The Great NIH Exercise Initiative: A Boon for Chronic Fatigue Syndrome (ME/CFS) and Fibromyalgia?

[Cort]

“This physical activity initiative aims to fundamentally change our understanding of what happens to the body on the molecular level when we exercise,” said James M. Anderson, M.D., Ph.D.

In Part II of a three-part look at recent major NIH efforts that may significantly impact chronic fatigue syndrome (ME/CFS) and fibromyalgia (FM) we find the NIH bringing its big guns to bear on the most problematic area of all for ME/CFS patients - exercise.

[fright]

[/fright]Few diseases, if any, are as defined by problems with physical activity as chronic fatigue syndrome (ME/CFS), and few diseases affect physical activity as dramatically as does fibromyalgia. Nobody, of course, knows why mild exercise can cause such relapse in ME/CFS or why more serious exercise can cause such pain in FM.

Maybe that's not such a surprise. It turns out that researchers know surprisingly little about what happens when we exercise. Sure they know what happens to the heart rate, blood flows, air intake, oxygen usage, etc., when we exercise but we know very little about what happens to the body at the molecular level. That's important, not just for exercise physiologists, but for ME/CFS and FM as well; it's at the molecular level where the key to ME/CFS and FM probably lies.

Our understanding of the molecular changes that occur during exercise is going to entirely change - and probably fairly rapidly - when the NIH's Molecular Transducers of Physical Activity in Humans Program (MoTrPAC; Motor…Pac - get it? Kind of?) gets rolling.

MotrPAC is going to take a deep dive into the world of exercise. By the time they're done we're going to have new ways to analyze what the heck goes wrong during exercise in ME/CFS.

You don’t think Dr. Collins wasn't thinking of chronic fatigue syndrome (ME/CFS) when he said this:

“The development of a so-called molecular map of circulating signals produced by physical activity will allow us to discover, at a fundamental level, how physical activity affects our health. This knowledge should allow researchers and doctors to develop individually targeted exercise recommendations and better help those who are unable to exercise.” Francis Collins

I do… In fact, the optimist in me wonders if the fatigue RFA grant Collins was reportedly considering for ME/CFS morphed into this $170 million dollar (not completely funded) project. (Why would Collins do this kind of run-around? Because he can get buy-in from the Institutes to spend a ton of money to study exercise. He can't get buy-in to spend that kind of money on ME/CFS.)

This is a biggie: it contains seven clinical sites, seven chemical analysis sites, animal models, a bioinformatics center, a coordination center, and finally and perhaps most importantly for diseases like chronic fatigue syndrome and fibromyalgia, the open sourced data information center.

Two of the 19 grants (Ron Davis and Dr. Montoya, take note) are going to two Stanford researchers (Michael Snyder, Stephen Montogomery) to identify and characterize all the molecules that form during or after exercise. Yes, that's after exercise as well…what an opportunity to study post-exertional malaise in ME/CFS.

At the end of this huge grant ($15.7 million - equal to the entire budget of the upgraded NIH ME/CFS program) these two Stanford researchers will know more about genomic, transcriptomic and epigenomic effects of exercise than anyone else alive…and it's all going to happen in the next five years.

One imagines that Nancy Klimas and Gordon Broderick with the multiple data points they've collected before, during and after exercise might have something to say to Drs. Michael Snyder and Stephen Montgomery, PhD. Of course, Dr. Montoya is using exercise in his immune studies at Stanford as well. One might think these researchers might be interested in the growing exercise data collected on the most exercise challenged illness group there is.

What an excellent control group ME/CFS patients would be (!). How better, after all, to explicate what goes right in exercise than by understanding what can go so wrong? Lead Stanford researcher Michael Snyder might very well agree:

“A lack of physical activity is a major factor in multiple diseases. This program provides an exciting opportunity to learn the molecular mechanisms underlying physical activity, with the goal of enabling new approaches to improving or maintaining individual health.”

Michael Snyder

Personally, I would put finding ways to enable ME/CFS patients to finally do the exercise they've been yearning for so many years as a top priority. One wonders how many ex-athletes - Jamison Hill's and others - are out there? (Please take the survey.) Anecdotal reports suggest they abound in ME/CFS. Some people think ex-athletes may be over-expressed in ME/CFS. Thirty-seven years ago I was an avid runner and exerciser. Never did I dream such a fundamental part of my life could be taken away so completely.

