In a large sleep study that surveyed more than 2,300 people with MS, researchers found that 70% reported having at least one sleep disorder, but that 12% or fewer had received a diagnosis of, or treatment for, a sleep disorder. These sleep disorders, including insomnia, obstructive sleep apnea and restless leg syndrome, were associated in this study with abnormal levels of fatigue, a common symptom experienced by people with MS. Steven D. Brass, MD, MPH, MBA (University of California, Davis) and colleagues report their findings in the Journal of Clinical Sleep Medicine (2014 Sep 15;10:1025-3). This study and other research findings suggest that identifying and treating sleep disorders experienced by people with MS could significantly improve quality of life.
Background: MS symptoms and the sleep problems that tangle up with them are many and diverse. Some are directly related to symptoms; some may be caused by the location of MS
lesions (areas of damage) within the brain. Others may stem from stress. If untreated, sleep problems can increase fatigue, one of the most common symptoms of MS, occurring in about 80 percent of people. Fatigue can significantly interfere with a person's ability to function at home and work, and is one of the primary causes of early departure from the workforce. University of California, Davis researchers launched an investigation to get data on the prevalence of sleep disorders in a large sample of people with MS, and how these disorders correlate with fatigue and daytime sleepiness.
The Study: Investigators submitted a survey to the Society’s Northern California Chapter, who mailed it out to 11,400 people from its database who identified themselves as having MS. The survey included questions relating to demographics as well as questionnaires used to discern primary sleep disorders, sleepiness, fatigue severity, and sleep patterns.
Of 2,810 who responded (24.6%), 2,375 were included in the study. Of these, 70% screened positive for at least one sleep disorder. In total, 37.8% screened positive for obstructive sleep apnea, 31.6% for moderate to severe insomnia, and 36.8% for restless legs syndrome. Of these, only 4% (apnea), 11% (insomnia), and 12% (restless legs) reported being diagnosed by a health care provider with these sleep disorders. Thirty percent noted excessive daytime sleepiness. More than 60% reported an abnormal level of fatigue, and abnormal fatigue was associated with screening positive for a sleep disorder.
Conclusion: This study – the largest sleep study conducted to date in people with MS – adds to growing evidence of a high prevalence of sleep disorders experienced by people with MS, and highlights a potential link between MS fatigue and sleep disorders. The researchers conclude that identifying and treating sleep disorders experienced by people with MS could significantly improve quality of life.
"This study shows how important it is to think about what role sleep problems play in fatigue," says Nicholas LaRocca, PhD, Vice President of Health Care Policy for the National MS Society. "Discussing this with a healthcare provider can help people affected by MS to find solutions to sleep problems, and improve their daily lives."
Read more about sleep disorders and MS (.pdf).
Get sleep tools and tips from the National Sleep Foundation.