Abstract

Background: Persons with multiple sclerosis (PwMS) are at increased risk to report poor sleep patterns and lower physical activity indices. To date, data on longitudinal objectively sleep assessment is missing. In the present study, we investigated the pattern of objective sleep and subjective physical activity indices over a period of 13.5 months, under naturalistic conditions.Method: 13.5 months after their first assessment, a total of 16 PwMS (mean age = 49.13 median EDSS score: 5; 11 females) were reassessed on their objective sleep via portable sleep-electroencephalogram (EEG-) devices, along with their subjective sleep patterns (symptoms of insomnia, restless legs syndrome (RLS), and sleep-disordered breathing), physical activity indices, psychological functioning (symptoms of depression, fatigue, daytime sleepiness), and MS-related information (fatigue, EDSS; disease-modifying treatments). While the baseline assessment was performed in a rehabilitation center, the follow-up assessment took place at participants' naturalistic and familiar setting.Results: Statistically, symptoms of depression and fatigue, subjective sleep, and physical activity levels did neither increase, nor decrease over time, although descriptively, both moderate and vigorous physical activity levels decreased, and fatigue and subjective insomnia increased. Time awake after sleep onset statistically significantly decreased, while light sleep duration increased by trend.Conclusions: Among a smaller sample of PwMS, objective sleep in their naturalistic setting remained fairly stable over a mean time lapse of 13.5 months after clinic discharge. Physical activity levels descriptively decreased. The present results are of clinical and practical importance for treatment counseling: PwMS can be reassured that their sleep quality does not deteriorate, once they have left a rehabilitation center. Further, they should be encouraged to keeping their physical activity levels as stable as possible.

Highlights

  • Multiple sclerosis is a chronic inflammatory autoimmune disease of the central nervous system (CNS) [1, 2]

  • We aimed at expanding previous research on the following dimensions: First, we investigated, if and if so, to what extent objectively assessed sleep at baseline was associated with objectively assessed sleep on average 13.5 months later at follow-up and assessed under naturalistic conditions in persons with multiple sclerosis (PwMS)’s home setting

  • The key findings of this small longitudinal study among persons with multiple sclerosis (PwMS) and performed under naturalistic conditions were that about 13.5 months after discharge from a rehabilitation center, descriptively, symptoms of depression remained fairly stable; descriptively, fatigue and subjective sleep scores worsened; and objectively, measured wake time after sleep onset statistically significantly improved

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Summary

Introduction

Multiple sclerosis is a chronic inflammatory autoimmune disease of the central nervous system (CNS) [1, 2]. The immune system is activated against the self and damages myelin layers of axons of the CNS. This damage and its location may result in symptoms such as impaired vision and motor functions, sensory loss, and fatigue, impaired sleep, and cognitive decline. Several reviews [4,5,6,7] compared sleep patterns between persons with multiple sclerosis (PwMS) and healthy controls. Persons with multiple sclerosis (PwMS) are at increased risk to report poor sleep patterns and lower physical activity indices. We investigated the pattern of objective sleep and subjective physical activity indices over a period of 13.5 months, under naturalistic conditions

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