Vitkova M, Gdovinova Z, Rosenberger J, Szilasiova J, Nagyová I, Mikula P, Krokavcova M, Groothoff JW, van Dijk JP. Factors associated with poor sleep quality in patients with multiple sclerosis differ by disease duration. Disabil Health J. 2014;7(4):466-71
BACKGROUND:Sleep disturbance is a common symptom of multiple sclerosis (MS) and knowledge about factors that contribute to poor sleep quality is scarce.
OBJECTIVE:The aim was to explore the differences in the prevalence and determinants of poor sleep quality in a sample of patients with MS with disease duration ≤5 years and >5 years.
METHODS:We collected data from 152 consecutive patients with MS; 66 patients (78% women, averaged 37.35 ± 10.1 years) were in the group with disease duration ≤5 years and 86 patients (73.3% women, averaged 42.10 ± 9.4 years) in the group with disease duration >5 years. Patients filled out the Sleep Quality Index, the Hospital Anxiety and Depression Scale, the Multidimensional Fatigue Inventory, one item of the Incapacity Status Scale regarding bladder problems and one item of the Short Form-36 regarding pain.
RESULTS:The prevalence of poor sleep is significantly higher in patients with longer disease duration (34.8 vs. 51.2%). Anxiety, reduced motivation and mental fatigue (all p < 0.05) were associated with poor sleep quality in patients with disease duration ≤5 years, whereas pain (p < 0.01), depression and mental fatigue (both p < 0.05) were in patients with disease duration >5 years.
CONCLUSION: Sleep problems are present in patients with MS with both short and long disease duration, but these problems are associated with different factors. These should be recognized and managed in addition to the treatment of sleep disorders.
Sleep problems are well recognised in MS and this looks at the causes and indicates that they may have different routes in early MS anxiety is a problem whereas as depression and pain and morerelevant in late disease.