Prevalence of and risk factors for severe cognitive and sleep symptoms in ME/CFS and MS, 2017, Nacul et al

From Jun 2017

Full text at https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5477754/

 

'those with household incomes of more than £15,000 per year were less likely to experience severe symptoms than those with less than this'

That is interesting.

 

Does anyone else think the researchers' interpretation is backwards? Instead, perhaps they should have stated that those who experience severe symptoms were less likely to have household incomes of more than £15,000.

 

They have to state it the way the analysis was made. There is no interpretation. Which is what is good about the paper. They are not drawing any conclusions, just giving us facts. That can seem boring but it allows us to do our own interpretations.

 

An intriguing correlation with all sorts of possibilities.

 

"Our findings suggest that people with ME/CFS who are smokers, or have a low income, are more likely to report severe cognitive and sleep symptoms."

How is smoking relevant?

 

An interesting question that the presented facts pose.

 

Increased sympathetic tone?

 

I sleep like a baby now but I still smoke like a chimey.

 

Smoking turns out to be relevant to a remarkable range of diseases. We were very surprised when it became clear that smoking increases both risk of and severity of rheumatoid arthritis, which was supposed to be a purely immune disease. Button course smoking is likely to correlate non-causally with all sorts of things.

 

@Jonathan Edwards . . . but why are the negative effects (cognitive issues and poor sleep) of smoking worse for M.E than MS and normals? Our immune system?

 

'An interesting question that the presented facts pose.'

 

Aahh ... but what are you smoking?

 

Reversing the association, why are cognitive issues and poor sleep risk factors for smoking? Is there an interpretation that involves nicotine and the nervous system?

 

Ha.ha. Just cigarettes.

 

I think in this sort of context 'risk factor' just means a predictor of an association. No causal link is presumed either way. If there is a time sequence that may be relevant at least in excluding a backwards causation.

 

The association could "merely" be that poor/disadvantaged people are more likely to smoke. As severity level of ME increases, I would imagine the vast majority of patients would feel greater financial pressure.

http://www.who.int/tobacco/research/economics/rationale/poverty/en/

https://www.ons.gov.uk/peoplepopula...15-03-19/adultsmokinghabitsingreatbritain2013

 

Simply giving more money to people in poverty (regardless of the cause) solves an incredible amount of problems. In this case I suspect it leads to better health care and access to general symptomatic treatments not easily available from the NHS for ME/CFS patients. Money might mean less reliance on sleep-hygiene advice and more practical solutions involving meds, supplements, etc.

And having a higher income often gives people the option to live in a quieter environment. Sharing a flat/apartment on a noisy city street must be pretty hellish, and would certainly impact sleep. Similarly, more money could mean an extra room is affordable, so partners can sleep separately and avoid disturbances from snoring and movement.

 

I think the latter more than the former. But I live in a country where healthcare is generally affordable (free if declared low income).
Having control over more of your life (where you live, noise, timing, stresses both social and physical etc).
I note the threshold they mention is not wealth but absence of financial difficulty.

What are these early interventions they mention? Do they exist?