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Area of Science:

  • Neurology
  • Sleep Medicine
  • Epidemiology

Background:

  • Sleep disorders like obstructive sleep apnea and restless legs syndrome are common in both the general population and individuals with chronic conditions such as multiple sclerosis (MS).
  • Understanding sleep disturbances in MS is crucial for improving patient quality of life.

Purpose of the Study:

  • To compare the prevalence of sleep disorders, fatigue, depression, and chronotype in adult patients with multiple sclerosis (PwMS) against a representative sample of São Paulo city residents.
  • To investigate the relationship between disease severity (Expanded Disability Status Scale - EDSS) and sleep complaints in PwMS.

Main Methods:

  • A comparative study design was employed, contrasting PwMS with participants from the São Paulo Epidemiologic Sleep Study (Episono).
  • Statistical analyses included multivariate analysis of variance (MANOVA), analysis of variance (ANOVA), Pearson correlation, and propensity score matching.
  • Sleep questionnaires, fatigue, depression, and chronotype were assessed, with age, sex, and physical activity as covariates.

Main Results:

  • The general population sample (Episono group) reported worse sleep quality and greater daytime sleepiness than PwMS.
  • Obstructive sleep apnea and restless legs syndrome were more prevalent in the Episono group.
  • No significant difference in chronotype was observed between groups; fatigue was highly prevalent in PwMS, with no correlation found between EDSS and sleep complaints.

Conclusions:

  • Disease Modifying Drug (DMD)-treated PwMS exhibited fewer sleep complaints but higher fatigue levels compared to the general population sample.
  • The findings suggest that immunomodulatory drugs used in MS treatment might influence sleep patterns and fatigue.
  • Further research is warranted to elucidate the complex interplay between MS, its treatment, and sleep disturbances.