Sleep Problems and Symptom Correlates in People with Multiple Sclerosis (MS): A Pilot Study

Background: Sleep problems are common in people with multiple sclerosis (MS).  According to a recent study, sleepiness can manifest with other symptoms, especially in different subgroups of people with MS (Newland et al., 2014). However, the day to day associations between sleep and symptoms of fatigue, and pain remain unclear, and warrant further investigation (Pokryszko-Dragan et al., 2013).

Objectives: To compare the prospective relationships between sleep and other symptoms of MS, including fatigue, depression, pain, frequent urination, and demographic characteristics in people with MS.

Methods: The Pittsburgh Sleep Quality Index (PSQI) collected sleep information at baseline and the Self-report Expanded Disability Status Scale (SR-EDSS) measured disability. The MS-Related Symptom Scale (MS-RS) was sent via emailed electronic diary (ED) messages to a link from Redcap data capture to people with MS for 7 consecutive days, over a 2 week period.

Results: Data from electronic diaries (EDs) were collected from 28 people with MS from an MS clinic and the community. The majority (83%) was female, with mean age of 42 (SD), and SR-EDSS score of 3.7 (SD).  The mean global PSQI score was 7.9 (SD). There were significant differences observed for sleep problems with younger age (r = -.250, p =. 04) and higher SR-EDSS score (r = .544, p = .04). Furthermore, there were significant associations between sleep problems and pain (p < .0001), depression (p= .009), frequent urination (p <.0001), and fatigue (p =.003). Data were analyzed using SAS 9.4.

Conclusions: Sleep problems are a frequent complaint among people with MS. Our preliminary data suggest that sleep problems are associated with greater disability. Interventions are needed to target the specific sleep issues in people with MS. These results support investigation of the longitudinal course of sleep and associated changes in symptoms in this population.