Sleep quality, daytime sleepiness, fatigue, and quality of life in patients with multiple sclerosis treated with interferon beta-1b: results from a prospective observational cohort study

Abstract

BackgroundSleep disorders and fatigue are common in multiple sclerosis (MS). The underlying causes are not fully understood, and prospective studies are lacking. Therefore, we conducted a prospective, observational cohort study investigating sleep quality, fatigue, quality of life, and comorbidities in patients with MS.MethodsPatients with relapsing-remitting MS or clinically isolated syndrome treated with interferon beta-1b were followed over two years. The primary objective was to investigate correlations between sleep quality (PSQI), fatigue (MFIS), and functional health status (SF-36). Secondary objectives were to investigate correlations of sleep quality and daytime sleepiness (ESS), depression (HADS-D), anxiety (HADS-A), pain (HSAL), and restless legs syndrome (RLS). We applied descriptive statistics, correlation and regression analyses.Results139 patients were enrolled, 128 were available for full analysis. The proportion of poor sleepers (PSQI≥5) was 55.47% at the beginning and 37.70% by the end of the study (106 and 41 evaluable questionnaires, respectively). Poor sleepers performed worse in MFIS, SF-36, ESS, HADS-D, and HADS-A scores. The prevalence of patients with RLS was low (4.5%) and all were poor sleepers. Poor sleep quality was positively correlated with fatigue and low functional health status. These relationships were corroborated by multivariable-adjusted regression analyses. ESS values and poor sleep quality at baseline seem to predict sleep quality at the one-year follow-up. No variable predicted sleep quality at the two-year follow-up.ConclusionsOur results confirm the high prevalence of poor sleep quality among patients with MS and its persistent correlation with fatigue and reduced quality of life over time. They highlight the importance of interventions to improve sleep quality.Trial registrationThe study was registered at clinicaltrials.gov: NCT01766063 (registered December 7, 2012). Registered retrospectively (first patient enrolled December 6, 2012).Electronic supplementary materialThe online version of this article (10.1186/s12883-018-1113-5) contains supplementary material, which is available to authorized users.

Restless legs syndrome and health‐related quality of life in adults with multiple sclerosis

“…Similarly, reduced HRQOL in the psychological domain was associated with worse RLS severity, poorer sleep quality, greater fatigue and a greater frequency of depression and anxiety symptoms. These results are similar to previous literature that has demonstrated significant correlations between HRQOL and fatigue, poor sleep (Lobentanz et al., ; Amato et al., , Boe Lunde et al., ; Tabrizi & Radfar, ; Kotterba et al., ), depression (Amato et al., ; Lobentanz et al., ) and anxiety (Fruehwald, Loeffler‐Stastka, Eher, Saletu, & Baumhackl, ) in persons with MS. Importantly, this is the first study to identify severity of RLS as an important correlate of HRQOL and this association may be accounted for by fatigue, depression and anxiety.…”

Fatigue as an Extra-Intestinal Manifestation of Celiac Disease: A Systematic Review

“…Furthermore, two of the included studies found that fatigue was associated with reduced HRQoL and increased sleep problems, respectively [ 12 , 14 ]. Although there is currently very limited documentation on these associations, this appears to coincide with findings in other patient populations [ 28 , 29 , 30 , 31 , 32 ]. In addition, our review only found one study that was designed as an intervention with fatigue as the primary endpoint.…”

Sleep Abnormalities in Multiple Sclerosis

“…In addition other articles related to Health and Sleep Physiology were included to support our general arguments. Articles were reviewed by two independent reviewers and a total of 37 articles were selected for inclusion in the present review [4,14,16,17,18,19,22,23,24,25,26,29,31,32,33,34,35,36,37,38,39,41,42,43,49,50,51,53,55,56,61,62,63,64,66,67,70].…”

“…Therefore, RLS in MS could be considered as a real secondary form of RLS which can be attributed to other factors such as CNS lesions [48] and cervical cord damage [49] and not to iron-related parameters. Impact: Sleep-related movement disorders, especially RLS, have an enormous impact on aspects related to QoL such as sleep quality, depression, fatigue, body composition and functional capacity of MS patients [50,51]. In addition, the impact on functional capacity and physical fitness increases the disability levels and encourages a more sedentary life style, increasing further the overall cardiovascular risk [46,50].…”