Abstract
Objective: A limited number of studies with inconsistent results have assessed the factors associated with sleep quality in patients with multiple sclerosis (MS). This study aimed to evaluate sleep quality and to investigate the associations between sleep quality and demographic and health-related characteristics, anemia, fatigue and physical activity in Turkish patients with MS. Methods: A cross-sectional study was conducted in a sample of 102 patients with MS who were followed in a neurology outpatient clinic of a tertiary hospital in Turkey between March 2015 and November 2015. Data were collected by an information form, the Pittsburgh Sleep Quality Index, the Visual Analogue Scale for Fatigue and the short version of the International Physical Activity Questionnaire. Anemia was evaluated by measuring hemoglobin levels. Data analysis were performed using descriptive statistics, Mann-Whitney U-test, Kruskal-Wallis H test, Spearman’s correlation coefficients and logistic regression analysis with backward stepwise elimination. Results: The mean global Pittsburgh Sleep Quality Index score was 5.98 ± 3.94, and 52.0% of the participants reported poor sleep quality. Twenty patients (19.6%) had anemia. Patients with higher fatigue were more likely to have poor sleep quality (adjusted Odds Ratio, 1.283; 95% confidence interval, 1.031–1.596, p = 0.026). Conclusions: Poor sleep quality was common in patients with MS and higher levels of fatigue predicted poorer sleep quality. A better understanding of risk factors related to sleep quality may facilitate effective interventions that improve health outcomes.
Highlights
Multiple sclerosis (MS) is a chronic inflammatory, demyelinating, degenerative and disabling disease of the central nervous system that severely affects the quality of life of patients [1]
PSQI, Pittsburgh Sleep Quality Index. † Group differences were measured by Mann-Whitney U-tests, except for income level (KruskalWallis H test, χ2)
Higher levels of fatigue in patients with MS predicted poorer sleep quality. This result shows that fatigue is an independent and modifiable risk factor for poor sleep quality in patients with MS, and it is consistent with previous studies [8,9]
Summary
Multiple sclerosis (MS) is a chronic inflammatory, demyelinating, degenerative and disabling disease of the central nervous system that severely affects the quality of life of patients [1]. Several studies have demonstrated that sleep quality in patients with MS is influenced by factors such as gender, the use of immunotherapy for the treatment of MS, psychological burden of disease [2], functional disability [4,7], comorbidity, pain due to MS [4], disease duration, anxiety, depression, motivation, mental fatigue [6], general fatigue [5,8,9], the presence of restless legs syndrome [3], physical activity [10] and health-related quality of life [7]. Other studies have reported that gender, physical fatigue, general fatigue [6] and physical activity [11] have no effect on sleep quality of patients with MS
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