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Examining sleep, fatigue, and daytime sleepiness in pediatric multiple sclerosis patients
Abu-Bakar Zafar1, Jayne Ness, Sarah Dowdy
1Department of Medicine, University of Alabama at Birmingham, Birmingham, AL 35294, USA. abz8578@uab.edu
Insights
Pediatric multiple sclerosis (MS) patients showed better sleep hygiene and less daytime sleepiness than matched controls. However, both groups reported increased fatigue compared to historical data.
Area of Science:
- Neurology
- Pediatrics
- Sleep Medicine
Background:
- Multiple sclerosis (MS) affects 2-5% of patients before age 18.
- Sleep disorders are common in MS patients.
- The impact of sleep problems on fatigue and sleepiness in pediatric MS is not well understood.
Purpose of the Study:
- To compare sleep disturbances, fatigue, and daytime sleepiness in pediatric MS patients versus a matched control group.
- To investigate the prevalence and effects of sleep issues in young MS patients.
Main Methods:
- Utilized the modified Epworth Sleepiness Scale for daytime sleepiness.
- Assessed sleep quality and hygiene using the Adolescent Sleep Wake and Hygiene Scale.
- Measured fatigue levels with the PediatricQL Multidimensional Fatigue Scale.
Main Results:
- Pediatric MS patients and controls had similar fatigue levels, but higher than historical controls.
- Pediatric MS patients demonstrated better sleep hygiene, specifically in 'sleep stability'.
- Pediatric MS patients reported less daytime sleepiness compared to matched controls.
Conclusions:
- Better sleep hygiene in pediatric MS patients may contribute to reduced daytime sleepiness.
- Fatigue levels in both MS and control groups were higher than historical controls, highlighting the importance of proper matching.
- Findings suggest sleep quality and hygiene are crucial factors in managing pediatric MS symptoms.
Background:
About 2-5% of patients with multiple sclerosis (MS) experience their first symptoms before age 18. Sleep disorders occur frequently in MS. The prevalence of sleep problems and their impact on fatigue and daytime sleepiness in pediatric MS is unknown.
Objective:
To determine whether pediatric MS patients have more sleep disturbances, fatigue, and daytime sleepiness compared with an age-, sex-, and race-matched control group.
Methods:
Patients and age-, sex-, and race-matched controls were surveyed to quantify daytime sleepiness via the modified Epworth Sleepiness Scale, sleep quality and hygiene through the Adolescent Sleep Wake and Hygiene Scale, respectively, and fatigue using the PediatricQL Multidimensional Fatigue Scale.
Results:
Pediatric MS patients (n = 30) and age-, sex-, and race-matched controls (n = 52) had similar levels of fatigue; however, when compared with previously published historical controls, both groups reported worse fatigue across all dimensions (p < 0.05). Pediatric MS patients also had similar sleep quality compared with the matched controls, but reported better sleep hygiene on the 'sleep stability' dimension (p < 0.05). In addition, pediatric MS patients had less daytime sleepiness than the matched controls (p < 0.05).
Conclusion:
Although patients with MS reported similar levels of fatigue, they have better sleep hygiene, which could possibly account for the decreased amount of excessive daytime sleepiness. Also, when compared with historical controls, the MS and control samples reported more fatigue. Thus, caution must be taken when using published control data, especially when not properly matched.
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