Treating sleep disturbance may help MS fatigue

Sleep disturbance may be an important factor contributing to fatigue in MS patients, according to authors of the first study to describe the pattern and causes of sleep problems in patients with MS. The study involved 60 outpatients with MS, who kept a sleep diary for seven days and completed the Fatigue Severity Scale and the Epworth Sleepiness Scale. The diary results showed that sleep disturbance was common among patients and was often associated with treatable symptoms. However, the authors explain that the study duration was only one week, and the study was not designed to measure depression or alcohol intake.Sleep problems on at least two nights in the week were frequent and included difficulty falling asleep (42% of patients), waking during the night (53% of patients), and waking earlier than desired (58% of patients). Anxiety and pain or discomfort were the most common cause of patients finding it difficult to fall asleep, and nocturia was the most common cause of waking during the night. Waking to pass urine was also a common cause of waking earlier than desired. However, the frequency of sleep problems was not related to global disability.Insomnia was significantly correlated with daytime fatigue in patients who woke during the night (described as "middle insomnia"), and this association remained after controlling for disability. The authors suggest, "As nocturia was overwhelmingly the most important cause of middle insomnia, it is possible that addressing this symptom may improve not only sleep, but also fatigue."The authors conclude, "We would recommend that questions about sleep are included in the regular review of patients with MS, in particular those reporting fatigue." They add that symptomatic treatment for nocturia and pain may help manage sleep disturbance.Reference...