title: Sleep quality perception in the chronic fatigue syndrome: correlations with sleep efficiency, affective symptoms and intensity of fatigue.
abstract: OBJECTIVE
  One of the core symptoms of the chronic fatigue syndrome (CFS) is unrefreshing sleep and a subjective sensation of poor sleep quality. Whether this perception can be expressed, in a standardized questionnaire as the Pittsburgh Sleep Quality Index (PSQI), has to our knowledge never been documented in CFS. Furthermore, correlations of subjective fatigue, PSQI, affective symptoms and objective parameters such as sleep efficiency are poorly described in the literature.
  
  
  METHODS
  Using a cross-sectional paradigm, we studied subjective measures like PSQI, Fatigue Severity Scale scores and intensity of affective symptoms rated by the Hamilton Depression and Anxiety scales as well as objective sleep quality parameters measured by polysomnography of 28 'pure' (no primary sleep and no psychiatric disorders) CFS patients compared to age- and gender-matched healthy controls.
  
  
  RESULTS
  The PSQI showed significantly poorer subjective sleep quality in CFS patients than in healthy controls. In contrast, objective sleep quality parameters, like the Sleep Efficiency Index (SEI) or the amount of slow-wave sleep did not differ significantly. Subjective sleep quality showed a correlation trend with severity of fatigue and was not correlated with the intensity of affective symptoms in CFS.
  
  
  CONCLUSIONS
  Our findings indicate that a sleep quality misperception exists in CFS or that potential nocturnal neurophysiological disturbances involved in the nonrecovering sensation in CFS are not expressed by sleep variables such as the SEI or sleep stage distributions and proportions.
authors.affiliation: Sleep Laboratory, Department of Psychiatry, University Hospital Brugmann, Brussels, Belgium. daniel.neu@skynet.be
authors.forename: Daniel
authors.initials: D
authors.lastname: Neu
authors.forename: Olivier
authors.initials: O
authors.lastname: Mairesse
authors.forename: Guy
authors.initials: G
authors.lastname: Hoffmann
authors.forename: Amirouche
authors.initials: A
authors.lastname: Dris
authors.forename: Luc J
authors.initials: LJ
authors.lastname: Lambrecht
authors.forename: Paul
authors.initials: P
authors.lastname: Linkowski
authors.forename: Paul
authors.initials: P
authors.lastname: Verbanck
authors.forename: Olivier
authors.initials: O
authors.lastname: Le Bon
mesh_terms: D000339:Affect; D001290:Attitude; D003430:Cross-Sectional Studies; D004576:Electromyography; D015673:Fatigue Syndrome, Chronic / Q000175:diagnosis* / Q000453:epidemiology*; D005260:Female; D006801:Humans; D008297:Male; D017286:Polysomnography; D015995:Prevalence; D011446:Prospective Studies; D011602:Psychophysiologic Disorders / Q000453:epidemiology; D012720:Severity of Illness Index; D012890:Sleep / Q000502:physiology*; D012894:Sleep Stages / Q000502:physiology; D011795:Surveys and Questionnaires