Sleep Care

Chronic Fatigue Syndrome

Chronic Fatigue Syndrome (CFS) was introduced by the Centers for Disease Control in 1988, however CFS has a long history in and out of the United States dating back to the eighteenth century.  Prior to being known as CFS the condition was called Chronic Epstein-Barr Virus Syndrome, Atypical Poliomyelitis, Chronic Fatigue Immune Dysfunction Syndrome, Chronic Mononucleosis Syndrome and Iceland Disease; just to name a few.  While it has been given numerous names, the complexity and severity of this ailment remain debilitating for its sufferers.  It is characterized by serious and chronic fatigue that is not eased by rest, lasts for 6 months or longer, and is not directly attributed to any other diseases.

Aside from chronic fatigue, there are several other indicators of this disease.  To begin, the inception of tiredness impedes on normal activity and sufficient sleep does not lead to any feelings of rejuvenation.  In addition, severe headaches, joint pain, forgetfulness, loss of concentration, confusion, irritability, sore throat, muscle aches, muscle weakness and tenderness in lymph nodes have all been described in relation to CFS.  A medical diagnosis of this disease will require at least four of the symptoms above and the lack of any other sources known to cause extreme fatigue, aside from depression. While there are a number of tests that can be done to eliminate any other potential reasons for the symptoms, there are no tests that will positively verify that a patient has this condition.  Often times, patients that suffer from Chronic Fatigue Syndrome will show positive results on MRI tests that indicate brain swelling or nerve cell destruction.  In addition, there times when numbers of certain white blood cells are higher than others in the patient.

While there is no explicit cure for Chronic Fatigue Syndrome, there are a number of treatment options available to help manage and ultimately overcome the disease.  To clarify, some of the greatest treatment exercises begin with a healthy diet, and sleep management and relaxation techniques.  Sleep management includes beginning and maintaining a night time regimen, avoiding naps during the day, regulating noise, temperature and light in your bedroom, avoid caffeine at least 6 hours before bed time, and using the bedroom strictly for sex and rest.  Furthermore, there are several therapy options that include Cognitive-behavioral Therapy, Graded Exercise Therapy, and pharmacologic therapies, among others.   Antidepressants and other medications have also been prescribed to patients that can potentially benefit from such medications.

Fortunately, there are several support group options available for people dealing with this lingering syndrome.  Many virtual groups were started by patients dealing with the same issues and concerns surrounding this illness.  There are numerous benefits to meeting with others that are also suffering from this illness.  First, the group provides a comfortable environment for sharing stories, grievances, and successes related CFS.  Also, groups can contain members that are in different stages of the ailment, therefore they can share experiences and methods for coping; they can also offer beneficial and up-to-date information to other members.  When looking for support groups there are features that should be avoided and qualities that should stand out.  Steer clear of groups that guarantee remedies, push for personal information from members, ask for expensive member dues or require that patients buy products from members or organizers.  Instead, qualities to look for in support groups are that they have some longevity and include members that can attest to its benefits.  Additionally, most support groups are free or ask for voluntary donations that will be used for the purpose of meeting, such as snacks and informational packets.  The best way to find a good support group is by contacting your local hospitals or medical clinics.

Patients struggling with chronic fatigue syndrome may be helped the most when standard treatment is coupled with cognitive behavior therapy or exercise therapy, new British research suggests. The apparent promise of cognitive behavior therapy and “graded exercise therapy” offers considerable hope to patients combating the complex condition characterized by profound tiredness, impaired concentration, diminished memory, sleep difficulties and muscle and joint pain, the study authors said. The findings also support the somewhat controversial notion that incremental adjustments in physical behavior and/or mental attitude can ultimately have a positive impact on the disorder, the authors said.

The standard intervention, known as specialist medical care, is centered around giving patients information about their condition, advice on how to manage symptoms and assistance with coping approaches. The research team behind the new study found little appreciable benefit with a third alternate therapeutic approach that focuses on helping patients strictly structure their activity and relaxation routines to match their severely reduced energy levels. This strategy, known as “adaptive pacing therapy,” assumes that chronic fatigue syndrome is not, in fact, reversible with behavioral changes.

“Patients who received either graded exercise therapy or cognitive behavior therapy reported less fatigue and better function than those who received either adaptive pacing therapy or specialist medical care alone,” said study author Dr. Peter D. White, a professor of psychological medicine at Barts and the London School of Medicine, and a psychiatrist at St Bartholomew’s Hospital in London. White and his colleagues report their findings in the Feb. 18 online edition of The Lancet. The authors noted that it is not yet understood what gives rise to chronic fatigue syndrome (CFS).

The cognitive behavioral therapy targets the building fear and avoidance of activity that can exacerbate CFS. In effect, it seeks to break a vicious cycle in which mental inhibitions actually perpetuate and aggravate the underlying chronic fatigue. Exercise therapy, also known as “GET,” tries to reduce fatigue and disability by gradually helping patients increase their activity levels to improve their overall physical fitness.

To explore which therapies or combinations of therapies might be best, 641 chronic fatigue patients from four different rehabilitation centers in Britain were divided up into one of four groups. Over the course of a year, all got standard specialist medical care, while three of the groups received one additional treatment: pacing therapy, cognitive therapy or exercise therapy. White and his team found the greatest improvements in terms of both fatigue levels and physical function were experienced by those patients who were treated with standard therapy in combination with either cognitive therapy or exercise therapy. What’s more, patients who got a combination of standard treatment and pacing therapy fared no better than those who got standard treatment alone. Specifically, 60 percent of the standard/cognitive or standard/GET patients experienced fatigue and function improvements, while 30 percent reported “normal levels” of fatigue and function. Half as many of the standard therapy alone or standard/pacing patients reported normal fatigue and function levels.

White noted that all the treatments were equally safe, and serious reactions were rare. “Patients now have a choice of two moderately effective and safe treatments that can help them towards a healthier life,” he said.

While there is no known cure for Chronic Fatigue syndrome, there are several options for coping, managing and ultimately overcoming this condition.  Most importantly, there is support out there for patients who feel that they can benefit from a community of other patients.  Just because there is not one direct remedy does not mean that this ailment cannot be overcome; all it takes is a little effort from the patient and guidance from a medical professional leading to the best routes for each patient.

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