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Fatigue is common in the general population, and is the hallmark of chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME). Although the occurrence of sleep difficulties is known to be common in subjects with fatigue, research on insomnia in such subjects is absent. The current study sought to examine the impact comorbid insomnia has on level of fatigue in subjects with chronic fatigue. The aim of this study is to assess the relationship between insomnia and chronic fatigue, and examine if the relationship is affected by the endocrine activity in the HPA axis. The following hypotheses were tested: 1) Do patients with chronic fatigue and comorbid insomnia experience more fatigue than patients with chronic fatigue without comorbid insomnia? 2) Do patients with chronic fatigue and with initially comorbid insomnia experience more fatigue after treatment than chronic fatigue patients without comorbid insomnia? 3) Do patients with chronic fatigue who experience improvement in insomnia after treatment also experience less fatigue by the end of treatment compared with patients who do not experience improvement in insomnia? 4) Is the potential relationship between insomnia and chronic fatigue influenced by the activity of the HPA axis as expressed by variation in cortisol output measured by Trier Social Stress Test for Groups (TSST-G)? The study sample consisted of 75 patients with chronic fatigue. Thirty-three met criteria for insomnia, while 42 did not. While staying at Hysnes Rehabilitation Center in Trondheim, Norway, they received a work-related Acceptance and Commitment Therapy (ACT) treatment intervention lasting 3.5 weeks. In addition, they participated in a standardized stress test (Trier Social Stress Test) pre- and post-treatment. Saliva cortisol samples were collected during the test in order to measure variation in cortisol output. The current finding is the first description of how insomnia in patients with chronic fatigue is associated with higher levels of fatigue (p < .05). Further, this study gives preliminary support indicating that remission of insomnia in patients with chronic fatigue can significantly reduce levels of fatigue (p < .05), and furthermore improve the physiological stress-response (p < .05). These results might encourage clinicians to assess and provide specific treatment for insomnia in patients with chronic fatigue as this might improve their treatment results. An aim for further research should be to investigate the effect of specified treatment for insomnia in patients with chronic fatigue.

Diss. (sammanfattning) Stockholm : Karolinska institutet, 2007. / Härtill 4 uppsatser.

Thesis (Master of Science (Hons.) Social Ecology) -- University of Western Sydney, Hawkesbury, 1994. / "A dissertation submitted in fulfilment of the requirements for the degree of Master of Science (Honours) in Social Ecology in the University of Western Sydney - Hawkesbury" Bibliography : leaves 288-300.

Purpose: The aim of the systematic review was to address whether psychological interventions were able to reduce fatigue severity or the impact of fatigue in individuals with Multiple Sclerosis. The empirical study aimed to evaluate the effectiveness of a CBT based self-help workbook at reducing perceived impact of fatigue in a clinical sample of MS patients. Methods: A systematic search of the literature was carried out between the years 1980 and February 2015 to review whether psychological interventions were effective for fatigue management in Multiple Sclerosis. A randomised controlled trial examined the effectiveness of a CBT-based self-help workbook for the reduction of fatigue impact in MS. Participants were randomly allocated to one of three groups treatment as usual (TAU), pure self-help (PSH) or guided self-help (GSH). Results: Eleven studies were included in the systematic review, which indicated that CBT based interventions aiming to reduce fatigue or depression were most effective at reducing the severity of fatigue. Impact of fatigue can be reduced through mindfulness, CBT, motivational interviewing and to a lesser extent acceptance and commitment therapy. The empirical study did not find any significant differences between groups, however satisfaction with the workbook was high. Conclusions: The review suggests that there is a clear role for psychological interventions in fatigue management in MS, although further robust research into different therapeutic modalities is needed. From the empirical study it appears that the low level CBT-based intervention for fatigue in MS was not effective at reducing the perceived impact of fatigue. This study reflects an inclusive, clinical sample, recruited from a specialist rehabilitation unit, with high levels of multidisciplinary input which may have diluted any potential effect of the workbook. Objectives: The aim of the systematic review was to address whether psychological interventions are able to reduce fatigue severity or the impact of fatigue in individuals with Multiple Sclerosis Data sources: A search was conducted of: Psychinfo, Medline, Embase, CINAHL between 1980 and February 2015. Review methods: All studies were evaluated against a set of quality criteria by author (KG) with a proportion of studies being independently reviewed by author (DP) to ensure reliability of ratings. Results: Eleven studies were included in the review. CBT based interventions with a focus on fatigue management and depression appear to significantly reduce fatigue severity with medium to large effect. Significant reductions in fatigue impact can be found from mindfulness groups, motivational interviewing and CBT. Effect sizes for CBT interventions ranged from negligible to medium. For the mindfulness and motivational interviewing interventions effect sizes were not able to be calculated. The acceptance and commitment therapy intervention did not find a significant reduction in fatigue but found a medium effect for the intervention. Conclusions: There is a clear role for psychological interventions in the reduction of fatigue management but more high quality research needs to be carried out.

