Tweet
Below is a recent study about sleep and multiple sclerosis. Interesting and not at all surprising. I've also added a few other recent studies for all of you to, ahem, sleep on. How are your Zzzs? How many hours do you average a night? Take naps? Do you think the lack of sleep is causing your fatigue or is it your MS? - Dave
-------------------------------
J Clin Sleep Med. 2014 Sep 15;10(9):1025-31. doi: 10.5664/jcsm.4044.
The underdiagnosis of sleep disorders in patients with multiple sclerosis.
Brass SD, Li CS, Auerbach S.
Abstract
STUDY OBJECTIVES:
To report at a population level the prevalence of restless legs syndrome, insomnia, and the risk of obstructive sleep apnea in multiple sclerosis patients. Sleep patterns and associations with fatigue and daytime sleepiness were identified.
METHODS:
A cross-sectional study was performed using a written survey that was mailed to 11,400 individuals from the Northern California Chapter of the National Multiple Sclerosis (MS) Society Database who self-identified as having MS. The survey included individual questions relating to demographics as well as several standard validated questionnaires related to primary sleep disorders, sleepiness, fatigue severity, and sleep patterns.
RESULTS:
Among the 11,400 surveys mailed out, 2,810 (24.6%) were returned. Of these, 2,375 (84.5%) met the inclusion criteria. Among the completed surveys, 898 (37.8%) screened positive for obstructive sleep apnea, 746 (31.6%) for moderate to severe insomnia, and 866 (36.8%) for restless legs syndrome. In contrast, only 4%, 11%, and 12% of the cohort reported being diagnosed by a health care provider with obstructive sleep apnea, insomnia, and restless legs syndrome, respectively. Excessive daytime sleepiness was noted in 30% of respondents based on the Epworth Sleepiness Scale. More than 60% of the respondents reported an abnormal level of fatigue based on the Fatigue Severity Scale. Both abnormal fatigue and sleepiness scores were associated with screening positive for obstructive sleep apnea, insomnia, and restless legs syndrome.
CONCLUSION:
A significant percentage of MS subjects in our sample screened positive for one or more sleep disorders. The vast majority of these sleep disorders were undiagnosed. Greater attention to sleep problems in this population is warranted, especially in view of fatigue being the most common and disabling symptom of MS.
PRESS RELEASE:
Sleep disorders widely undiagnosed in individuals with multiple sclerosis
(SACRAMENTO, Calif.) —In what may be the largest study of sleep problems among individuals with multiple sclerosis (MS), researchers at UC Davis have found that widely undiagnosed sleep disorders may be at the root of the most common and disabling symptom of the disease: fatigue.
Conducted in over 2,300 individuals in Northern California with multiple sclerosis, the large, population-based study found that, overall, more than 70 percent of participants screened positive for one or more sleep disorders.
The research highlights the importance of diagnosing the root causes of fatigue among individuals with MS, as sleep disorders may affect the course of the disease as well as the overall health and well-being of sufferers, the authors said.
The study "The Underdiagnosis of Sleep Disorders in Patients with Multiple Sclerosis," is published online today in the Journal of Clinical Sleep Medicine.
"A large percentage of MS subjects in our study are sleep deprived and screened positive for one or more sleep disorders," said Steven Brass, associate clinical professor and director of the Neurology Sleep Clinical Program and co-medical director of the UC Davis Sleep Medicine Laboratory.
"The vast majority of these sleep disorders are potentially undiagnosed and untreated," he said. "This work suggests that patients with MS may have sleep disorders requiring independent diagnosis and management."
Fatigue is the hallmark of multiple sclerosis, an inflammatory disease affecting the white matter and spinal cord of sufferers. MS symptoms include loss of vision, vertigo, weakness and numbness. Patients also may experience psychiatric symptoms. Disease onset generally is between the ages of 20 and 50 years. The cause of the MS is not known, although it is believed to be an autoimmune condition.
Sleep disorders are known to occur more frequently among patients with MS. To gauge the extent of sleep disorders among people with MS, Brass and his colleagues surveyed members of the Northern California Chapter of the National MS Society. Subjects were recruited in 2011.
More than 11,000 surveys were mailed to prospective participants. Of those, 2,375 met inclusion criteria and were included in the study. Consistent with the reported epidemiology of multiple sclerosis, the majority (81 percent) were female and Caucasian (88 percent). The mean age of the participants was 54.
Study participants were asked to complete a 10-page survey, which included a detailed sleep history and questions assessing obstructive sleep apnea, daytime sleepiness, insomnia and restless legs syndrome.
Most of the participants - nearly 52 percent - said it took them more than one half hour to fall asleep at night, and nearly 11 percent reported taking a medication to fall asleep. Close to 38 percent of participants screened positive for obstructive sleep apnea. Nearly 32 percent had moderate to severe insomnia and nearly 37 percent had restless legs syndrome. Moderate insomnia was experienced by nearly 25 percent of respondents.
However, most of the participants had not been diagnosed with a sleep disorder by a physician. While nearly 38 percent reported having obstructive sleep apnea, only a little more than 4 percent reported being diagnosed by a physician with the condition. Similar statistics were seen for other sleep disorders.