Even if the Stanford group can't find a way to include a few ME/CFS patients in their huge study, within five years or so we should have a bevy of molecular targets that Ron Davis, Derya Unutmaz, Patrick McGowan,Ian Lipkin, Gordon Broderick, Zaher Nahle or other ME/CFS researchers interested in the molecular roots of this disease should be able to analyze.

[fright]

[/fright]Stanford isn't the only possible ME/CFS connection. Marcas Bamman at the University of Alabama at Birmingham's "Center for Exercise Medicine" will lead one of the clinical centers. One wonders if he might be interested in what's happening in Jarred Younger's Neuroinflammation, Fatigue and Pain Lab on the same campus.

Plus, included in those omics' (genomics, epigenomics, transcriptomics, proteomic's) analyses are extensive metabolomics studies as well. MoTrPAC isn’t just whistling dixie with regard to metabolomics either. The Emory Chemical Analysis Center in Georgia appears to be almost entirely devoted to metabolomics. Boasting a "state-of-the-art ultra-high resolution accurate mass high-field Orbitrap tandem mass spectrometer", the group will use "global, targeted and spatially resolved metabolomics" to produce "unequivocal chemical identification(s) of novel molecular transducers". The Mayo Rochester site will also attempt to fuse proteomics and metabolomics date to generate molecular maps of physical activity.

What a serendipitous project this is. Just as ME/CFS research at the NIH starts to finally begin to ramp up (expect an announcement on that in the next couple of weeks) it embarks on an ambitious project to understand the molecular roots of the most problematic activity of all in ME/CFS - exercise. For once we have good timing.

• Check out Pt I of the series on the big NIH Initiatives under way :The Electroceutical Revolution - an ME/CFS and FM Perspective"

 

[waiting]

Incredibly exciting news -- thanks!

 

[Cort]

Incredibly exciting news -- thanks!

I agree! I was astonished to come across it. I hope that ME/CFS researchers can find a way to collaborate with these guys.

 

[Seven]

Newton ( in U.K.) found 2 groups one that can excercise one that cannot. I hope they do not lump the 2 groups in a way that will cancel each other out ( showing no issues) And the data is gather in a way that will allow soubgrouping later, in case is confirmed only part of the population has issues.

 

[Cort]

Newton ( in U.K.) found 2 groups one that can excercise one that cannot. I hope they do not lump the 2 groups in a way that will cancel each other out ( showing no issues) And the data is gather in a way that will allow soubgrouping later, in case is confirmed only part of the population has issues.

They're not actually studying ME/CFS (yet) but subgroups will obviously always be an issue.

 

[Cecelia]

I share your enthusiasm, Cort, and hope this study will strip the covers off how our bodies, these days, feel about exercise.

I also appreciate how you wrote the article, making overt the links between researchers we would benefit from, as well as quoting jargon verbatim (in the section about the Chemical Analysis Center in Georgia), so that even if we are all still a little muzzy about what exactly is meant, that at least you haven't added to the possible confusion via interpretation. I actually wish that a lot of professionals would spare us their inaccessible jargon. I know it makes them look smart and in the know but things will work out better if more of us understand. Patients really are part of the team.

 

[Phil Hayward]

Even with information from the cellular level, though, what are the chances that we will get to know more about "causes"? What is going on at the cellular level might just all be symptoms. We might just be getting incredibly well-informed about symptoms and not getting any closer to discovering the causes and the correct order of the cascade of effects.

At least we are now well beyond the "its all in the imagination" stage, if only all practitioners were getting the memo. Even so, in spite of the constant addition of information about what is wrong in the actual physical and nervous tissue of CFS and FM patients, there remains a "foot in the door" for the hypothesis that this still "all starts in the mind" or "the attitude". I have always said this is outrageous BS because I went down with FM from the point of being very confident in my physical prowess and thinking I was invulnerable because I kept myself so fit.

I was in denial for a long time, believing that my "lost form" was on the verge of being regained, after all, I was working very hard on it in the same ways that had worked to make myself very fit in the first place. I kept up a training regime of around 300 miles per week on the bicycle even into approximately the first 3 years of full-blown FM. The doctors kept saying there was nothing wrong with me (according to their tests) in spite of loss of fitness, inability to recover after exercise, all-over pain that had me writhing every few seconds in my waking existence, hydration issues, excessive urination, etc. Finally someone thought of checking those "tender points"....

