Sleep Disorders in Relapsing-Remitting Multiple Sclerosis Patients

Introduction and Objective(s) Poor sleep is a frequent symptom in patients with multiple sclerosis (MS). Sleep may be influenced by MS-related symptoms and adverse effects from immunotherapy and symptomatic medications. We aimed to study the prevalence of poor sleep and the influence of socio-demographic and clinical factors on sleep quality in MS- patients with a view to establishing correlations between the different variables and the frequency of sleep disturbances. Material(s) and Method(s) The study was based on a questionnaire that included questions concerning sociodemographic and clinical data. Sleep complaints were evaluated by Pittsburgh Sleep Quality Index (PSQI) and a global PSQI score was used to separate good sleepers (≤5) from poor sleepers (>5). The Epworth Sleepiness Scale (ESS) and Insomnia Severity Index (ISI) was used to detect excessive daytime sleepiness or insomnia. Restless legs syndrome rating scale (RLSRS) is used to rate the discomfort of legs. Hospital Anxiety and Depression Scale (HADS) aims to measure the symptom of severity of anxiety and depression (HADS > 11). The modified form of the Fatigue Impact Scale (MFIS) was used to assess fatigue in multiple sclerosis. The degree of physical disability was evaluated following the Expanded Disability Status Scale (EDSS). Symptoms of pain, nycturia, spasticity and lesions on imaging were registred. Results were compared between good and poor sleepers among MS patients Result(s) Forty patients (32 females and 8 males) were enrolled into the study. The sex ratio was 0.25. The mean age was 35.5. ± 9.47 years. The mean EDSS was 2.98± 2.38. The average of disease duration (DD)was 6.2± 3.47 years. Forty percent of patients with MS reported poor sleep. One patient has a narcolepsy (2.5%) and one patient has restless legs syndrom (2.5%). Fatigue (p = 0.042), depression (p = 0.04), nycturia (p = 0.003) were associated with sleep disturbance. No significant difference was found with higher EDSS, gender, form of MS, duration of evolution, lesions on imaging. Conclusion(s) Poor sleep is common in patients with MS. Early identification and treatment of modifiable risk factors may improve sleep and quality of life in MS.