Risk of obstructive sleep apnea in multiple sclerosis: Frequency, clinical and radiological correlates

Abstract

BackgroundPrimary sleep disorder, especially, obstructive sleep apnea (OSA), are noted to occur in MS patients at higher frequency than the general population. ObjectivesOur objectives are: (1) To assess the frequency of OSA risk among MS patients. (2) To evaluate the relationship between OSA risk and self-reported fatigue and sleepiness. (3) To evaluate the relationship between OSA risk and clinical disability, radiological findings and treatment status. MethodsWe enrolled 124 patients with multiple sclerosis, there were 53 men and 71 women with mean age (31.12 ± 7.48) All participants completed questionnaires: STOP-Bang, Berlin, Fatigue Severity Scale (FSS) and Epworth sleepiness scale (ESS) and their disability was assessed using Expanded Disability Status Scale (EDSS). ResultsAmong the completed surveys, 46.8% screened as high risk for OSA based on STOP-BANG questionnaire, and 45.2% based on Berlin questionnaire. About 64.5% of subjects screened positive for fatigue using FSS and 38.7% reported excessive day time sleepiness. Comparing MS patients diagnosed with high risk of OSA and those without, there was significant difference between the two groups regarding age (P < 0.001), gender (P < 0.001), disease duration, (P = 0.04), presence of brainstem lesions (0.04) and disease modifying therapy (DMT) use (P = 0.002). ESS and FSS positive scores were each significantly correlated with positive STOP BANG and Berlin outcomes (p < 0.001). EDSS showed significant correlation with positive STOP-Bang and Berlin scores. ConclusionsOSA risk appears to be high in MS patients with increased risk of fatigue and increasing disability.