At that point I started trying "something else" other than pushing myself! But it was 20 years until I discovered a multi-disciplinary protocol that wound the condition back. It was actually my mental determination to push myself - "no pain no gain" - that obstructed me all that time, from discovering that correct pacing was the most important key. So I have no patience at all with the argument that I still hear, that these conditions "start with a negative attitude" or some such arrogant cop-out from practitioners who don't want to admit "it is THEM who don't know enough to be able to understand this condition". Of course they see a lot of people who "believe they can't do" XYZ - those people actually can't do it, physically. Even if they used to do those things, and more, and were proud of it - and dam well knew they lost the ability in spite of every honest effort on their part.

 

[Cort]

I share your enthusiasm, Cort, and hope this study will strip the covers off how our bodies, these days, feel about exercise.

I also appreciate how you wrote the article, making overt the links between researchers we would benefit from, as well as quoting jargon verbatim (in the section about the Chemical Analysis Center in Georgia), so that even if we are all still a little muzzy about what exactly is meant, that at least you haven't added to the possible confusion via interpretation. I actually wish that a lot of professionals would spare us their inaccessible jargon. I know it makes them look smart and in the know but things will work out better if more of us understand. Patients really are part of the team.

Thanks Cecelia and good point about patients being part of the team

 

[Cecelia]

Even with information from the cellular level, though, what are the chances that we will get to know more about "causes"? What is going on at the cellular level might just all be symptoms. We might just be getting incredibly well-informed about symptoms and not getting any closer to discovering the causes and the correct order of the cascade of effects.

At least we are now well beyond the "its all in the imagination" stage, if only all practitioners were getting the memo. Even so, in spite of the constant addition of information about what is wrong in the actual physical and nervous tissue of CFS and FM patients, there remains a "foot in the door" for the hypothesis that this still "all starts in the mind" or "the attitude". I have always said this is outrageous BS because I went down with FM from the point of being very confident in my physical prowess and thinking I was invulnerable because I kept myself so fit.

I was in denial for a long time, believing that my "lost form" was on the verge of being regained, after all, I was working very hard on it in the same ways that had worked to make myself very fit in the first place. I kept up a training regime of around 300 miles per week on the bicycle even into approximately the first 3 years of full-blown FM. The doctors kept saying there was nothing wrong with me (according to their tests) in spite of loss of fitness, inability to recover after exercise, all-over pain that had me writhing every few seconds in my waking existence, hydration issues, excessive urination, etc. Finally someone thought of checking those "tender points"....

At that point I started trying "something else" other than pushing myself! But it was 20 years until I discovered a multi-disciplinary protocol that wound the condition back. It was actually my mental determination to push myself - "no pain no gain" - that obstructed me all that time, from discovering that correct pacing was the most important key. So I have no patience at all with the argument that I still hear, that these conditions "start with a negative attitude" or some such arrogant cop-out from practitioners who don't want to admit "it is THEM who don't know enough to be able to understand this condition". Of course they see a lot of people who "believe they can't do" XYZ - those people actually can't do it, physically. Even if they used to do those things, and more, and were proud of it - and dam well knew they lost the ability in spite of every honest effort on their part.

Phil, I think I understand the anguish and frustration of trying to continue the physical activities one had been able to do before. In my case, I also felt humiliation and isolation, because I would be clearly failing at the task--dancing or playing music with people--but could not explain my new failure or believe others would understand, and hence--possibly--care. I retreated and stopped trying to do those things, which helped me establish a new boundary re my reduced abilities, but I was not able to take those friends or that exuberance with me. The joy of being able to do what I had, and also to be smart enough to do a certain level of satisfying work, to have a certain level of conversation--that went without an explanation and without understanding. Friends left and possibilities ended without recognition or compassionate response.

So anyway, we have to make a new way for ourselves within a different set of limitations and possibility. There are still possibilities and we can re-create our lives within them.

 

[AquaFit]

Phil and Cecilia,
Been there at both places! Thank you for sharing. I've felt so alone in this aspect of sports and dancing. I wish too I would have been diagnosed sooner and not prematurely worn out body parts that weren't meant for some types of prolonged exercise.

