A Demographic and Polysomnographic Investigation of Fatigue and Sleep Disorders in Patients with Multiple Sclerosis

Abstract

Objective: To investigate fatigue and sleep disorders based on demographic, clinical and polysomnographic data and show their effects on the quality of life in multiple sclerosis (MS) patients. Materials and Methods: Thirty MS patients were enrolled in the study depending on the results of the polysomnography (PSG), Fatigue Severity scale, Epworth Sleepiness scale (ESS), Pittsburgh Sleep Quality Iindex, Beck Depression and Anxiety inventories. Patients, using (n=16) and non-using (n=14) interferon, were compared with each other in all parameters; ESS and PSG data were compared with a control group consisting of 19 healthy people. Short form-36 (SF-36) data were also compared with the society norms. Results: Central fatigue was observed in 86.7% of the patients. PSG data revealed that stage N2 sleep duration of those who did not use interferon was significantly longer than those who used it (p<0.001). According to the PSG, total sleep time, sleep efficiency, stage N3 and rapid eye movement time, mean respiratory disturbance index, sleep latency and the mean value of total leg movements were significantly higher in the patient group than in the control group (p<0.001). All parameters of SF-36 were significantly lower in patient group (p<0.001). The stage N3 sleep time length was found related with physical component summary of SF-36 (p<0.001). Conclusion: MS patients have high level of fatigue and additionally there are weighty disturbances in objective and subjective sleep parameters. Our findings were revealed that all the components of quality of life decreased significantly in these patients. Furthermore, our study showed that deep sleep duration was related with physical activity and emphasized the importance of sleep evaluation in MS patients.

Keywords

• Fatigue
• sleep disorders
• multiple sclerosis
• polysomnography