Pain prevalence, severity and impact in a clinic sample of multiple sclerosis patients

Archibald, Catherine J.; McGrath, Patrick J.; Ritvo, Paul; Fisk, John D.; Bhan, Virender; Maxner, Charles; Murray, T. J.

doi:10.1016/0304-3959(94)90188-0

Cited by 185 publications

(174 citation statements)

References 12 publications

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“…More than half of our patients endorsed multiple nocturnal symptoms. While numerous studies have identified pain as a predictor of poor sleep quality, fatigue, and overall diminished functioning in MS patients, 39,40 our findings underscore the point that nocturnal discomfort experienced by MS patients may be described in terms other than pain. More importantly, our data highlight the importance of addressing treatable symptoms that may cause fatigue in patients with MS through reduced sleep efficiency or other mechanisms.…”

Section: Discussionsupporting

confidence: 56%

Obstructive Sleep Apnea and Fatigue in Patients with Multiple Sclerosis

Braley

Segal

Chervin

2014

Journal of Clinical Sleep Medicine

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Study Objectives: The prevalence of obstructive sleep apnea (OSA) in persons with multiple sclerosis (MS) remains unknown, and little information exists regarding the relative contributions of OSA to symptoms of MS-related fatigue in the presence of other clinical and sleep-related confounders. The objectives of this study were to investigate the prevalence of diagnosed OSA and OSA risk among MS patients, and to assess relationships between fatigue severity, OSA, OSA risk, and sleep quality among persons with MS. Methods: N = 195 MS patients completed a questionnaire comprised of items regarding OSA diagnosis, sleep quality and quantity, daytime symptoms, and 4 validated scales: the Epworth Sleepiness Scale, Fatigue Severity Scale, Insomnia Severity Index, and STOP-Bang questionnaire. Medical records were also accessed to examine clinical characteristics that may predict fatigue or OSA risk. Results: N = 41 patients (21%) carried a formal diagnosis of OSA. N = 110 (56%) of all patients, and 38 (93%) of those with diagnosed OSA had STOP-Bang scores ≥ 3, indicating an elevated OSA risk. In regression models, the most signifi cant predictors of higher FSS scores were higher STOP-Bang scores (p = 0.01), higher number of nocturnal symptoms (p < 0.0001), and higher disability level (p < 0.0001). Conclusions: Sleep disturbances, and OSA in particular, may be highly prevalent yet underrecognized contributors to fatigue in persons with MS. S C I E N T I F I C I N V E S T I G A T I O N SM ultiple sclerosis (MS) is an autoimmune disease of the central nervous system that causes myelin destruction and axonal damage in the brain and spinal cord. Multiple sclerosis is the leading cause of non-traumatic neurological disability among young adults, and is associated with a variety of debilitating symptoms, including fatigue.Fatigue affects up to 90% of multiple sclerosis patients at some point during their disease course.1-4 This highly debilitating symptom imposes signifi cant socioeconomic consequences 5 and is a leading cause of diminished quality of life among individuals with MS.3 Although MS-related fatigue is often multifactorial, identifi cation of treatable causes that may contribute to its severity is an essential element of management of this symptom.Obstructive sleep apnea (OSA) may exacerbate fatigue severity in MS. This treatable disorder of sleep and breathing is a known cause of fatigue and related symptoms in general population studies, 6 and constitutes a signifi cant risk factor for cardiovascular disease, metabolic syndrome, motor vehicle accidents, reduced productivity, cognitive dysfunction, and poor quality of life.7-14 Yet, despite its impact in the general population, the extent to which OSA contributes to fatigue in persons with MS is poorly understood, and the prevalence of OSA in MS remains unclear. Whereas some contend that the prevalence of OSA is higher in MS patients than in the general population, heterogeneity in subjects studied, sample sizes, and outcome measures have led to highly variable e...

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Section: Discussionsupporting

confidence: 56%

Obstructive Sleep Apnea and Fatigue in Patients with Multiple Sclerosis

Braley

Segal

Chervin

2014

Journal of Clinical Sleep Medicine

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“…Some previous studies have reported that MS-related disability is associated with pain, 3,6 whereas others have found no association. 34,35 Possible explanations for conflicting findings include vast differences in sample sizes (with larger, survey studies more likely to find significant associations), different aspects of pain explored (acute pain, chronic pain, experience of any pain, frequency, intensity, or pain interference), different instruments used to measure different aspects of pain, and differences in how MS-related disability is measured (clinical examination or self-report). Thus, the relationship between pain and disability remains unclear.…”

Section: Discussionmentioning

confidence: 99%

Association Between Pain and Mindfulness in Multiple Sclerosis

Senders¹,

Borgatti²,

Hanes³

et al. 2018

International Journal of MS Care

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Background: Chronic pain is a common symptom in people with multiple sclerosis (MS) and often requires a multimodal approach to care. The practice of mindfulness has been shown to decrease the experience of pain in other conditions, yet little is known about the relationship between mindfulness and pain in people with MS. The objective of this study was to evaluate the association between pain interference and trait mindfulness in people with MS.

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“…Archibald and colleagues 99 found no difference between the pain and no-pain groups in the Kurtze EDSS, but did find that those with pain had a significantly lower score on the Mental Health Inventory (MHI) (mean 159.2, SD. 28.4, versus mean 170.4, SD.…”

Section: Prevalencementioning

confidence: 99%

Treatments for spasticity and pain in multiple sclerosis: a systematic review

Beard

Hunn²,

Wight³

2003

Health Technol Assess

237

131

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Pain prevalence, severity and impact in a clinic sample of multiple sclerosis patients

Cited by 185 publications

References 12 publications

Obstructive Sleep Apnea and Fatigue in Patients with Multiple Sclerosis

Obstructive Sleep Apnea and Fatigue in Patients with Multiple Sclerosis

Association Between Pain and Mindfulness in Multiple Sclerosis

Treatments for spasticity and pain in multiple sclerosis: a systematic review

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