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Behavioral Interventions to Improve Sleep Outcomes in Individuals With Multiple Sclerosis: A Systematic Review
David Turkowitch1, Sarah J Donkers2, Silvana L Costa3,4
1From the Department of Physical Therapy, Rehabilitation Science, and Athletic Training (DT, CS) and AR Dykes Library (PV), University of Kansas Medical Center, Kansas City, KS, USA.
International Journal of MS Care
|January 12, 2024
Summary
Cognitive behavioral therapy and education interventions show promise for improving sleep in multiple sclerosis patients. However, more research is needed due to variability in study quality and intervention methods.
Area of Science:
- Neurology
- Sleep Medicine
- Rehabilitation
Background:
- Sleep disturbances are a prevalent issue for individuals diagnosed with multiple sclerosis (MS).
- Effective interventions are needed to address sleep problems in the MS population.
Purpose of the Study:
- To systematically review and identify effective behavioral interventions for improving sleep in individuals with multiple sclerosis.
Main Methods:
- Comprehensive literature searches were conducted across multiple databases (Ovid MEDLINE, Embase, Web of Science) in December 2021.
- A rigorous review process involved independent assessment by four reviewers for title/abstract screening and full-text evaluation, with consensus achieved by a fifth reviewer.
- Data extraction and quality appraisal were performed by four reviewers, ensuring accuracy and assessing risk of bias.
Main Results:
- Cognitive behavioral therapy for insomnia (CBT-I), general cognitive behavioral therapy/psychotherapy, and education/self-management support interventions demonstrated positive effects on sleep outcomes.
- The quality appraisal revealed a range of scores from low to high, suggesting a potential for bias across the included studies.
Conclusions:
- Significant variability exists in intervention types, dosage, outcome measures, interventionist qualifications, participant samples, and study quality, hindering direct comparison and synthesis.
- Further research is essential to conclusively establish the efficacy of most identified interventions for sleep disturbances in multiple sclerosis.
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