Email updates

Keep up to date with the latest news and content from BMC Neurology and BioMed Central.

Open Access Highly Accessed Research article

Chronic widespread musculoskeletal pain, fatigue, depression and disordered sleep in chronic post-SARS syndrome; a case-controlled study

Harvey Moldofsky1* and John Patcai23

Author Affiliations

1 Sleep Disorders Clinic of the Centre for Sleep and Chronobiology, 340 College St., Suite 580, Toronto, ON M5T 3A9, Canada

2 St. John's Rehab Hospital, 285 Cummer Ave, Toronto, ON M2M 2G1, Canada

3 Department of Medicine, University of Toronto, #3S805 - 200 Elizabeth Street, Toronto, ON M5G 2C4 Canada

For all author emails, please log on.

BMC Neurology 2011, 11:37  doi:10.1186/1471-2377-11-37

Published: 24 March 2011

Abstract

Background

The long term adverse effects of Severe Acute Respiratory Syndrome (SARS), a viral disease, are poorly understood.

Methods

Sleep physiology, somatic and mood symptoms of 22 Toronto subjects, 21 of whom were healthcare workers, (19 females, 3 males, mean age 46.29 yrs.+/- 11.02) who remained unable to return to their former occupation (mean 19.8 months, range: 13 to 36 months following SARS) were compared to 7 healthy female subjects. Because of their clinical similarities to patients with fibromyalgia syndrome (FMS) these post-SARS subjects were similarly compared to 21 drug free female patients, (mean age 42.4 +/- 11.8 yrs.) who fulfilled criteria for fibromyalgia.

Results

Chronic post-SARS is characterized by persistent fatigue, diffuse myalgia, weakness, depression, and nonrestorative sleep with associated REM-related apneas/hypopneas, an elevated sleep EEG cyclical alternating pattern, and alpha EEG sleep anomaly. Post- SARS patients had symptoms of pre and post-sleep fatigue and post sleep sleepiness that were similar to the symptoms of patients with FMS, and similar to symptoms of patients with chronic fatigue syndrome. Both post-SARS and FMS groups had sleep instability as indicated by the high sleep EEG cyclical alternating pattern rate. The post-SARS group had a lower rating of the alpha EEG sleep anomaly as compared to the FMS patients. The post-SARS group also reported less pre-sleep and post-sleep musculoskeletal pain symptoms.

Conclusions

The clinical and sleep features of chronic post-SARS form a syndrome of chronic fatigue, pain, weakness, depression and sleep disturbance, which overlaps with the clinical and sleep features of FMS and chronic fatigue syndrome.