Monday, 28 May 2012

Sleep disorders in MS: a hidden problem

EpubNeau et al.  Sleep Disorders and Multiple Sclerosis: A Clinical and Polysomnography Study. Eur Neurol. 2012 May 23;68(1):8-15. 

Background: MSers report sleep disturbances (SD) and excessive daytime sleepiness (EDS) more frequently than the general population. 


Objectives: To evaluate SD and EDS in MSers and to test the reliability of subjective sleep questionnaires. 

Methods: Demographic and clinical characteristics of unselected consecutive MSers were collected. Different questionnaires were used to assess quality of sleep, daytime sleepiness, fatigue, anxiety, depression and quality of life (QoL). Nocturnal polysomnography and Multiple Sleep Latency Test (MSLT) were performed in 25 selected MSers with fatigue and with or without EDS. 

Results: 205 MSers were enrolled. More than half of the MSers were classified as 'poor sleepers'. In multivariate analysis, SD were correlated with disability, fatigue, depression, QoL, and pain, but not with EDS. Subjective sleepiness evaluated with the Epworth Sleepiness Scale and SD with the Pittsburgh Sleep Quality Index were not correlated with the results of the objective assessments of vigilance (MSLT) and sleep. 

Conclusions: SD and EDS are frequent among MS patients. Objective assessment of vigilance and sleep can be challenging but MS patients who are poor sleepers should receive immediate assessment and treatment in order to improve QoL.


"Poor sleep hygiene and sleep disorders is another hidden disability in MS. Poor hygiene refers to bad habits, for example sleeping too much in the day, the inappropriate use of stimulants (caffeine, modafinil), no exercise, etc. Other factors that play a role is poor bladder function with nocturia (needing to pass urine at night), pain, spasms, restless legs, etc. I am beginning to realise that we need to take this issue a lot more seriously from a clinical perspective. I would be interested to know how many of you have a sleep disorder."

9 comments:

  1. I'm reading this at 2 am so, yes, I have sleep disturbance. If I am lucky, I get to sleep four uninterrupted hours.

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  2. Thank you for bringing attention to this issue, Prof G. I never was a good sleeper to begin with, but ever since I was diagnosed, it has gotten worse. I don't think I have any symptomatic reason for me not to get a full night's rest. And I spend most of the following day just trying to feel awake and energetic enough to be productive. At the recommendation of my neuro, I'm going to see a sleep specialist next month.

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  3. I am pleased you have raised this as it has such a knock on effect for people's live. I am aware of poor sleep hygiene caused partly by not being able to face getting up from the sofa in good time and going to bed - or should I say I am ill disciplined?

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  4. re; "I'm going to see a sleep specialist next month."

    Please remember than MSers are also susceptible to sleep disorders that are unrelated to your MS, for example obstructive sleep apnoea. This is why we have to keep an open mind and address the problem as a separate issue to MS. Therefore seeing a sleep specialist may be a good thing. What the specialist will provide is a formal sleep study.

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  5. Re; ".. should I say I am ill disciplined?"

    Ill discipline is the food of life; too much self-discipline is bad for you. So is not enough.

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  6. I have sleep problem. I only sleep at least 4 hours a day. I usually sleep at 3 to 4 am. I'm currently reading Dr. Mercola's article about sleep problem. Do you agree with his tips? Here's the article - http://articles.mercola.com/sites/articles/archive/2010/10/02/secrets-to-a-good-night-sleep.aspx

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  7. Re: "Do you agree with his tips?"

    They sound reasonable, but most of the tips are not evidence-based. I suspect individuals will found out what works with trial and error.

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  8. I have always been an early riser, even as a teenager! I am now in my 60s, I was diagnosed 30 years ago. My symptoms are increasing and I now find that I am sleeping until mid morning, which is unheard of. Is over sleeping a common symptom of MS?

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