Abstract
Fatigue is a frequent and debilitating symptom of multiple sclerosis (MS) with rates ranging anywhere from 53 to 90%. Despite its high prevalence and grave impact on overall functioning and quality of life, the accurate definition, quantification, and etiology of fatigue have plagued the MS literature and clinical care for decades. With regard to its etiology, MS-related fatigue has been construed as being either primary or secondary. Primary fatigue is purported to be related to centrally mediated processes of the disease whereas secondary fatigue is thought to be a result of the host of factors that may accompany MS (e.g., depression, sleep disturbance). The present paper focuses on secondary fatigue and the role of sleep disturbance, in particular. Despite the intuitive assumption that sleep problems could contribute to fatigue, sleep problems in MS have gone fairly unrecognized until recently. The present paper provides a brief review of the literature pertaining to the prevalence and nature of sleep problems in MS as well as their association with fatigue. A replication of this author’s and others work is presented further demonstrating that sleep disturbance is a significant contributor to fatigue in MS when taking into account disease variables, depression, and sleep disturbance.
Highlights
Since the first report of fatigue being a prevalent and significant problem in multiple sclerosis (MS) [1] the definition, accurate quantification of fatigue in MS, and etiology has perplexed investigators
Study findings from a recent investigation that replicates previous work demonstrating that sleep disturbance is a significant contributor to fatigue in MS when taking into account disease variables, depression, and sleep disturbance is presented
The present paper focuses on secondary fatigue and the role of sleep disturbance
Summary
Since the first report of fatigue being a prevalent and significant problem in multiple sclerosis (MS) [1] the definition, accurate quantification of fatigue in MS, and etiology has perplexed investigators. Since Attarian’s editorial in 2009 the number of published articles with MS and sleep in the title is 46 At this rate, the number of published articles on sleep in MS over the past 5 years is one a half times more than what was published in the preceding two decades of the 2009 editorial (see Figure 1). These articles have been published worldwide and span the gamut of looking at the incidence of various sleep disorders to the role of sleep on quality of life and fatigue to the effects of treating sleep problems in MS. Data from a few studies that have demonstrated that effective treatment of such sleep problems can result in reduced fatigue among individuals with MS are provided
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