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Sleep disorders in multiple sclerosis: a case-control study using the São Paulo Epidemiologic sleep study (Episono)
Vanessa Granato Toscano1, Fernando Morgadinho Coelho1,2, Gilmar Fernandes do Prado1
1Universidade Federal de São Paulo, Departamento de Neurologia e Neurocirurgia, São Paulo SP, Brazil.
Arquivos De Neuro-Psiquiatria
|October 17, 2022
Summary
Patients with multiple sclerosis (MS) experience less frequent sleep disorders but more fatigue compared to the general population. Disease-modifying drugs may influence these sleep outcomes in MS patients.
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.
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