1Sondes Bader, 1Emna Ellouz
1Neurology Department, Gabes Hospital, Gabes, Tunisia
Multiple sclerosis (MS) is a chronic autoimmune disease of the central nervous system (CNS) common in young adults. Patients with MS have a significant variety of problems that alter their quality of life including sleep disorders which are often underdiagnosed and poorly managed.The aim of our study was to assess the prevalence of sleep disorders among multiple sclerosis patients and to explore their associated sociodemographic and clinical factors.
Material(s) and Method(s):
We conducted a cross-sectional study, carried out on patients with multiple sclerosis who consult in the neurology department in Gabeshospital during a period of five months, from the 1st June 2021 to 25th October 2021.We used a pre-established sheet exploring the socio-demographic, clinical and therapeutic data of the patients.Sleep quality was assessed by the Pittsburgh Sleep Quality Index (PSQI).The Expanded Disability Status Scale (EDSS) to quantify disability in MS patients.The Symbol Digit Modalities Test (SDMT) to detect cognitive impairment.Data were analyzed using the software SPSS (20th edition).
Nineteen patients were included. Eleven(57,9%) were females, mean age was 31,5 (SD=8,06) years.Fifty tow percent were married.Only two patients(10,5%)had a family history of MS.Four patients(21,1%) had a family psychiatric history.Five patients (26,3%) had a psychiatric history including depression in 10,5% anxiety disorder in 10,5% and psychotic disorder in 5,2% of cases.All patients had the remitting form of MS.The average age of onset of the disease was 25 years(19-48).Average course of the disease was 6 years (1-13).Median SDMT score was 29 (18-41).Median score of EDSS was 2,9.Sleep disorders werereported by 52,6 of MS patients, 73.6% of cases reported insomnia and 42,1reported parasomniaincluding nightmaresin 21%.The mean total score on the PSQI scale was 6,7 ± 3,8 [2–15].26,3% of patients were objectively poor sleepers. On univariate analysis, sleep disorders were positively correlated with anxiety symptoms (p=0.013). There is a significant association between sleep disorders and subcortical white matter lesion (p= 0,17; 90% VS 33%), age(p=0,37) and the high educational level(p=0,31).No differences were observed regarding sex, marital and occupational status, family history of psychiatric disorders, disease course, disability according to the EDSS and cognitive impairment according to SDMT.
Our results indicate that sleep disorders are common in MS patients.Age, anxiety symptoms and particular brain lesion were associated with the prevalence and severity of sleep disorders in MS patients.Screening and Managing sleep disorders and associated anxiety symptoms in MS patients may lead to improve their quality of life.