Sleep Apnea and Chronic Fatigue Syndrome

Sleep Apnea is a diagnosis du jour. It occurs in over 30% of the population for one type, Obstructive Sleep Apnea[2008], with a much higher rate for older individuals (at least 44%) and overweight individuals. The incidence for men is almost three times the incidence for women (the opposite ratio seen for CFS). Nose cartilage grows with age which is one factor for the increasing incidence. The article Sleep apnea as the cause of chronic fatigue syndrome [1994] suffers from the title being read and not the content (which speculates that it should be investigated and is not a demonstrated fact).

These common medical conditions have a higher incidence of sleep apnea: type 2 diabetes [68,69], polycystic ovary syndrome [7072], refractory hypertension [73], coronary artery disease [7476], congestive heart failure with systolic dysfunction [7779], and stroke [8082].  Wait, CFS, IBS and FM are not in this list.

CFS and Sleep Apnea share some common symptoms: fatigue, depression. A health professional can easily mis-conclude that Sleep Apnea is the cause of CFS — because: more than 50% of CFS patients have sleep apnea (the fact that more than 50% of age and weight match healthy population have sleep apnea is ignored).

  • Undiagnosed and comorbid disorders in patients with presumed chronic fatigue syndrome. [2013] found that ~ 30% of patients that met the Fukuda criteria for CFS had any sleep disorders.  This is the same rate reported elsewhere for the general population.
  • Sleep apnea and psychological functioning in chronic fatigue syndrome. [2009] found “Participants (CFS, SAHS, controls) completed questionnaires and were evaluated for SAHS ( sleep apnea/hypopnea syndrome ); 68 percent were subsequently diagnosed with SAHS. CFS participants with and without SAHS did not differ”. Again, CFS incidence matches that of the general population
  • Sleep disorders in patients with chronic fatigue. [1994]  “In conclusion, chronically fatigued patients with suggestive symptoms may have potentially treatable coexisting sleep disorders that are not associated with meeting criteria for CFS or a current psychiatric disorder.” This is a round-about way of saying that there is no detectable relationship between the incidence of CFS and the incidence of sleep disorders.

So bottom line:  sleep apnea is independent of having Chronic Fatigue Syndrome. I know a person that was given a CFS (and a Lyme diagnosis) that recovered when treated for sleep apnea. This is not surprising because most medical professionals (apart from rigorous research professionals) tend not to follow published criteria or do the tests that should show a problem that is CFS, namely:

  • Very high 1,25D levels — this is an autoimmune indicator (does not indicate which one)
  • SPECT scan having major abnormalities (MRI will be normal)
  • Inherited Coagulation Defects and hypercoagulation when the full panel of tests are done (often only one or two are done)

Many of my readers may have sleep apnea, or any one of a dozen treatable conditions that share symptoms with CFS. You may wish to review your medical tests that indicate if you have CFS. If none of the above have been done — approach your MD to order one of them. If the result is negative, you may wish to press for a second one of them. If all three are negative — then you likely have a different condition (which your MD may not like — because he will need to identify it and treat you!)