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Sleep EEG Microstructures
Why do people with Long COVID and ME/CFS wake up unrefreshed, even when a standard sleep study looks close to normal? A 2026 study in the journal SLEEP points to the fine-grained structure of sleep itself. In this Open Medicine Foundation Journal Club, Dr. Danielle Meadows walks through "Facility-Measured Sleep Electroencephalographic Microstructures in Long COVID" (Sun et al., 2026), from Dr. Janet Mullington's team at Beth Israel Deaconess Medical Center in collaboration with OMF's Computational Research Center for Complex Diseases. WHAT THE STUDY FOUND Researchers recorded overnight in-lab polysomnography (a clinical sleep study) in 28 people with Long COVID, 28 age- and sex-matched healthy controls, and 19 people with ME/CFS. They analyzed sleep EEG microstructures: detailed patterns in brain activity that standard sleep staging doesn't capture. Compared with healthy controls, both the Long COVID and ME/CFS groups showed: - Sleep spindles (short bursts of brain activity tied to memory) that lost frequency more steeply, called a more negative spindle chirp - Spindles firing too early relative to slow oscillations, the large, slow brain waves of deep sleep - Higher infraslow oscillation power, a very slow rhythm linked to the brain's overnight waste-clearance (glymphatic) system In Long COVID, earlier spindle timing correlated with worse self-reported rest quality. That ties an objective brain measure to the lived experience of unrefreshing sleep. The ME/CFS group showed additional features, including more widespread infraslow elevation and more alpha-delta sleep, which suggests related but distinct biological profiles. Limitations: sample sizes were small, ME/CFS participants came from a single clinical center, and the healthy control group differed in racial composition from the patient groups. These findings generate hypotheses and need replication in larger, more diverse cohorts. This video is for education only; please talk with your clinician about any medical decisions. CHAPTERS 0:00 Welcome and housekeeping 2:20 Why standard sleep studies can miss unrefreshing sleep 3:57 Study design: Long COVID, ME/CFS, and healthy controls 7:31 What EEG and polysomnography measure 9:19 Sleep macrostructure vs. microstructure 10:25 Slow oscillations and sleep spindles 12:16 Spindle chirp and infraslow oscillations 15:06 Who was studied and conventional sleep results 18:10 Brain activity by sleep stage in Long COVID 24:19 ME/CFS comparison: beta power and alpha-delta sleep 26:09 Spindle chirp in Long COVID and ME/CFS 30:10 Spindle timing: early coupling with slow oscillations 34:44 Infraslow oscillations and brain waste clearance 37:32 Shared sleep signatures in Long COVID and ME/CFS 40:45 Linking EEG findings to how rested patients feel 44:31 Recap of key findings 46:07 Glymphatic function, neuroinflammation, and spinal fluid research 49:36 Thalamocortical loop and overlaps with Alzheimer's and autism 52:50 Possible treatment implications and sleep biomarkers 55:25 Distinct ME/CFS and Long COVID profiles 57:34 Audience Q&A 1:05:23 Closing Q&A topics include sharing this research with your doctor, supplemental oxygen, access to advanced sleep EEG analysis, ME/CFS vs. narcolepsy type 1, 40Hz sound, and CPAP. RESOURCES Read the paper (SLEEP, 2026): https://doi.org/10.1093/sleep/zsag090 Join Research Insiders for more Journal Club sessions: https://lp.constantcontactpages.com/sl/BLsWz83/OMFJournalClub Support this research: https://www.omf.ngo/?form=donatenow ABOUT OMF Open Medicine Foundation is a global nonprofit accelerating discovery, diagnostics, treatments, and cures for ME/CFS, Long COVID, and related multi-system chronic complex diseases (MSCCD).