This post-positivist research study explored the possible relationship between Chronic Fatigue and Immune Dysfunction Syndrome (CFIDS) and the presence of underlying psychological and emotional issues. An exploratory design with naturalistic methods of inquiry was utilized to investigate whether the presence, or absence, of these issues had any impact on the overall disease process.

Bakgrund: Myalgisk encefalomyelit/ Chronic Fatigue Syndrome (ME/CFS) är en komplex kronisk sjukdom med okänd etiologi och utan medicinsk botande behandling. Kunskapen om sjukdomen är låg bland hälso-och sjukvårdspersonal vilket kan leda till att patienter får gå lång tid utan stöd. Sjuksköterskan är ansvarig att uppdatera sina kunskaper och stödja personerna genom personcentrerad vård för att uppnå hälsa och minska lidande. Genom att studera personers egna upplevelser av sjukdomen, utifrån deras livsvärld, kan ny kunskap och förståelse skapas.  Syfte: Att beskriva vuxna personers upplevelse av att leva med Myalgisk encefalomyelit/ Chronic Fatigue Syndrome (ME/CFS) Metod: Till metod valdes en kvalitativ litteraturstudie med en induktiv ansats baserad på två patografier och sju kapitel ur en antologi. Innehållsanalysen gjordes efter inspiration från Lundman och Hällgren Graneheims beskrivning, analysen skedde huvudsakligen manifest med latenta inslag. Resultat: Analysen resulterade i tre kategorier och sex underkategorier. I kategorin Sjukdomens konsekvenser begränsar livet framkom att personerna upplevde att livet begränsades på grund av de förändrade fysiska och mentala förmågorna. I kategorin Förändrat jag framkom att personerna upplevde att den de var förändrades. I kategorin, Svårigheter att hantera sjukdomen, framkom att personerna upplevde svårigheter att lära sig leva med och acceptera sjukdomen, men att de lärde sig hantera den med hjälp av olika strategier och ett nytt sätt att tänka. De beskrev även upplevelser av bristande kunskap, svårigheter att få en diagnos och en känsla av att inte bli tagen på allvar i kontakt med vården.   Slutsats: Myalgisk encefalomyelit/ Chronic Fatigue Syndrome (ME/CFS) har en djup påverkan på hela personen, fysiskt, mentalt och psykiskt liksom att den påverkar relationer, familjedynamik, funktionsförmåga, välbefinnande och vardagsliv. Sjukdomen är svår att lära sig leva med och det finns ett behov av stöd, strategier och information från sjukvården för att  underlätta personens anpassning till vardagen och välbefinnande.

Bakgrund: ME/CFS är en allvarlig, kronisk och komplex multisystemsjukdom som ofta och dramatiskt begränsar de drabbade personernas aktivitet. De vetenskapliga beläggen gällande effekten av interventioner riktade mot funktion och funktionsnedsättning är begränsade. Nuvarande kunskapsläge indikerar att arbetsterapeuten kan bidra i vården av personer med ME/CFS, men behov av vidare forskning finns. Syfte: Att med denna litteraturöversikt kartlägga och beskriva aktuell forskning gällande arbetsterapeutens roll för personer med diagnosen ME/CFS. Metod: Datainsamling för litteraturöversikten genomfördes baserat på utarbetade urvalskriterier i tre relevanta databaser; PubMed, CINAHL och PsycINFO och resulterade i tio artiklar, sju kvantitativa och tre kvalitativa studier. Studiernas kvalitet granskades och sedan utfördes en latent innehållsanalys. Resultat: Analysen resulterade i fyra kategorier: Att ge klientcentrerat stöd för strategier i aktivitet, Att justera terapeutiskt förhållningssätt vid aktivitetsanpassning, Att beakta gruppbehandlingens terapeutiska värde samt Att bidra till professionernas teamsamverkan. Slutsats: Arbetsterapeutens kompetens är ett viktigt bidrag i rehabiliteringen på grund av den komplexa aktivitetssituation som diagnosen innebär. / Background: ME/CFS is a serious, chronic and complex systemic disease which often and dramatically limits the activity of the affected. The existing scientific evidence of interventions regarding function and disability is limited. The current level of knowledge indicates that the occupational therapist can contribute to the care for people with ME/CFS, but there is a need for further research. Aim: The aim of this literature overview was to map out and describe current research regarding the role of the occupational therapist for people diagnosed with ME/CFS. Method: Data collection for the literature overview was conducted based on developed selection criterias in three relevant databases; PubMed, CINAHL and PsycINFO which resulted in ten articles, seven quantitative and three qualitative studies. The quality of the included studies were assessed and finally a latent content analysis was completed which resulted in four categories. Result: The content analysis resulted in four categories: to supply a client centered support for strategies in activity, to adjust therapeutic approach in occupational adaptation, to consider the therapeutic value of the group treatment, and to contribute to the professional team collaboration. Conclusion: The expertise of the occupational therapist is an important contribution to rehabilitation due to the complex occupational situation for people diagnosed with ME/CFS.

