Dr Manuel Romero, head of rheumatology at Hospital Quirónsalud Córdoba, warned in Madrid that chronic fatigue syndrome symptoms frequently mislead patients and doctors.
Romero explained that unlike typical tiredness, resting does not restore energy for people with the condition, and physical or mental effort clearly worsens their symptoms.
Chronic fatigue syndrome, also known medically as myalgic encephalomyelitis, is a complex illness marked by severe, sustained exhaustion. Hospital Quirónsalud Córdoba is a major private medical center in southern Spain, while La Razón, which published the interview conducted by journalist Belén Tobalina, is a national daily newspaper headquartered in Madrid.
Differentiating Sleep Apnea and Post-Exertional Malaise
Romero stated that clinicians must rule out other underlying causes of exhaustion before confirming a diagnosis, with obstructive sleep apnea being a primary condition to evaluate.
Patients suffering from sleep apnea frequently report sleeping for many hours yet waking up feeling as though they have not slept at all. Romero noted that while individuals with chronic fatigue syndrome report identical experiences due to unrefreshing sleep, sleep apnea stems specifically from impaired breathing quality during the night and must be confirmed through formal sleep diagnostic studies.
Because sleep apnea can be treated effectively, identifying and managing it can significantly relieve patient fatigue. Romero added that if incapacitating exhaustion, post-exertional malaise, cognitive difficulties, and an inability to remain standing persist after successful sleep apnea treatment, doctors must consider chronic fatigue syndrome.
The hallmark indicator of chronic fatigue syndrome is post-exertional malaise. Romero noted that routine tasks previously tolerated, such as grocery shopping, attending a family meal, or managing a busier morning, can trigger severe relapse.
Following such efforts, patients may remain significantly worse for several days, experiencing increased fatigue, widespread pain, brain fog, or flu-like symptoms.
Wide Array of Misleading Symptoms
Romero outlined the core symptoms of the condition, which center on intense exhaustion where the body fails to respond, alongside post-exertional malaise and unrefreshing sleep.
Cognitive issues are also widespread among patients, including difficulties with concentration, short-term memory loss, and slowed mental processing.
Other symptoms include muscle and joint pain, headaches, sore throats, painful lymph nodes, dizziness, palpitations, digestive discomfort, intolerance to standing upright, and heightened sensitivity to light, noise, or odors.
Romero explained that patients often consult doctors for isolated complaints, such as feeling dizzy while standing in a queue or developing food intolerances, rather than reporting general fatigue.
While these symptoms appear unrelated in isolation, Romero emphasized that they form a clear diagnostic pattern when combined with deep fatigue and post-exertional deterioration.
He described the condition not simply as a low battery, but as a breakdown in the system that regulates energy, sleep, exertion, concentration, and the autonomic nervous system.
Diagnostic Rates and Demographic Factors
Romero noted that diagnostic rates are rising and clinics are seeing more patients, though he clarified that not all tiredness qualifies as chronic fatigue syndrome.
He attributed the increase in diagnoses to heightened medical awareness, improved clinical screening, post-infectious conditions, and modern lifestyle demands that push individuals past their physical limits.
The illness can affect young adults and teenagers. While Romero declined to state definitively whether onset ages are decreasing, he confirmed that medical professionals are actively screening for and identifying the condition earlier than in the past.
Romero highlighted that women are diagnosed far more frequently than men, driven by biological and social factors. Biological differences involve distinct functioning of immune, hormonal, and autonomic nervous systems across sexes.
Socially, many women face double or triple burdens that combine employment, household management, child care, and elder care, alongside intense personal pressures to perform. Romero added that men also suffer from the illness, though they often delay seeking medical care.
Seasonal Variations and Treatment Options
Addressing potential seasonal triggers, Romero stated that chronic fatigue syndrome does not behave like a seasonal allergy and follows no fixed pattern.
However, he observed that many patients suffer pronounced discomfort and intolerance during extreme temperatures in both winter and summer.
Romero emphasized that there is currently no curative treatment or approved medication that permanently eliminates fatigue for all patients with chronic fatigue syndrome.
Instead, clinical care relies on targeted management and palliative care to address debilitating symptoms, prevent severe relapses, and improve quality of life.
Romero urged realistic expectations, noting that while some patients experience significant improvement, others achieve only partial relief or remain severely limited.
He concluded that medications are selected strictly to manage specific symptoms rather than cure the underlying condition.
