Epub: Neau et al. Sleep Disorders and Multiple Sclerosis: A Clinical and Polysomnography Study. Eur Neurol. 2012 May 23;68(1):8-15.
Background: MSers report sleep disturbances (SD) and excessive daytime sleepiness (EDS) more frequently than the general population.
Objectives: To evaluate SD and EDS in MSers and to test the reliability of subjective sleep questionnaires.
Methods: Demographic and clinical characteristics of unselected consecutive MSers were collected. Different questionnaires were used to assess quality of sleep, daytime sleepiness, fatigue, anxiety, depression and quality of life (QoL). Nocturnal polysomnography and Multiple Sleep Latency Test (MSLT) were performed in 25 selected MSers with fatigue and with or without EDS.
Results: 205 MSers were enrolled. More than half of the MSers were classified as ‘poor sleepers’. In multivariate analysis, SD were correlated with disability, fatigue, depression, QoL, and pain, but not with EDS. Subjective sleepiness evaluated with the Epworth Sleepiness Scale and SD with the Pittsburgh Sleep Quality Index were not correlated with the results of the objective assessments of vigilance (MSLT) and sleep.
Conclusions: SD and EDS are frequent among MS patients. Objective assessment of vigilance and sleep can be challenging but MS patients who are poor sleepers should receive immediate assessment and treatment in order to improve QoL.
“Poor sleep hygiene and sleep disorders is another hidden disability in MS. Poor hygiene refers to bad habits, for example sleeping too much in the day, the inappropriate use of stimulants (caffeine, modafinil), no exercise, etc. Other factors that play a role is poor bladder function with nocturia (needing to pass urine at night), pain, spasms, restless legs, etc. I am beginning to realise that we need to take this issue a lot more seriously from a clinical perspective. I would be interested to know how many of you have a sleep disorder.”