I have a little bit of everything (ME,CFS,EDS,FM) since birth and it's expressed slowly throughout my life. I used to love riding my bike through hill and dale as a kid then when I was in my 20s I couldn't ride my racer bike anymore because my hands would become numb. Had to give up skating (though I wasn't great at it) because my feet ached first at then end of skating then eventually when I put on my skates and stood up. I won first place at my elementary school and third in the regional for running long jump - probably because I could practice on the farm which was soft peat so I didn't pound my feet too hard. Dancing was doable - love swing and latin and tango but I'd have to take every lesson series twice because I couldn't cognitively pick up the series of moves. I felt like my IQ was was zero! The instructor was very nice - she actually would move my leg or arm through the motion sometimes when I couldn't get it. (Proprioception, now I know.) Cecilia, for social dancing, I had a very kind friend who was a terrific dancer and a big talker - we'd chat on the dance floor while I picked up her moves and I listened, freeing up cognitive space. I memorized her dance moves and then adapted them as my own. No one knew what I was doing - it wasn't all fun for me, it was fun and work. That required a friend with super self confidence and a heart of gold.

When I first got married my husband would push me to go to the gym daily, which I wanted to do but couldn't. I felt really bad about that and for years he thought I was a little lazy. There was no way I could explain it - I looked fine! I couldn't tell him back then about all the naps I took while he was at work. When I tried to lose weight after childbirth I still hadn't been diagnosed and but I knew something was really wrong with my body. I thought I'd go slow and long on the treadmill, alternating running and walking when I ripped a toe muscle. That was it. I finally told my husband something is really wrong with me, and I searched out doctors that would confirm it. We went through the whole "don't give into your illness" routine of denial. Now he knows I need naps and he appreciates that I don't use my illness as an excuse but there are limitations. I have to say that what I am grateful for in this whole process is that I've become much more health aware (I thought I was before!) and I've benefited from having quality people in my life. There's no time for vain or shallow people or pursuits.

 

[Simon]

Very interesting, not least as Michael Snyder has in the past said he'll help Ron Davis with ME/CFS stuff. And I do buy the argument that understanding the response to exercise in healthy people is key to understanding what goes wrong in mecfs too. But you''d need to have other disease comparison groups too - people with MS seem to react very differently.

 

[Cecelia]

Phil and Cecilia,
Been there at both places! Thank you for sharing. I've felt so alone in this aspect of sports and dancing. I wish too I would have been diagnosed sooner and not prematurely worn out body parts that weren't meant for some types of prolonged exercise.

I have a little bit of everything (ME,CFS,EDS,FM) since birth and it's expressed slowly throughout my life. I used to love riding my bike through hill and dale as a kid then when I was in my 20s I couldn't ride my racer bike anymore because my hands would become numb. Had to give up skating (though I wasn't great at it) because my feet ached first at then end of skating then eventually when I put on my skates and stood up. I won first place at my elementary school and third in the regional for running long jump - probably because I could practice on the farm which was soft peat so I didn't pound my feet too hard. Dancing was doable - love swing and latin and tango but I'd have to take every lesson series twice because I couldn't cognitively pick up the series of moves. I felt like my IQ was was zero! The instructor was very nice - she actually would move my leg or arm through the motion sometimes when I couldn't get it. (Proprioception, now I know.) Cecilia, for social dancing, I had a very kind friend who was a terrific dancer and a big talker - we'd chat on the dance floor while I picked up her moves and I listened, freeing up cognitive space. I memorized her dance moves and then adapted them as my own. No one knew what I was doing - it wasn't all fun for me, it was fun and work. That required a friend with super self confidence and a heart of gold.

When I first got married my husband would push me to go to the gym daily, which I wanted to do but couldn't. I felt really bad about that and for years he thought I was a little lazy. There was no way I could explain it - I looked fine! I couldn't tell him back then about all the naps I took while he was at work. When I tried to lose weight after childbirth I still hadn't been diagnosed and but I knew something was really wrong with my body. I thought I'd go slow and long on the treadmill, alternating running and walking when I ripped a toe muscle. That was it. I finally told my husband something is really wrong with me, and I searched out doctors that would confirm it. We went through the whole "don't give into your illness" routine of denial. Now he knows I need naps and he appreciates that I don't use my illness as an excuse but there are limitations. I have to say that what I am grateful for in this whole process is that I've become much more health aware (I thought I was before!) and I've benefited from having quality people in my life. There's no time for vain or shallow people or pursuits.

