The Most Important Symptom
by William Collinge, Ph.D.

The single most important symptom to treat in CFIDS is the sleep disorder. This is because good quality sleep is necessary for healing. Recent scientific evidence indicates that people with CFIDS and fibromyalgia (FM) have a deficiency in "non-REM" sleep, a deep part of the sleep cycle that is critical for restoration and healing. So, even though you may be asleep for a lot of hours, if you are not getting adequate non-REM sleep, you will not awaken refreshed, and your body will not get the support it needs to restore health.

Some researchers suspect that at the root of CFIDS and FM may actually be a primary sleep disorder. This idea is supported by the findings of a Canadian researcher who studied the effects of non-REM sleep deprivation on a group of medical students. Over a period of several nights, each time the students were going into non-REM phase, they were deliberately disturbed. The result was that in a few days they developed all the classic symptoms of CFIDS and FM.

Research has shown that the sleep medications currently available, while they may help you sleep, do not help with the disturbance of the non-REM phase. What can you do to support your body's need for good quality sleep? There are several issues you can address.

1. "Night People." I know that many people consider themselves "night people," take a long time to be going to bed in the early morning hours and sleeping later into the day. You may feel that you just can't get to sleep before 1 a.m., or that your body just doesn't "want" to go to sleep earlier. Or perhaps you have operated his way for a number of years even before you got sick.

   While this pattern may seem natural to you, it is a learned habit and is not a natural part of your body's metabolic functioning. The body's physiology and neurochemistry are designed to be responsive to the natural cycles of nature, including daylight and dark ness. Your pineal gland, which regulates your hormonal system and is involved in the release of melatonin, is very sensitive to daylight and darkness.

   Of course, you can override your body's natural functioning to some degree with learned habits. However, you can help it restore harmony if you will come back into a more natural timing of your sleep pattern. This means establishing your bedtime around 10 p.m.

   If you are currently in the habit of staying up much later, you can gradually move your bedtime up by getting up a few minutes earlier each morning progressively for several days. This will make it easier to go to bed sooner, until gradually you reach your target of a 10 p.m. bedtime.

2. "My mind won't quiet down." The body may be ready to sleep, but as you know, you can't sleep if your mind is speeding. It's clear that the disease process of CFIDS affects the neurological system, and this may contribute to the speeding and agitated mind you experience at bedtime. There are several ways you can work with this.

First is to eliminate all stimulants from your diet—particularly caffeine (coffee, chocolate, black tea)—even in the morning. Such stimulants take a long time to be detoxed and eliminated from your body, and their effects can linger far longer than they might in a normal healthy person. Second, finish your evening meal by or 6:30 p.m., so that your body's digestive processes can be at rest when you go to bed. If you need to alter your eating pattern earlier in the day to establish this, then work back wards accordingly. Third, do not watch television in the evening. The whole purpose of television is to stimulate your neurological system as much as possible with bright flashing colors, sharp noises, compelling emotional images, etc. (In fact, you would do your neurological system a big favor to eliminate TV altogether.) Let the evening hours be restful and non-stimulating so that you can more easily calm the mind for sleep.

Fourth, when your mind is speeding and you can't get to sleep, give it a focus. This can be in the form of the repetition of a comforting word or phrase with each breath. For example, on the in-breath you may think to yourself "breathing in," and on the out-breath, "breathing out." Any word or phrase you prefer will do. The point is that you keep gently returning the mind to a comfortable, non-stimulating focus whenever you notice that it has wandered into stimulating thought.

This mental focus process can go on as long as necessary. It is far preferable to do this than to allow the mind to become caught up in worry about the consequences of not sleeping. You are allowing the body to rest, and you are not stimulating the mind further with worrisome thoughts. Any degree of rest that you are capable of on a given night is a contribution to your healing.

Editor's note: Dr. Collinge is a researcher and writer in the field of behavioral medicine, living in Sebastopol, CA. He began working with CFS during the Lake Tahoe epidemic in the 1980s. His book, Recovering from Chronic Fatigue Syndrome: A Guide to Self-Empowerment (Putnum, 1993) and an accompanying set tapes, The Home Self-Empowerment Program, are available from the CFIDS Health Buyers Club. (The book is also available in local bookstores.)

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