Sleep Macrostructure, Cyclic Alternating Pattern and CSF Cytokines in De Novo Relapsing-Remitting Multiple Sclerosis:...

Area of Science:

• Neurology
• Sleep Medicine
• Immunology

Background:

• Sleep disorders are common in multiple sclerosis (MS).
• Understanding sleep disturbances in early MS is crucial for management.
• Objective and subjective sleep assessments in de novo patients are needed.

Purpose of the Study:

• To compare objective and subjective sleep parameters in de novo relapsing-remitting MS patients versus healthy controls.
• To investigate correlations between cerebrospinal fluid (CSF) cytokines and sleep alterations.
• To explore the impact of obstructive sleep apnea (OSA) on sleep in MS patients.

Main Methods:

• Overnight polysomnography and sleep quality assessments were performed on 21 de novo MS patients and 21 healthy controls (HCs).
• CSF cytokine analysis was conducted on MS patients.
• Sleep macrostructure and cyclic alternating pattern (CAP) were analyzed.

Main Results:

• MS patients exhibited increased sleep period time, time in bed, REM sleep latency, N3 sleep percentage, and wakefulness after sleep onset.
• MS patients showed reduced sleep efficiency and REM sleep percentage compared to HCs.
• Sleep alterations were more pronounced in MS patients with OSA.
• Increased CAP time and rate, particularly A3 indices and A phase duration, indicated sleep fragmentation.
• IL-1β correlated with longer Phase B duration, and IL-15 correlated with A3 mean duration.
• Fatigue was negatively correlated with A1 mean duration and cycle mean duration.

Conclusions:

• De novo relapsing-remitting MS is associated with significant sleep fragmentation.
• Obstructive sleep apnea exacerbates sleep disturbances in MS patients.
• Pro-inflammatory cytokines (IL-1β, IL-15) may modulate sleep architecture in MS.
• Addressing sleep quality is essential for comprehensive multiple sclerosis management.