Polysomnographic and multiple sleep latency testing data in a large sample of patients with chronic fatigue syndrome and their relationship with subjective scores

The effect of foot reflexology on fatigue in hemodialysis patients: a meta-analysis study

OBJECTIVE

this meta-analysis study analyzed the effect of foot reflexology on fatigue in hemodialysis patients by combining the results of independent studies on this subject.

METHOD

meta-analysis study. A literature search was conducted in seven databases. The methodological quality of the included studies was assessed using tools proposed by the Joanna Briggs Institute. Comprehensive Meta-Analysis v3 was used for meta-analysis.

RESULTS

eight studies were included in the meta-analysis. The result of the meta-analysis standardized mean difference = 1.580 (95% Confidence Interval = 1.075 - 2.085 p = 0.000). The result of the subgroup analysis performed based on the number of foot reflexology sessions standardized mean difference = 1,478 (95% Confidence Interval = 1,210 - 1,747, p = 0.000).

CONCLUSION

it was concluded that foot reflexology can be used to reduce fatigue in hemodialysis patients. No information was provided in the investigated studies about the possible side effects and negative effects of foot reflexology. (1) This study found that foot reflexology reduced fatigue levels. (2) The 10-session foot reflexology was the most effective. (3) This study will guide nurses and health workers. (4) Reflexology is one of the non-pharmacological methods used to relieve fatigue.

The Relationship Between Improvement in Insomnia Severity and Long-Term Outcomes in the Treatment of Chronic Fatigue

Background: The current treatments of choice for patients with chronic fatigue are moderately effective. One way to advance treatments is identifying process variables associated with good treatment outcomes. There is little knowledge regarding a possible association between insomnia and long-term outcomes in the treatment of chronic fatigue.

Aims: Testing whether (1) improvement in insomnia is associated with improvement in levels of fatigue at 1-year follow-up, and (2) if such a relationship remains when controlling for improvement in levels of anxiety and depression, and pain in patients with chronic fatigue.

Methods: Patients having been on sick leave 8 weeks or more due to chronic fatigue were referred to a return-to-work program. They received an intensive 3.5-week inpatient treatment program based on acceptance and commitment therapy (ACT). Before treatment and at 1-year follow-up the patients completed questionnaires assessing levels of insomnia severity, pain, anxiety and depression, and fatigue.

Results: A regression analysis found that changes in insomnia-severity were associated with changes in fatigue-levels at 1-year follow-up. When changes in levels of anxiety and depression were entered in the regression analysis, anxiety and depression was significantly associated with levels of fatigue but insomnia was not. The association between anxiety and depression and fatigue was at a trend level when pain was entered into the model.

Conclusion: Long-term improvement in insomnia severity was significantly associated with long-term improvement in chronic fatigue, but not independently of long-term improvement in anxiety and depression, and pain.

Trial Registration:https://clinicaltrials.gov/, identifier NCT01568970.

Sleep-wake rhythm disturbances and perceived sleep in adolescent chronic fatigue syndrome

Chronic fatigue syndrome (CFS) is characterized by long-lasting, disabling and unexplained fatigue that is often accompanied by unrefreshing sleep. The aim of this cross-sectional study was to investigate sleep-wake rhythm and perceived sleep in adolescent CFS patients compared to healthy individuals. We analysed baseline data on 120 adolescent CFS patients and 39 healthy individuals included in the NorCAPITAL project. Activity measures from a uniaxial accelerometer (activPAL) were used to estimate mid-sleep time (mid-point of a period with sleep) and time in bed. Scores from the Karolinska Sleep Questionnaire (KSQ) were also assessed. The activity measures showed that the CFS patients stayed significantly longer in bed, had a significantly delayed mid-sleep time and a more varied sleep-wake rhythm during weekdays compared with healthy individuals. On the KSQ, the CFS patients reported significantly more insomnia symptoms, sleepiness, awakening problems and a longer sleep onset latency than healthy individuals. These results might indicate that disrupted sleep-wake phase could contribute to adolescent CFS; however, further investigations are warranted.