I am touched by your story, Aquafit! It is so interesting how you perceived your difficulties and what you did with them and the people in your life. This is all very key for us!

 

[tkinsf]

Wow, this is the only CFS initiative that I've ever been excited about. I'll bet they'll learn a lot about CFS even if they don't include CFS patients in the study. Theyll eventually find a great deal of correlation between the temporal post-exercise molecular responses and CFS symptom patterns. And finding such patterns will be a key to finding the treatment. Thanks for the report.

 

[tkinsf]

Even with information from the cellular level, though, what are the chances that we will get to know more about "causes"? What is going on at the cellular level might just all be symptoms. We might just be getting incredibly well-informed about symptoms and not getting any closer to discovering the causes and the correct order of the cascade of effects.

Phil, here is my thinking. There are literally thousands of myokines, metabolites, immune cells and molecules that ebb and flow for several days after an execise. If they can pinpoint particular molecules, we have something physical to pursue, and knowing the culprit molecules may point us precisely what/where to look. For example, if the symptoms track only normal inflammatory myokines and lukocytes, we could further pursue with confidence the hypothesis that CFS/FMS is a hypersensitivity to inflammation, rather than the inflammation itself or hypometabolism. And studying the singaling pathways for those molecules may reveal the ultimate cause.

 

[Cort]

Even with information from the cellular level, though, what are the chances that we will get to know more about "causes"? What is going on at the cellular level might just all be symptoms. We might just be getting incredibly well-informed about symptoms and not getting any closer to discovering the causes and the correct order of the cascade of effects.

At least we are now well beyond the "its all in the imagination" stage, if only all practitioners were getting the memo. Even so, in spite of the constant addition of information about what is wrong in the actual physical and nervous tissue of CFS and FM patients, there remains a "foot in the door" for the hypothesis that this still "all starts in the mind" or "the attitude". I have always said this is outrageous BS because I went down with FM from the point of being very confident in my physical prowess and thinking I was invulnerable because I kept myself so fit.

I was in denial for a long time, believing that my "lost form" was on the verge of being regained, after all, I was working very hard on it in the same ways that had worked to make myself very fit in the first place. I kept up a training regime of around 300 miles per week on the bicycle even into approximately the first 3 years of full-blown FM. The doctors kept saying there was nothing wrong with me (according to their tests) in spite of loss of fitness, inability to recover after exercise, all-over pain that had me writhing every few seconds in my waking existence, hydration issues, excessive urination, etc. Finally someone thought of checking those "tender points"....

At that point I started trying "something else" other than pushing myself! But it was 20 years until I discovered a multi-disciplinary protocol that wound the condition back. It was actually my mental determination to push myself - "no pain no gain" - that obstructed me all that time, from discovering that correct pacing was the most important key. So I have no patience at all with the argument that I still hear, that these conditions "start with a negative attitude" or some such arrogant cop-out from practitioners who don't want to admit "it is THEM who don't know enough to be able to understand this condition". Of course they see a lot of people who "believe they can't do" XYZ - those people actually can't do it, physically. Even if they used to do those things, and more, and were proud of it - and dam well knew they lost the ability in spite of every honest effort on their part.

So well said, Phil! (I'm certainly a very slow learner in this area.)

Here's what I hope they find. I hope this effort comes up with molecules or compounds or whatever produced during exercise. I hope that when those molecules are compared to ME/CFS and FM patients that some will either be reduced or increased or different. Once they find significant differences they should be able to figure out what they mean or rather start pulling on the string until they get to an answer; such X enzyme when exercise starts doesn't work or the buildup of Y molecules people with ME/CFS have trouble with Z during exercise.

 

[Cort]

Phil and Cecilia,
Been there at both places! Thank you for sharing. I've felt so alone in this aspect of sports and dancing. I wish too I would have been diagnosed sooner and not prematurely worn out body parts that weren't meant for some types of prolonged exercise.

