Can enhancing SWS improve daytime function in patients with CFS?

睡眠障碍是慢性疲劳综合征(CFS)的核心症状，对日间功能和生活质量有巨大的负面影响。过去10年对睡眠的研究提供了证据，表明大脑的睡眠调节机制，特别是稳态，在慢性疲劳综合征中被破坏。睡眠动态平衡机制受损会导致夜间睡眠不佳，白天困倦和疲惫，导致这些患者出现主客观认知障碍。这项研究将汇集CFS、睡眠和精神药理学的专家，研究CFS的体内平衡障碍的性质及其对日间功能的影响。我们建议使用一种药物来增加深度恢复性睡眠(慢波睡眠)，这是夜间动态平衡睡眠的标志。我们将在CFS患者身上进行单剂激发试验，以确定这种短暂而安全的慢波睡眠(以及体内平衡机制)的药理增强将在多大程度上对白天的损害产生显著的有益影响。我们将包括嗜睡、警觉、记忆力和主观幸福感的测量。如果我们的结果是积极的，这将显然对CFS患者有几个潜在的好处。首先，它将强调CFS的一个主要生物功能，即睡眠-觉醒周期的动态平衡部分受到损害的程度。其次，它将使我们能够专注于一条特定的重要大脑途径。第三，它将使我们能够评估患者的日常功能和生活质量在多大程度上可能在良好的夜间提神睡眠后得到改善。第四，我们的结果将指导未来的主要研究计划，以更好地理解CFS潜在的睡眠障碍。最后，拟议的工作可能会提出潜在的治疗干预措施。

Sleep disturbance is a core symptom of chronic fatigue syndrome (CFS) and has a huge negative impact on daytime function and quality of life. Studies of sleep in the past 10 years have provided evidence that brain mechanisms of sleep regulation, and in particular homeostasis, are disrupted in CFS. Impaired homeostatic mechanisms of sleep result in poor sleep at night and sleepiness and fatigue during the day, contributing to the subjective and objective cognitive impairment seen in these patients. This study will bring together experts in CFS, sleep and psychopharmacology, to study the nature of homeostatic impairment in CFS and its impact on daytime function. We propose to use a pharmacological agent which increases deep restorative sleep (slow wave sleep) which is a marker for homeostatic drive to sleep at night. We will perform a single-dose challenge test in patient with CFS, to ascertain the extent to which this brief and safe pharmacological enhancement of slow wave sleep (and thus of homeostatic mechanisms) will have a significant beneficial impact on daytime impairment. We will include measures of sleepiness, vigilance, memory and subjective well-being. If our results are positive, this will clearly have several potential benefits to CFS sufferers. First, it will underscore the extent to which a major biological function, namely the homeostatic component of the sleep-wake cycle, is impaired in CFS. Second, it will enable us to focus on a specific important brain pathway. Third, it will allow us to evaluate the extent to which patients' daily functions and quality of life are likely to improve following a good night's refreshing sleep. Fourth, our results would direct future major programmes of research into understanding better the underlying sleep disorder in CFS. Finally, the proposed work may suggest potential therapeutic interventions.