"Sleep disorder frequency, sleep patterns and complaints of excessive daytime sleepiness suggest that sleep problems may be a hidden epidemic in the MS population, separate from MS fatigue," Brass said.
-------------------------------
J Clin Sleep Med. 2014 Sep 15;10(9):1025-31. doi: 10.5664/jcsm.4044.
The underdiagnosis of sleep disorders in patients with multiple sclerosis.
Brass SD, Li CS, Auerbach S.
Abstract
STUDY OBJECTIVES:
To report at a population level the prevalence of restless legs syndrome, insomnia, and the risk of obstructive sleep apnea in multiple sclerosis patients. Sleep patterns and associations with fatigue and daytime sleepiness were identified.
METHODS:
A cross-sectional study was performed using a written survey that was mailed to 11,400 individuals from the Northern California Chapter of the National Multiple Sclerosis (MS) Society Database who self-identified as having MS. The survey included individual questions relating to demographics as well as several standard validated questionnaires related to primary sleep disorders, sleepiness, fatigue severity, and sleep patterns.
RESULTS:
Among the 11,400 surveys mailed out, 2,810 (24.6%) were returned. Of these, 2,375 (84.5%) met the inclusion criteria. Among the completed surveys, 898 (37.8%) screened positive for obstructive sleep apnea, 746 (31.6%) for moderate to severe insomnia, and 866 (36.8%) for restless legs syndrome. In contrast, only 4%, 11%, and 12% of the cohort reported being diagnosed by a health care provider with obstructive sleep apnea, insomnia, and restless legs syndrome, respectively. Excessive daytime sleepiness was noted in 30% of respondents based on the Epworth Sleepiness Scale. More than 60% of the respondents reported an abnormal level of fatigue based on the Fatigue Severity Scale. Both abnormal fatigue and sleepiness scores were associated with screening positive for obstructive sleep apnea, insomnia, and restless legs syndrome.
CONCLUSION:
A significant percentage of MS subjects in our sample screened positive for one or more sleep disorders. The vast majority of these sleep disorders were undiagnosed. Greater attention to sleep problems in this population is warranted, especially in view of fatigue being the most common and disabling symptom of MS.
PRESS RELEASE:
Sleep disorders widely undiagnosed in individuals with multiple sclerosis
(SACRAMENTO, Calif.) —In what may be the largest study of sleep problems among individuals with multiple sclerosis (MS), researchers at UC Davis have found that widely undiagnosed sleep disorders may be at the root of the most common and disabling symptom of the disease: fatigue.
Conducted in over 2,300 individuals in Northern California with multiple sclerosis, the large, population-based study found that, overall, more than 70 percent of participants screened positive for one or more sleep disorders.
The research highlights the importance of diagnosing the root causes of fatigue among individuals with MS, as sleep disorders may affect the course of the disease as well as the overall health and well-being of sufferers, the authors said.
The study "The Underdiagnosis of Sleep Disorders in Patients with Multiple Sclerosis," is published online today in the Journal of Clinical Sleep Medicine.
"A large percentage of MS subjects in our study are sleep deprived and screened positive for one or more sleep disorders," said Steven Brass, associate clinical professor and director of the Neurology Sleep Clinical Program and co-medical director of the UC Davis Sleep Medicine Laboratory.
"The vast majority of these sleep disorders are potentially undiagnosed and untreated," he said. "This work suggests that patients with MS may have sleep disorders requiring independent diagnosis and management."
Fatigue is the hallmark of multiple sclerosis, an inflammatory disease affecting the white matter and spinal cord of sufferers. MS symptoms include loss of vision, vertigo, weakness and numbness. Patients also may experience psychiatric symptoms. Disease onset generally is between the ages of 20 and 50 years. The cause of the MS is not known, although it is believed to be an autoimmune condition.
Sleep disorders are known to occur more frequently among patients with MS. To gauge the extent of sleep disorders among people with MS, Brass and his colleagues surveyed members of the Northern California Chapter of the National MS Society. Subjects were recruited in 2011.
More than 11,000 surveys were mailed to prospective participants. Of those, 2,375 met inclusion criteria and were included in the study. Consistent with the reported epidemiology of multiple sclerosis, the majority (81 percent) were female and Caucasian (88 percent). The mean age of the participants was 54.
Study participants were asked to complete a 10-page survey, which included a detailed sleep history and questions assessing obstructive sleep apnea, daytime sleepiness, insomnia and restless legs syndrome.
Most of the participants - nearly 52 percent - said it took them more than one half hour to fall asleep at night, and nearly 11 percent reported taking a medication to fall asleep. Close to 38 percent of participants screened positive for obstructive sleep apnea. Nearly 32 percent had moderate to severe insomnia and nearly 37 percent had restless legs syndrome. Moderate insomnia was experienced by nearly 25 percent of respondents.
However, most of the participants had not been diagnosed with a sleep disorder by a physician. While nearly 38 percent reported having obstructive sleep apnea, only a little more than 4 percent reported being diagnosed by a physician with the condition. Similar statistics were seen for other sleep disorders.
"Sleep disorder frequency, sleep patterns and complaints of excessive daytime sleepiness suggest that sleep problems may be a hidden epidemic in the MS population, separate from MS fatigue," Brass said.
Comment