New Study Focuses on Sleep Troubles and Quality of Life in MS Patients

New Study Focuses on Sleep Troubles and Quality of Life in MS Patients

A new study investigated the influence of sleep disturbance, fatigue and disability on the quality of life (QOL) in multiple sclerosis (MS) patients.

Health-related QOL measurements are important tools for assessing the impact of a disease on self-reported physical, mental, emotional, and social functioning. Most studies show that QOL is not related to the degree of disability while fatigue is often cited as one of the troublesome symptoms.

Around 53%–90% of MS patients report chronic fatigue, and an additional 54% suffer from disturbed sleep. Considering the effect sleep disorders have on comorbid conditions such as heart disease, obesity, and diabetes, investigating the causes of sleep disturbance in MS should be a priority. However, while it is generally acknowledged that good sleep quality is a crucial factor for health, few studies have investigated the effect of sleep, fatigue, and disability for QOL.

The study — Fatigue, Sleep Quality, and Disability in Relation to Quality of Life in Multiple Sclerosis, published in the International Journal of MS Care by Fatemeh Moghaddam Tabrizi and Moloud Radfar from the Urmia University of Medical Sciences, Iran — enrolled 217 patients from an outpatient clinic. Sleep quality, fatigue severity, disability, and quality of life were assessed using a number of questionnaires.

Researchers found that sleep quality and fatigue had a strong impact on QOL, both physical and mental. The authors could also observe a correlation between the subscales of QOL measuring physical and mental QOL — a result likely indicating that mental QOL decreases following a decreased physical QOL.

The study also noticed an association between sleep quality and fatigue. In addition to the obvious explanation, that sleepiness due to sleep disorders can be perceived as fatigue, a lack of sleep may also induce a feeling of fatigue by increasing levels of inflammatory cytokines, which are immune signaling molecules.

The team also found an association between the level of disability and QOL, although the patients included in the study had relatively low levels of neurological disability. The results showed that both physical and mental QOL are affected soon after disease onset. Also, the level of disability was related to fatigue, but not to sleep quality.

The present study clearly showed the importance of screening for fatigue and sleep disturbance in MS patients. Since sleep disorders have a profound effect on both QOL and other health-related factors, and are potentially treatable, the authors argue that early intervention could be beneficial. While such interventions might improve QOL in MS patients, more research is needed to understand the causes of sleep disturbance in MS.


  1. April says:

    I have Malignant Primary Progressive Multiple Sclerosis and am bedridden now. Most people would assume since I’m bedridden that I must spend a lot of time sleeping. However, that couldn’t be the furthest thing from the truth! I rarely sleep! I get about 4-5 hours of light sleep within a 24 hour period. And most recently I’ve had an even harder time sleeping at all!!
    I’ve been awake now for 38 hours straight! And you’d think with the medication I take would make me sleep/pass out/drowsy…it hasn’t been working at all and I’m not sure what is going on that’s keeping me wide awake when I’m completely (above and beyond) exhausted!! My eyes hurt so bad, I now have an ear infection (just to put the icing on the cake!). I seriously wonder how I’m still alive?! No sleep for so long, relentless progression in several areas of my body causing further severities in my disabilities due to MS. And no appetite but several stomach issues (I’d venture to guess that that’s due to having so much medication going into an empty stomach).
    My husband keeps telling me that at some point I’m just going to ‘crash’ and have a long sleep….well from his mouth to Gods ears!!
    Multiple Sclerosis is truly a MonSter ? and certainly has no rhyme or reason to how it will impact one person from another person with the same diagnosis of this ‘snowflake’ disease (no two of us with MS have the same MS journey..just like no two snowflakes will ever look the same)

    Now that I’ve commented – May God grant me the sleep I so desperately need! And may all my fellow MSers get some good rest as well. That’s my New Years wish for us all!

    • Patrick Fontenello says:

      Wow! I take r-modenafil (Nuvigil) to stay awake because of diagnosed narcolepsy and fatigue, both associated with my secondary progressive m.s. I was diagnosed at age forty-three with remitting-relapsing m.s. I had only a slight tremor and optic neuritis of the left eye at that time. And so it stayed for approximately three years, then things suddenly came alive. It started with a mild burning sensation in my calves but quickly escalated to full blown, full time spasticity and many, many other signs of the spinal lesions that had developed in addition to the brain lesions we already knew about. Now, it is five years later and m.s. has taken a lot from me; my ability to drive (I know hand controls, but you can’t drive if you’re asleep), my ability to walk, etc… But, there is no but, I’ve got no gems of wisdom from this rotten thing. I just take it one day, hour, minute, second, or whatever at a time. More will be revealed, the end has yet to be written.

      • Angelpuff says:

        It is an evil thing….MS and because it is so different in everyone; a good treatment is hard to pin down. The body doesn’t respond to one med in one person as it might work in another. It is such a hit and miss thing. I am sure it is very related to the location of the lesions also. I am a Physician Assistant and my husband has progressive MS. He has so many lesions in his brain, brain stem and spinal cord. The brain stem is the most dangerous since it controls the vital functions such as blood pressure, heart rate etc… You are so wise just to take it one day, one moment at a time. It is the only thing one can do. Our hearts and prayers go out to you!

    • Angelpuff says:

      Dear April,
      My husband suffers the same! It goes both directions here and only as it wants to. sometimes he sleeps a lot (rarely) and other times he has been up for days or only sleeps 2-3 hours a night. It is horrible. I am sure it has a lot to do with where lesions are located but big help that is. Meds don’t seem to work as they normally would in most people. Praying you will get some much needed sleep soon.

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