Dr. Martina Melzer, published: 13.02.2022
Our sleep is divided into different stages, sometimes we sleep more lightly, sometimes really deeply, sometimes our eyes move (REM sleep), sometimes not (non-REM
sleep). Approximately every 90 minutes we go through all stages once. After that, we wake up briefly, whether we notice it or not. Deep sleep seems to be particularly important for our recovery
and probably takes place in the first four to five hours of sleep. After that, we start to toss and turn more.
During sleep, some of our body systems switch to the pause button to regenerate. But not all of them. Some are highly active, for example the brain. Digestion also runs at full speed, the liver detoxifies, hormones are formed, cells renew themselves, and the immune system fights pathogens.
People with chronic fatigue know this: They sleep 12 hours, get up and feel like dead. Zero recovery, as if
they had partied until 4 a.m. or taken sleeping pills with alcohol (very dangerous!). At 10 o'clock they could already lie down again, at noon and in the afternoon anyway, at 8 o'clock they crawl
back into bed. That's the bad thing about fatigue: sleep doesn't recover you.
Studies suggest that inflammation in the brain may play a role in this, and sleep phases may also be disturbed. For some people, too much of our body's stress hormone, cortisol, is mistakenly produced in the evening and at night. In contrast, in the morning, when it is supposed to wake us up, there is too little cortisol. A slower breakdown of the sleep hormone melatonin can also make you sleepy in the morning. In part, our internal clock goes haywire, and dysregulation of the autonomic nervous system also messes with our sleep.
Then there's the glymphatic system. Our entire body is permeated by the lymphatic system. It is part of the immune system, transports nutrients, brings tissue fluid to the bloodstream, and rids the organism of toxins. The brain also has such a system - the glymphatic system. Our brain, the nerve cells and the immune cells in the brain, the glia, consume a lot of energy. This also produces a lot of toxins and cellular waste that must be disposed of. This is done by the glymphatic system, among others. If its function is impaired, for example due to sleep disorders, you can feel as if you have Alzheimer's in the morning.
There are numerous reasons why people with the symptom fatigue or the disease ME/CFS have poor sleep (and not
only them). Some examples:
The list could go on and on. So you have to become a detective yourself and find out the causes that disturb your sleep. Then you can eliminate the biggest troublemakers step by step and by trial and error. Since illnesses can also be behind sleep problems, you should definitely talk to a doctor about it. For example, nocturnal breathing pauses (sleep apnea) are dangerous and should be treated. A depression or anxiety disorder also usually requires long-term psychotherapy. And hyperthyroidism or hypothyroidism can be better controlled with medication, among other things.
Just as there are an almost infinite number of causes for bad nights, there are also an almost infinite number of possible solutions. Again, become a detective and find out what works for you. It is extremely important for people with fatigue to find more restful sleep!
Some examples that can positively influence sleep:
There is also typical advice on sleep hygiene:
PS: Of course, I research and check everything I write here as well as possible. Nevertheless, I am only human and make mistakes. In addition,
I may draw completely different conclusions as someone else would. Simply because they fit my story. But every story is different.
Important: The content on this page is for informational purposes only and is not a substitute for talking to your doctor or other therapist. The content reflects my personal experiences, research and findings that have helped me and that I therefore want to share. However, in your personal case, completely different things may play a role and other things may help. Please talk to your doctor or therapist before making any decisions that affect your physical or mental health. Also important: I don't want to convince anyone of anything here. Rather, I want to point out possible ways that hopefully can help some people to improve or overcome their Fatigue or ME/CFS.
Jürgen Zulley: Schlafkunde
Shawn Stevenson: Sleep smarter
Dr. Anne Fleck: Energy
Dan Neuffer: CFS Unravelled
Morris G et al: The putative role of oxidative stress and inflammation in the pathophysiology of sleep dysfunction across neuropsychiatric disorders: Focus on chronic fatigue syndrome, bipolar disorder and multiple sclerosis. Sleep Med Rev 2018
Sakkas GK et al: Sleep Abnormalities in Multiple Sclerosis. Curr Treat Options Neurol 2019
Dr. Rosamund Vallings: Chronic Fatigue Syndrome
A Komaroff: Does sleep flush waste from the brain? JAMA 2021