep quality in adolescents with chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME). J Clin Sleep Med. 2017;13(9):1057–1066.

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