Bakgrund: Orsaken till uppkomsten av myalgisk encefalomyelit/kroniskt trötthetssyndrom är inte helt utredd men vanligtvis debuterar sjukdomen efter en infektionssjukdom, exponering av miljögifter eller vid stress och större livshändelser. Symtomen är många och svårighetsgraden varierar. Det är en svårdiagnostiserad sjukdom utan specifika biomarkörer för diagnosställning. Sjukdomen är ännu outforskad vilket försämrar sjuksköterskans möjlighet att hjälpa personerna på ett personcentrerat sätt. Syfte: Syftet var att belysa erfarenheter av att leva med myalgisk encefalomyelit/kroniskt trötthetssyndrom. Metod: Studien utformades som en allmän litteraturstudie där tio resultatartiklar användes. Analys av resultatartiklarna genomfördes enligt Popenoe et al. (2021). Resultat: I resultatet identifierades tre huvudkategorier följt av åtta underkategorier. Resultatet visade att sjukdomen upplevdes ge fysiska och psykiska konsekvenser. Sjukdomens svårighetsgrad varierade men gemensamt var upplevelsen av stora begränsningar. Begränsningarna ledde ofta till frustration, ensamhet och ett behov att omvärdera sin identitet. Personer med myalgisk encefalomyelit/kroniskt trötthetssyndrom upplevde en oförståelse och okunskap hos omgivningen och inom vården. Resultatet visade också en stor variation av känslor rörande acceptans och återhämtning bland personerna. Konklusion: För att vården ska förbättras och tillvaron förändras för personer som lever med ME/CFS behövs mer kunskap och förståelse kring sjukdomen. / Background: The cause of myalgic encephalomyelitis/chronic fatigue syndrome is not completely understood, but usually the disease debuts after an infection, exposure to environmental toxins or during stress and major life events. The symptoms are many and varies in severity. It is difficult to diagnose the disease and there are no specific biomarkers for diagnosis. The disease is still unexplored which makes it hard for nurses to help these people in a person-centered way. Purpose/Aim: The purpose was to highlight experiences of living with myalgic encephalomyelitis/chronic fatigue syndrome. Method: The study was designed as a general literature study, where ten result articles were used. Analysis of the result articles were done according to Popeneo et al. (2021). Results: In the results, three main categories were identified, followed by eight subcategories. The results showed that the disease was perceived to give physical and psychological consequences. The degree of severity of the disease thus varied, but in general was the experience of major limitations. The limitations often led to frustration, loneliness and a need for re-evaluate one’s identity. Strategies for coping and an everyday planning was common. The lack of understanding and ignorance about the disease, created an obstacle between the healthcare and the patients. In addition, the results showed that feelings about recovery and acceptance varied. Conclusion: In order for care to improve and life to change for people living with ME/CFS, more knowledge and understanding about the disease is needed.

Chronic, noncommunicable diseases such as chronic fatigue syndrome (also known as myalgic encephalomyelitis) are rapidly becoming a worldwide epidemic that profoundly affects public health and productivity. Chronic fatigue syndrome (CFS) is characterised by severe and debilitating fatigue and although its etiology is still unknown, recent studies have found considerable evidence that mitochondrial dysfunction and oxidative stress might be responsible for the underlying energy deficit in these patients. Adenine and pyridine nucleotides could be used as potential biomarkers for energy related disorders such as chronic fatigue syndrome because of their various functions in the energy and redox pathways. The first part of this study focussed on developing a liquid chromatography electrosprayionisation tandem mass spectrometry (LC-ESI-MS/MS) method for the quantification of these nucleotides in blood samples. Due to the instability of nucleotides in biological matrices it was also necessary to find a suitable extraction method that would be able to stop enzymatic activity via protein precipitation. Out of the four extraction methods investigated during this study, deproteinisation of whole blood samples with perchloric acid produced the highest nucleotide abundances. Although nucleotide standards were found to be stable in perchloric acid, nucleotide levels in blood samples were not stabilised by addition of perchloric acid. The second part of this study consisted of measuring the nucleotide levels in blood samples of controls and possible CFS patients in order to test the proof of concept of the new LCESI- MS/MS method. Despite changes in the nucleotide levels due to perchloric acid and problems with nucleotide instability, it was still possible to distinguish between the two groups based on the results obtained with the new LC-ESI-MS/MS method. The newly developed LC-ESI-MS/MS method proved to be reliable and adequate for nucleotide quantification in whole blood samples, thus the aim of this study was achieved. / MSc (Biochemistry), North-West University, Potchefstroom Campus, 2014