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The Impact of Sleep-Related Disorders on the Sleep Quality in Patients With Multiple Sclerosis in a Saudi Cohort
Ismail A Khatri1,2,3, Khalid Bin Aziz2,3, Esraa Y Arabi4
1Department of Neurology, King Abdulaziz Medical City, Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia, ngha.med.sa.
Background:
Multiple sclerosis (MS) causes physical as well as psychosocial disability in young adults. Various sleep-related disorders have been reported in patients with multiple sclerosis (pwMS).
Objectives:
We determined the frequency and patterns of various sleep-related disorders in pwMS and correlated those with the sleep quality.
Methods:
This was an IRB-approved study done at King Abdulaziz Medical City, MNGHA, Riyadh, KSA. Informed consent was obtained. Validated questionnaires including Pittsburgh Sleep Quality Index (PSQI), Sleep Disorders Questionnaire (SDQ), and STOP-BANG Questionnaire were used. Data were analyzed using SPSS.
Results:
A total of 169 pwMS were included; 116 (69%) were females. Mean age was 35 ± 10 years; mean BMI was 27.6 ± 16.8 kg/m2. Almost half (47%) of the patients were employed, and most worked in day shift (85%). Caffeinated beverages were used by 87%; 16% were smokers. Relapsing remitting MS was the commonest type in 93%; 82% were using disease-modifying therapy (DMT). Sleep-related medications were used by 18%. Disability measured by EDSS was mild in 64%, moderate in 18%, and severe in 18%. Poor quality of sleep was reported by 74% (mean PSQI 7.8 ± 3.9). Circadian rhythm disorders were reported in 22%, psychiatric disorders in 18%, and parasomnias in 14%; 4% had high risk for sleep apnea. Psychiatric disorders (p = 0.05) and movement disorders (p = 0.05) were more frequently reported in women. Risk for insomnia (p = 0.03), circadian rhythm disorders (p = 0.013), and psychiatric disorders (p = 0.002) were associated with poor sleep quality. Type of MS and current treatment did not affect the frequency of sleep disorders or sleep quality.
Conclusions:
In our cohort of pwMS, sleep-related disorders were common. Risk for insomnia, psychiatric disorders, and circadian rhythm disorders were associated with poor sleep quality. Certain disorders showed a trend toward female preponderance. Disease severity and use of DMTs did not affect sleep quality in our cohort.
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