Sleep problems are common

Brass SD, Li CS, Auerbach S.The underdiagnosis of sleep disorders in patients with multiple sclerosis. J Clin Sleep Med. 2014 Sep 15;10(9). pii: jc-00207-12.

STUDY OBJECTIVES:To report at a population level the prevalence of restless legs syndrome, insomnia, and the risk of obstructive sleep apnea in multiple sclerosis patients. Sleep patterns and associations with fatigue and daytime sleepiness were identified.
METHODS:A cross-sectional study was performed using a written survey that was mailed to 11,400 individuals from the Northern California Chapter of the National Multiple Sclerosis (MS) Society Database who self-identified as having MS. The survey included individual questions relating to demographics as well as several standard validated questionnaires related to primary sleep disorders, sleepiness, fatigue severity, and sleep patterns.
RESULTS:Among the 11,400 surveys mailed out, 2,810 (24.6%) were returned. Of these, 2,375 (84.5%) met the inclusion criteria. Among the completed surveys, 898 (37.8%) screened positive for obstructive sleep apnea, 746 (31.6%) for moderate to severe insomnia, and 866 (36.8%) for restless legs syndrome. In contrast, only 4%, 11%, and 12% of the cohort reported being diagnosed by a health care provider with obstructive sleep apnea, insomnia, and restless legs syndrome, respectively. Excessive daytime sleepiness was noted in 30% of respondents based on the Epworth Sleepiness Scale. More than 60% of the respondents reported an abnormal level of fatigue based on the Fatigue Severity Scale. Both abnormal fatigue and sleepiness scores were associated with screening positive for obstructive sleep apnea, insomnia, and restless legs syndrome.
CONCLUSION:A significant percentage of MS subjects in our sample screened positive for one or more sleep disorders. The vast majority of these sleep disorders were undiagnosed. Greater attention to sleep problems in this population is warranted, especially in view of fatigue being the most common and disabling symptom of MS

I suspect you are thinking enough already….how many more papers telling us that MSers have sleep disturbances. have you tried the Epworth Sleepiness scale? This measures your dozing potential.

  • If your score is below 10 you have a healthy level of daytime sleepiness in comparison to the general population
  • If your score is between 10 and 18 you have an excessive level of daytime sleepiness compared to the general population which may require further attention. You should consider whether you are obtaining adequate sleep, need to improve your sleep hygiene and consult your doctor for further medical help
  • If your score is 18 or above you have a very high level of excessive daytime sleepiness and it is vital that you consult your doctor for further medical help
  • (NB: The Epworth sleep test does not prove or disprove that you have a sleep related problem as many factors contribute to excessive sleepiness, and this is just an indication of whether further investigation is required. Please take notice of the results and consult your doctor if your score is high)

If you don’t sleep you feel fatigued measured on the fatigue severity score.

There are a number or routes to promote sleep speak to your neuro

01 Mar 2014
“Sleep is a common topic of discussion on this blog. Why? Because it such a big problem in MSers. Sleep disorders, and poor sleep hygiene, are a major contributor to fatigue in MS.

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  • I think good quality sleep must be essential for MSers. I've read lack of sleep can cause flare ups of MS symptoms. I can completely relate to that. The brain would need good quality sleep to repair from a relapse.

    There is also this 'Sleep boosts brain cell numbers'. BBC news 4th Sept 2013.

    Scientists believe they have discovered a new reason why we need to sleep – it replenishes a type of brain cell.

    Sleep ramps up the production of cells that go on to make an insulating material known as myelin which protects our brain's circuitry.

    The findings, so far in mice, could lead to insights about sleep's role in brain repair and growth as well as the disease MS, says the Wisconsin team.

    The work is in the Journal of Neuroscience.

    Do neurologists normally ask MSers if they are getting enough sleep? I've not been asked that before at an appointment.

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