“There are at least four core symptoms in ME/CFS: pain, cognitive dysfunction, fatigue or post-exertional malaise, and non-restorative sleep. Thus, awakening unrefreshed is one of the cardinal symptoms of ME/CFS, and one of the last symptoms to resolve as one improves. You will probably wake up tired whether you sleep 4 hours or 14. Nevertheless, primary sleep disorders such as apnea and periodic leg movements occur in up to 60% of people with ME/CFS or FM, and can disrupt sleep. So, if such problems are suspected, then a sleep study would be in order.
Another characteristic of ME/CFS is “dysania,” or waking up stiff and sore or foggy-headed. Almost everyone awakens a little stiff and foggy-headed for the first few minutes, but PWCs really feel badly and this situation may last for 30 minutes to several hours – much longer than a normal healthy individual. One of my patients said, “I shuffle to the bathroom each morning like Tim Conway in his comedy show!” The treatment?: spend a few minutes in the bed loosening up, then try ‘waking up’ with a cup of coffee or a warm shower.”