I have a little bit of everything (ME,CFS,EDS,FM) since birth and it's expressed slowly throughout my life. I used to love riding my bike through hill and dale as a kid then when I was in my 20s I couldn't ride my racer bike anymore because my hands would become numb. Had to give up skating (though I wasn't great at it) because my feet ached first at then end of skating then eventually when I put on my skates and stood up. I won first place at my elementary school and third in the regional for running long jump - probably because I could practice on the farm which was soft peat so I didn't pound my feet too hard. Dancing was doable - love swing and latin and tango but I'd have to take every lesson series twice because I couldn't cognitively pick up the series of moves. I felt like my IQ was was zero! The instructor was very nice - she actually would move my leg or arm through the motion sometimes when I couldn't get it. (Proprioception, now I know.) Cecilia, for social dancing, I had a very kind friend who was a terrific dancer and a big talker - we'd chat on the dance floor while I picked up her moves and I listened, freeing up cognitive space. I memorized her dance moves and then adapted them as my own. No one knew what I was doing - it wasn't all fun for me, it was fun and work. That required a friend with super self confidence and a heart of gold.

When I first got married my husband would push me to go to the gym daily, which I wanted to do but couldn't. I felt really bad about that and for years he thought I was a little lazy. There was no way I could explain it - I looked fine! I couldn't tell him back then about all the naps I took while he was at work. When I tried to lose weight after childbirth I still hadn't been diagnosed and but I knew something was really wrong with my body. I thought I'd go slow and long on the treadmill, alternating running and walking when I ripped a toe muscle. That was it. I finally told my husband something is really wrong with me, and I searched out doctors that would confirm it. We went through the whole "don't give into your illness" routine of denial. Now he knows I need naps and he appreciates that I don't use my illness as an excuse but there are limitations. I have to say that what I am grateful for in this whole process is that I've become much more health aware (I thought I was before!) and I've benefited from having quality people in my life. There's no time for vain or shallow people or pursuits.

What a long search for answers. I'm so glad that you "came out" with your husband and he was mature enough to get it!

 

[Cort]

What I tried to say but you said it so much better

If they can pinpoint particular molecules, we have something physical to pursue, and knowing the culprit molecules may point us precisely what/where to look.

Phil, here is my thinking. There are literally thousands of myokines, metabolites, immune cells and molecules that ebb and flow for several days after an execise. If they can pinpoint particular molecules, we have something physical to pursue, and knowing the culprit molecules may point us precisely what/where to look. For example, if the symptoms track only normal inflammatory myokines and lukocytes, we could further pursue with confidence the hypothesis that CFS/FMS is a hypersensitivity to inflammation, rather than the inflammation itself or hypometabolism. And studying the singaling pathways for those molecules may reveal the ultimate cause.

 

[Cort]

Twenty-five percent of the people who answered the poll were "total athletes" !!! That's a very high percentage. I loved exercise and did it frequently but I didn't put myself in that category..I hope someone does a real statistically based survey at some point

 

[Steve]

I exercised seven days a week until fm fell of cliff three years ago and I hate that pain makes even walking tough, can feel my body deteriorating.

The article on the CNS included in these articles here came today, was wondering who might find it interesting and thought I'd post it here, somewhat relevant.

http://links.outsidemag.mkt6482.com...&j=OTYwODUzNjk4S0&mt=2&rj=OTYwODUzNjk4S0&rt=0

 

[Cort]

I exercised seven days a week until fm fell of cliff three years ago and I hate that pain makes even walking tough, can feel my body deteriorating.

The article on the CNS included in these articles here came today, was wondering who might find it interesting and thought I'd post it here, somewhat relevant.

http://links.outsidemag.mkt6482.com...&j=OTYwODUzNjk4S0&mt=2&rj=OTYwODUzNjk4S0&rt=0

Interesting article on the CNS! Could help explain why walking, orthostatic iintolerance issues aside is so exhausting...

When you do those bicep curls, your biceps aren’t the only thing getting a workout. Your central nervous system gets a workout, too, researchers believe, as it deals with all of the information that it’s processing—contracting one muscle, relaxing another, balancing your body, keeping a firm grip. That’s a fair bit of work. As a result, the nervous system gets a little fatigued, says Behm.

Now let’s say you drop the dumbbells and bust out the door for a run. Lower-body muscle groups like the quadriceps are larger than, say, elbow flexors and biceps. They have more motor units—the places in your legs where the electrical signal is converted to movement—and also have a larger percentage of fast-twitch muscle fibers, says Behm. All of these factors mean that using them puts a strain on a nervous system that’s already a little tired, the theory goes. It’s similar to what happens when the lights dim in a small town after a big factory turns on its machinery.