Chronic Fatigue Syndrome

Key points

• Now termed ME/CFS. NICE NG206 (2021), which replaced CG53, allows diagnosis once symptoms have persisted for 3 MONTHS (not the former 4 months) and are not explained by another condition.
• Post-exertional malaise — a delayed worsening of symptoms after activity — is a REQUIRED core symptom, alongside debilitating fatigue, cognitive difficulty ('brain fog') and unrefreshing sleep.
• Do NOT offer graded exercise therapy or any programme based on fixed incremental increases in activity · CBT may be offered only as supportive management, not as a cure · the core approach is energy management ('pacing') within the person's energy limit. Epidemiology
• more common in females
• past psychiatric history has not been shown to be a risk factor Fatigue is the central feature, other recognised features include
• sleep problems, such as insomnia, hypersomnia, unrefreshing sleep, a disturbed sleep-wake cycle
• muscle and/or joint pains