Sleep problems tied to fatigue, anxiety; should be addressed by clinicians
by Patricia Inacio, PhD | February 3, 2025
While people with multiple sclerosis (MS) seem to get a similar quantity of sleep relative to individuals without the disease, MS patients have significantly worse sleep quality than their healthy counterparts, according to a new review of several published studies.
The findings show that MS may affect a person’s subjective sleep quality — one’s “individual satisfaction with the sleep experience” — and healthcare professionals should consider this when addressing or preventing sleep-related issues such as anxiety, depression, and fatigue, the researchers suggested.
“Special consideration by clinicians in this regard may lead to a significant improvement in patients’ quality of life, due to the great influence of sleep quality in MS-related symptoms,” the team wrote.
Among such interventions, the researchers noted, are getting 7-9 hours of sleep each night, maintaining a consistent sleep/wake schedule, incorporating routine exercise into one’s daily schedule, and making use of “a contemplative practice,” such as meditation.
The review study, “Sleep quality in multiple sclerosis: A systematic review and meta-analysis based on Pittsburgh Sleep Quality Index,” was published in the journal Multiple Sclerosis and Related Disorders.
Quality but not quantity of sleep affected in MS, per study
Sleep disturbances are common in people with MS, and may arise due to a range of reasons, from medication side effects to changes in the circadian rhythm brought on by nerve damage, to disease symptoms such as pain or bladder issues.
As poor sleep can often impact a person’s ability to carry out daily tasks and participate in social interactions, such issues can have a significant effect on day-to-day life. Still, while many studies have explored differences in sleep quality between MS patients and healthy people, the results have been inconsistent.
To shed light on this, a team of researchers in Iran conducted a meta-analysis of published studies comparing the caliber of sleep and sleep efficiency in MS patients and healthy people. The analysis covered a total of 13 studies, published between 2004 and 2022, and involving 1,481 patients and 2,755 healthy people, who served as controls.
All of the studies measured subjective sleep satisfaction using a self-reported questionnaire called the Pittsburgh Sleep Quality Index (PSQI), which assesses sleep and sleep disturbances over one month. The PSQI comprises 19 questions across seven sleep components, including sleep duration, sleep disturbance, sleep latency — how long it takes for a person to fall asleep — and daytime dysfunction due to sleepiness. The tool also assesses sleep efficiency, meaning the percentage of time spent asleep while in bed, overall sleep satisfaction, and use of sleep medications.
Altogether, the pooled data from 10 studies revealed a significantly higher PSQI score for those with MS than for healthy controls, indicating worse sleep quality among patients. Among the five studies that involved individual components of PSQI, the caliber of sleep, sleep onset latency, the use of sleep medications, and daytime dysfunction were all significantly worse among MS patients.
“These findings suggest that while the quantity of sleep including sleep duration and sleep efficiency may be normal, the quality aspects of sleep are substantially compromised in patients with MS,” the team wrote.
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