Comorbidities Worsen Sleep Quality in Multiple Sclerosis

Comorbidities in multiple sclerosis (MS) are associated with reduced quality of sleep. A recent study that was published in the Multiple Sclerosis Journal emphasizes how crucial it is to manage comorbidities to improve the quality of sleep that MS patients get.

The impact that comorbidities in multiple sclerosis (MS) have on the quality of sleep experienced by affected patients is illustrated by this cross-sectional analysis.

As per the National Multiple Sclerosis Society, more than half of the people with MS also suffer from a sleeping condition including insomnia, narcolepsy, or sleep apnea.2. Inadequate sleep can exacerbate MS symptoms, and insomnia can be caused by a variety of things, such as drugs, related symptoms, or MS itself.

People with MS (PwMS) exhibited significantly higher rates of poor sleep quality than the general population (67% vs 33%-45%) in a previous study conducted by the present authors. Sleep issues were also more common in PwMS who had recently suffered a relapse, higher degrees of impairment, or “symptom clusters” (depression, anxiety, etc.). However, the study did not evaluate the connection between comorbidities and sleep quality. While a small number of studies have focused on the impact of comorbidities in PwMS, it has proven challenging to estimate the actual cost of comorbidities on sleep quality for each individual. The present authors carried out their new study to look at these associations in a sizable Australian cohort of MS patients to add to the body of literature.

To acquire information on comorbidity, data were gathered from the Australian Multiple Sclerosis Longitudinal Study, the MS Nurses and Sleep Survey, which was conducted in February and April of 2020, and the Lifestyle and Environment Surveys, which were conducted in October and December of 2016, 2018, and 2020. A total of 1597 people who answered the Pittsburgh Sleep Quality Index (PSQI), a 19-item survey regarding sleep quality over the previous month, and provided comorbidity data were included.

Higher PSQI levels were shown to be connected with more total comorbidities, according to the analysis. Higher PSQI scores were significantly linked (P <.001) with having 2 to 3 (95% CI, 1.22-2.89) or 4 or more (95% CI, 3.03-4.68) of any comorbidities, as well as 1 (95% CI, 0.29-1.84), 2 to 3 (95% CI, 1.32-2.69), or 4 or more (95% CI, 3.03-4.41) doctor-diagnosed comorbidities. Autoimmune disorders, anxiety, depression, myocardial infarction, anemia, rheumatoid arthritis, type 2 diabetes, inflammatory bowel disease, heart disease, eye disorders, allergies, migraines, hypertension, and high cholesterol were among the comorbidities that were substantially associated with higher PSQI scores.

Mental health disorders became the most common comorbidity group, explaining over half of the total effect, highlighting the significant impact of mental health disorders on sleep quality, the scientists note in their conclusion. Prior research has not specifically looked at how comorbidity groups affect the quality of sleep in MS patients, but it is clear that psychological loads, such as depression, hurt MS patients’ ability to sleep.

They continue by noting that earlier studies have suggested a possible link between sleep and depression and that further research on this reciprocal relationship may prove beneficial.

Based on these results, the researchers contend that treating or managing comorbidities in PwMS is important to help affected people sleep better.

For more information: The association of comorbidities with sleep quality among Australians with multiple sclerosis: Insights from the Australian Multiple Sclerosis Longitudinal Study, SageJournals, https://doi.org/10.1177/13524585241248278