• General practice
  • Primary care

Location:  UQ Centre for Clinical Research (Herston)

Type of student:  Volunteer/extra-curricular (this would be similar to an Honours project)

Type of work:

  • Literature review
  • Qualitative methods
  • Statistical analysis

Managing Chronic Fatigue using Insights from N-of-1 Studies


Chronic Fatigue Syndrome (CFS) is characterised by persistent fatigue lasting at least six months with a number of additional symptoms such as musculoskeletal pain, headaches, sleep problems and impaired cognitive function. CFS symptoms cannot be alleviated by rest and symptoms can be severe enough to have significant impact on an individual’s function and quality of life. CFS is a controversial condition due to its unknown aetiology; currently there is no known cure for CFS but a number of pharmacological and non-pharmacological approaches for managing the symptoms of CFS have been evaluated. 

Existing research on the aetiology and management of CFS has often made an implicit assumption that CFS symptoms do not change over time. For example, many studies measure fatigue retrospectively on one or few occasions, which prohibits an understanding of the dynamic nature of fatigue over time. Furthermore, little is known about the extent to which modifiable lifestyle factors (e.g. sleep, stress, mood, physical activity) may influence fatigue severity for individuals with CFS. The direction and magnitude of relationships between modifiable factors and fatigue severity may vary considerably between individuals. 

N-of-1 quantitative studies involve the repeated and frequent measurement of an outcome over time in one individual to draw conclusions that are specific to that individual. N-of-1 studies can provide novel insights into the patterns and predictors of fatigue over time at the individual level. Knowledge about patterns and predictors of fatigue over time may be crucial for informing the selection, optimisation and timing of appropriate interventions for CFS patients. 

Study aim

This study aims to explore the extent to which fatigue symptoms fluctuate over time, and the association between potentially modifiable factors (e.g. sleep, stress, mood, physical activity) and fatigue symptoms, in individuals with CFS.

Study Methods

Design: The project will involve a series of n-of-1 observational studies with up to 20 participants. 

Participants: Participants will be recruited from two CFS support groups in Brisbane.

Procedure: Participants will complete brief questionnaires three times a day for a period of 6 weeks via an electronic diary. Participants will complete measures of fatigue, sleep, stress, mood and a personally relevant item(s) chosen by the participant. At the end of the study the participant will receive detailed feedback about the data they provided and will be invited to discuss their experience of participation during a semi-structured interview.

Analysis: Daily data will be analysed using statistical techniques. Interview transcripts will be coded and analysed using thematic analysis.

Study outputs 

The findings from the project will be published in a peer-reviewed journal and presented at a national/international conference. 

Prerequisite skills:

  • Experience of using statistical techniques to analyse data and experience of conducting qualitative research is desirable but not necessary.

Time frame: 01/05/18-01/12/18




Dr Jane Nikles

Dr Jane Nikles

Senior Research Fellow
UQ Centre for Clinical Research

Contact person

Dr Suzanne McDonald

Research Methodologist
Newcastle University, UK