Fatigue and sleep-disordered breathing in multiple sclerosis: a clinically relevant association?

Area of Science:

• Neurology
• Sleep Medicine
• Pulmonology

Background:

• Fatigue is a primary concern for multiple sclerosis (MS) patients, significantly impairing quality of life.
• Emerging evidence links sleep-disordered breathing (SDB) to increased fatigue in MS.
• Investigating SDB's role in MS fatigue is crucial for improving patient outcomes.

Purpose of the Study:

• To determine the diagnostic value of routine respirography in MS patients experiencing severe fatigue.
• To assess the efficacy of continuous positive airway pressure (CPAP) treatment on fatigue levels in this population.

Main Methods:

• Prospective evaluation of 258 consecutive MS patients for severe fatigue using the Fatigue Severity Scale (FSS).
• Overnight respirography performed on 69 fatigued MS patients to diagnose SDB.
• Analysis of factors associated with SDB severity and the impact of CPAP therapy on FSS scores.

Main Results:

• Severe fatigue (FSS ≥5.0) was present in 38% of MS patients (97/258).
• SDB was diagnosed in 41% of tested MS patients (28/69).
• Male sex was the sole independent predictor of SDB severity (P = 0.003).
• CPAP therapy in 6 patients significantly reduced FSS scores (5.8 ± 0.5 to 4.8 ± 0.6, P = 0.04), though scores remained elevated.

Conclusions:

• Respirography should be considered in the routine care of MS patients with severe fatigue due to high SDB prevalence.
• CPAP therapy demonstrates potential in mitigating fatigue severity in MS patients with SDB.
• Further research is necessary to fully elucidate CPAP's impact on the overall quality of life for MS patients with SDB.