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Objectively assessed sleep quality parameters in Multiple Sclerosis at home: Association to disease, disease severity
Vaishali Vinod1, Karolina Saegner1, Walter Maetzler1
1Department of Neurology, University Hospital Schleswig-Holstein, 24105, Kiel, Germany.
Background:
Multiple Sclerosis (MS) is a chronic inflammatory autoimmune, neurodegenerative disease that affects regular mobility and leads predominantly to physical disability. Poor sleep quality, commonly reported in MS patients, impacts their physical activity (PA). Accelerometers monitor 24-h activity patterns, offering insights into disease progression in daily life.
Objective:
To test if the sleep quality variables of MS patients, as assessed with wrist-worn accelerometers, differ from those of controls and are associated with PA and disease severity variables.
Methods:
Seven-day raw accelerometer data collected from 40 MS patients and 24 controls was processed using an open-source GGIR package, from which variables of sleep quality (sleep efficiency, wake after sleep onset (WASO), sleep regularity index (SRI), intradaily variability (IV)) and PA (of different intensities: inactivity, light (LPA), moderate (MPA), vigorous (VPA)) were analyzed. The variables were compared between the two study groups and in MS patients, correlation tested associations among the variables of sleep quality, PA, and disease severity (assessed with the Expanded Disability Status Scale, EDSS).
Results:
Sleep efficiency was the only variable that differed significantly between MS patients and controls (lower in MS, p = 0.01). Both SRI (positively) and IV (negatively) correlated with the time spent in LPA and MPA. WASO correlated negatively with inactivity.
Conclusion:
This is one of the few studies with a wrist-worn accelerometer that shows a difference in sleep efficiency between MS patients and controls and, in MS, an association of sleep quality variables with PA variables.
Insights
Multiple Sclerosis patients exhibit lower sleep efficiency than controls. Sleep quality metrics like SRI and IV are linked to physical activity levels in MS, offering insights into daily functioning.
Area of Science:
- Neurology
- Sleep Medicine
- Rehabilitation Science
Background:
- Multiple Sclerosis (MS) is a chronic, neurodegenerative autoimmune disease impacting mobility and causing physical disability.
- Poor sleep quality is prevalent in MS patients, significantly affecting their physical activity (PA).
- Accelerometers offer objective, continuous monitoring of 24-hour activity patterns, valuable for assessing daily life impacts of MS.
Purpose of the Study:
- To determine if sleep quality variables, measured by wrist-worn accelerometers, differ between MS patients and healthy controls.
- To investigate the associations between sleep quality metrics, physical activity levels, and disease severity in MS patients.
Main Methods:
- Utilized 7-day accelerometer data from 40 MS patients and 24 controls, processed with the GGIR package.
- Analyzed sleep quality variables: sleep efficiency, wake after sleep onset (WASO), sleep regularity index (SRI), and intradaily variability (IV).
- Assessed physical activity (PA) at different intensities (inactivity, LPA, MPA, VPA) and disease severity (EDSS).
Main Results:
- Sleep efficiency was significantly lower in MS patients compared to controls (p=0.01).
- SRI positively correlated with light (LPA) and moderate (MPA) physical activity.
- IV negatively correlated with LPA and MPA, while WASO negatively correlated with inactivity.
Conclusions:
- This study demonstrates a significant difference in sleep efficiency between MS patients and controls using wrist-worn accelerometers.
- Findings highlight the association between specific sleep quality parameters and physical activity in individuals with MS.
- Objective accelerometer data provides valuable insights into the complex interplay between sleep, activity, and disease in MS.
