Sleep disorders and associated factors in multiple sclerosis patients: a cross-sectional study in Iran

Sleep disorders are commonly noted in people with multiple sclerosis (PwMS). These disorders are often underestimated due to the tendency of individuals to focus on their more noticeable physical symptoms. This study aimed to survey factors affecting the sleep disorders of PwMS in Iran.

This cross-sectional study recruited PwMS from the Isfahan Province of Iran. The International Restless Legs Syndrome Study Group, STOP-Bang, Berlin, and the Insomnia Severity Index questionnaires were employed to evaluate the severity of sleep disorders.

Seven hundred ninety-six PwMS (693 patients with relapsing-remitting MS and 103 patients with secondary-progressive MS) were included in the current study. 12.69% and 11.56% of patients were at high risk of obstructive sleep apnea (OSA) based on STOP-Bang and Berlin questionnaires, respectively. Also, 49.5% and 48.87% of participants experienced insomnia and severe restless legs syndrome (RLS), respectively. According to multivariable logistic regression, age (OR = 1.042, p = 0.001; OR = 1.041, p = 0.002) and gender (OR = 2.906, p < 0.001; OR = 2.491, p = 0.001) were associated with the STOP-Bang and Berlin scores, respectively. Also, the Expanded Disability Status Scale (EDSS) was associated with RLS (OR = 1.253, p < 0.001).

Sleep disorders, such as RLS, insomnia, and OSA, are highly prevalent among PwMS in Iran. Physicians should consider additional clinical characteristics, such as EDSS, when managing RLS. Moreover, demographic features, such as age and gender, significantly impact the risk of developing OSA.