Poor sleep quality in patients with multiple sclerosis: gender differences

Marianna Vitkova,Pavol Mikula,Jarmila Szilasiova,Sijmen A Reijneveld,Jitse P Van Dijk,Jaroslav Rosenberger,Zuzana Gdovinova,Johan W Groothoff

doi:10.1002/brb3.553

Abstract

ObjectivesMost of the psychological and physical factors associated with poor sleep quality in patients with multiple sclerosis (MS) have a different prevalence in women and men, but whether or not these factors contribute differently to sleep quality in women and men with MS remains unclear. The aim of this study was to identify possible gender differences in factors related to poor sleep quality in MS patients.Material and MethodsWe collected data from 153 patients with MS. Patients filled out the Pittsburgh Sleep Quality Index (PSQI), the Hospital Anxiety and Depression Scale, and one item of the Short Form‐36 regarding pain.ResultsThe best model of predictors of poor sleep quality consisting of gender, depression, anxiety, pain, and the interaction between gender and pain showed that the only variable interacting with gender, which was significantly associated with poor sleep quality was pain (odds ratio [OR] for interaction of pain with male gender was 15.4, 95% CI: 2.4; 39.5). Separate models for men and women consisting of pain, depression, anxiety, after adjustment for age, disease duration, and disability showed that pain was the only variable associated with poor sleep quality in men (OR = 12.7, 95% CI: 1.9; 29.6), whereas depression (OR = 4.1, 95% CI: 1.3; 13.2) and anxiety (OR = 6.8, 95% CI: 2.4; 19.1) were in women.ConclusionsFactors contributing to poor sleep quality in MS patients differ by gender. Depression and anxiety are associated with poor sleep quality in women, whereas pain is in men. This highlights the need to apply gender‐specific approaches to the treatment of sleep disorders.

Highlights

Most patients with multiple sclerosis (MS) complain of poor sleep quality (Vitková, Gdovinova, & Rosenberger, 2014), which frequent interferes with their daily activities and worsens their health-related quality of life (Merlino, Fratticci, & Lenchig, 2009)
We found that depression and anxiety were factors associated with poor sleep quality in women, whereas pain was associated with poor sleep quality in men
This study suggests that there might be an association between pain, depression, and anxiety on self-reported sleep quality that differs between men and women

Summary

| INTRODUCTION

Most patients with multiple sclerosis (MS) complain of poor sleep quality (Vitková, Gdovinova, & Rosenberger, 2014), which frequent interferes with their daily activities and worsens their health-related quality of life (Merlino, Fratticci, & Lenchig, 2009). Studies in the general population (Mallampalli & Carter, 2002) or in patients with other chronic disorders (Woosley, Lichtstein, & Taylor, 2012) explained the role of gender in sleep quality mostly by different prevalence rates of factors contributing to poor sleep in women and men. Research findings in these patients are rather ambiguous regarding gender differences in the prevalence of factors associated with sleep quality in MS patients They seem to be different from those reported for the general population and for other chronic disorders (Mallampalli & Carter, 2002; Woosley et al, 2012).

| MATERIALS AND METHODS

| DISCUSSION

| Strengths and limitations

Findings

| Conclusion