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Fatigue Is the Best PillowSleepiness vs Fatigue in Sarcoidosis: Sleepiness vs Fatigue in Sarcoidosis

Lee K. Brown, MD, FCCP
Author and Funding Information

From the Division of Pulmonary, Critical Care, and Sleep Medicine, Department of Internal Medicine, University of New Mexico School of Medicine; and the Program in Sleep Medicine, University of New Mexico Health Sciences Center.

Correspondence to: Lee K. Brown, MD, FCCP, Department of Internal Medicine, University of New Mexico School of Medicine, 1101 Medical Arts Ave NE, Bldg 2, Albuquerque, NM 87102; e-mail: lkbrown@alum.mit.edu


Financial/nonfinancial disclosures: The author has reported to CHEST the following conflicts of interest: Dr Brown serves on the Polysomnography Practice Advisory Committee of the New Mexico Medical Board and on the New Mexico Respiratory Care Advisory Board. He currently receives no grant or commercial funding pertinent to the subject of this article.

Reproduction of this article is prohibited without written permission from the American College of Chest Physicians. See online for more details.


Chest. 2013;143(6):1523-1525. doi:10.1378/chest.13-0508
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Sarcoidosis is, by definition, a multisystem disease, and as is common in such disorders, constitutional symptoms may occur, including fever, night sweats, malaise, arthralgias, and weight loss. In addition, the complaint of generalized fatigue is reported in up to 80% of patients with sarcoidosis and constitutes the most frequent constitutional symptom.1 Excessive daytime sleepiness might arguably be included as another constitutional manifestation of sarcoidosis, with putative mechanisms that could include sleep disruption due to respiratory symptoms, obstructive sleep apnea (OSA) from granulomatous involvement of the upper airway and/or corticosteroid-induced weight gain,2-6 a possible association with restless legs syndrome/periodic limb movement disorder,7 or even (rarely) secondary narcolepsy as a complication of neurosarcoidosis.8,9 As Ben Franklin’s quote suggests, fatigue and the need or wish to sleep may be highly interrelated, and given the very high prevalence of generalized fatigue in sarcoidosis, it is of utmost importance in any study investigating sleepiness in this disorder to accurately differentiate sleepiness from fatigue.

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