Being Sleepy and Tired

There is a fantastic post by luysii on his Chemiotics II blog. In it, he discusses his theory that senescent cell may be producing mediators that cause chronic fatigue syndrome (CFS). I think it’s a fascinating idea.

CFS is a terrible disease, made worse by the fact that some physicians don’t believe that it exists. Trust me, it does.

An interesting things about the disease is that it tend to occur in high income countries, and almost never in developing countries, and that in my experience, it tends to occur in women from mid to higher socioeconomic strata. This is in contrast to fibromyalgia, which in some ways is the sister of CFS, which tends to occur in lower socioeconomic strata. (I should say that the epidemiological data seems to indicate CFS is more common in lower socioeconomic classes and among minorities, but that is opposite of my experience.) Fibromyalgia is real, though some physicians don’t believe in it either. An interesting thing about fibromyalgia is that the trigger points, the parts of the body that causes pain when pressed, are the same as the acupuncture points.

An interesting thing about acupuncture points is that even after centuries, new points are still being discovered. A new point was discovered in the 1980’s and it cause quite a stir.

People have debated for along time over the cause of CFS. It often happens after an illness, such as a viral infection. But it’s not clear what the specific cause is. There is quite a debate over this. No organisms have been consistently found in these patients.

In some ways, this is similar to the debate about chronic Lyme disease, which has become raucous. It has even gotten to a point where lawsuits are flying and some medical associations are trying t o shut down physicians who are treating chronic Lyme disease. That’s pretty unusual–doctors are pretty laissez-faire about how other doctors apply their craft.

I haven’t dug deeply into the controversy, but applying some heuristics, the people who believe in chronic Lyme disease are probably right, since the mainstream doctors are getting so incensed about the issue. When the fringe groups are completely off base, the mainstream medical establishment usually just ignores them. The debate has the smell of the minority being right and the majority becoming very uncomfortable.

What I can say is that there is at least one semi-similar disease where a viral infection can cause kind of a similar problem.

The Story of Pandemrix

For example, I know about the history of Pandemrix vaccine in Europe. It was a flu shot that was approved in Europe in 2009. Just couple of months after launch, some parents started noticing something strange about some children who had received the vaccine. They would suddenly fall asleep. Abruptly, and without prior notice. Often, this would happen when they got excited.

At first, the mothers were ignored, as if they were crazy anti-vacciners.

Other cases soon followed. Then more. And then it became an epidemic, starting in Finland and Sweden. The governments of Finland and Sweden launched investigations. Shortly thereafter, the investigations in those and other countries concluded. The flu shot was causing a disease called narcolepsy. This is a rare disease, where a person falls asleep suddenly when he or she becomes excited.

This was a shock. Why would children who received this version of the vaccine develop narcolepsy? There are several hypothesis, including a hypothesis that the flu virus looks similar to a molecule that keeps you awake, so that your body starts neutralizing the keep-awake molecule when it tries to attack the virus. This is called molecular mimicry.

What happened is that the vaccine was causing an autoimmune disease and making antibodies against orexin, which is a neuropeptide that keeps you awake and alert.

Idiopathic Hypersomnia

Similarly, there is conditi0n called idiopathic hypersomnia. People with this condition sleep fourteen, eighteen, twenty hours a day. They’re always sleepy. It seems to be caused by some small protein, called somnogen, that is found in their spinal fluid, that binds to GABA receptors. GABA receptors are what Valium binds to. These patients are essentially on valium all day long.

The source of this somnogen? It’s not clear, but I suspect it may turn out to a bacteria. There is a little-known effect of a compound called muramyl tripeptide, which comes from the cell wall of muycobacteria. If you give it to cats, they fall into deep sleep for days. So we know that bacteria can produce somnogens with profound effects. Another example is the African sleeping sickness, which puts people into commas. It is not a far fetched theory to think that an infectious agent can cause fatigue or sleep.


2 thoughts on “Being Sleepy and Tired”

  1. Richard: Thanks. Feel free to take the idea (measuring p15^INK4a in white cells to look for evidence of senescent cells producing fatigue) and run with it. The original work came from oncology, but the idea could be applied to any of the conditions described above associated with excessive fatigue. I am a 79 year old retired clinical neurologist with no academic affiliation and no way to test it.

  2. I’ve just received word that the idea will be tested at a major university.

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