Poor Sleep in Patients with Multiple Sclerosis

Hanne Marie Bøe Lunde,Lars Bø,Tommy F Aae,William Indrevåg,Kjell-Morten Myhr,Jan Aarseth,Bjørn Bjorvatn,Friedemann Paul

doi:10.1371/journal.pone.0049996

Hanne Marie Bøe Lunde, Lars Bø + Show 6 more

Open Access

https://doi.org/10.1371/journal.pone.0049996

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Journal: PloS one	Publication Date: Nov 14, 2012
Citations: 147	License type: CC BY 4.0

Affiliation: Haukeland University Hospital, University of Bergen

Abstract

BackgroundPoor sleep is a frequent symptom in patients with multiple sclerosis (MS). Sleep may be influenced by MS-related symptoms and adverse effects from immunotherapy and symptomatic medications. We aimed to study the prevalence of poor sleep and the influence of socio-demographic and clinical factors on sleep quality in MS- patients.MethodsA total of 90 MS patients and 108 sex-and age- matched controls were included in a questionnaire survey. Sleep complaints were evaluated by Pittsburgh Sleep Quality Index (PSQI) and a global PSQI score was used to separate good sleepers (≤5) from poor sleepers (>5). Excessive daytime sleepiness, the use of immunotherapy and antidepressant drugs, symptoms of pain, depression, fatigue and MS-specific health related quality of life were registered. Results were compared between patients and controls and between good and poor sleepers among MS patients.ResultsMS patients reported a higher mean global PSQI score than controls (8.6 vs. 6.3, p = 0.001), and 67.1% of the MS patients compared to 43.9% of the controls (p = 0.002) were poor sleepers. Pain (p = 0.02), fatigue (p = 0.001), depression (p = 0.01) and female gender (p = 0.04) were associated with sleep disturbance. Multivariate analyses showed that female gender (p = 0.02), use of immunotherapy (p = 005) and a high psychological burden of MS (p = 0.001) were associated with poor sleep among MS patients.ConclusionsPoor sleep is common in patients with MS. Early identification and treatment of modifiable risk factors may improve sleep and quality of life in MS.

Highlights

Patients with multiple sclerosis (MS) frequently report poor sleep, and sleep disorders are more common in MS patients compared to healthy controls [1]
Among MS-patients, we aimed to identify possible socio-demographic and clinical factors associated with the risk of being a poor sleeper
The proportion of MS patients (67.1%) that reported poor quality of sleep was significantly higher than the controls (43.9%) (p = 0.002)

Summary

Introduction

Patients with multiple sclerosis (MS) frequently report poor sleep, and sleep disorders are more common in MS patients compared to healthy controls [1]. Causes of poor sleep in MS are likely multifactorial, and potential triggers may relate to adverse effects from immunotherapy and symptomatic medications and to MS-associated symptoms, such as pain and fatigue [2]. Among MS-patients, we aimed to identify possible socio-demographic and clinical factors associated with the risk of being a poor sleeper. Two prior studies have described the socio-demographic and clinical factors associated with poor sleep, both lacking a control group for comparisons [1,6]. A casecontrol study looking at the socio-demographic and clinical associations with poor sleep in MS, has not been published previously. We aimed to study the prevalence of poor sleep and the influence of socio-demographic and clinical factors on sleep quality in MS- patients

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Conclusion