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10.1186/s10020-024-00976-8 171 StefaniG.SlackF

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Patients are monitored with ENoG/EMG, blink reflex, and standardized facial scoring over 212 weeks, and continuation or de-escalation is determined by predefined thresholds and longitudinal trends

Common patterns include: Poor or fragmented sleep Loss of deep restorative sleep Early morning awakening Persistent fatigue despite adequate rest Reduced stress resilience Accelerated aging appearance despite healthy lifestyle Cognitive dullness or reduced mental clarity Difficulty recovering from stress or illness These symptoms often coexist with normal standard blood tests , which is why deeper evaluation is important